Todd A. Miano
University of Pennsylvania · Rehabilitation Medicine
Active 2006–2024
About
Todd A. Miano, PharmD, PhD, is an Assistant Professor of Epidemiology in Biostatistics and Epidemiology at the Hospital of the University of Pennsylvania within the Perelman School of Medicine. His work as a critical care pharmacist and epidemiologist aims to reduce harm from adverse drug events in acutely ill patients. His research primarily focuses on understanding the determinants and impacts of nephrotoxicity, which is the rapid loss of kidney function caused by drug toxicity, and the health impacts of drug-drug interactions. Nephrotoxic acute kidney injury (AKI) is a significant, modifiable cause of AKI in hospitalized patients, especially in the context of polypharmacy, where multiple drugs can interact to increase toxicity risk. His research integrates observational causal inference studies, prospective molecular epidemiologic studies, and randomized clinical trials to examine the safety of nephrotoxic drugs and explore the molecular mechanisms underlying toxicity. Dr. Miano has advanced the understanding of phenotyping methods for nephrotoxic AKI, notably challenging the reliance on serum creatinine as a biomarker due to its poor sensitivity and specificity. His seminal work demonstrated that commonly prescribed antibiotics can cause false elevations in creatinine, leading to pseudo-nephrotoxicity, and proposed cystatin C as a more accurate biomarker for detecting kidney function changes during antibiotic treatment. His research has also shown that kidney disease significantly modifies the severity of drug-drug interactions mediated by hepatic metabolism inhibition, providing mechanistic insights into drug interactions encountered in clinical practice.
Research topics
- Medicine
- Internal medicine
- Intensive care medicine
- Anesthesia
- Emergency medicine
Recent grants
NIH · $127k · 2016
Drug-drug interactions and kidney disease in hospitalized patients
NIH · $791k · 2021–2025
Frequent coauthors
- 52 shared
Michael G. S. Shashaty
University of Pennsylvania
- 41 shared
Sean Hennessy
University of Pennsylvania
- 32 shared
Jason D. Christie
University of Pennsylvania
- 32 shared
Niels D. Martin
University of Pennsylvania
- 28 shared
C.A.G. Ittner
University of Pennsylvania
- 28 shared
John P. Reilly
- 27 shared
Tiffanie K. Jones
University of Pennsylvania
- 25 shared
David E. Leaf
Harvard University
Education
- 2019
Doctor of Philosophy (Epidemiology)
University of Pennsylvania
- 2015
Master of Science in Clinical Epidemiology
University of Pennsylvania
- 2006
PharmD, School of Pharmacy
Virginia Commonwealth University
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