About

Yuvaram Nellore Vilambi Reddy, MBBS, MPH, is an assistant professor of medicine specializing in renal-electrolyte and hypertension at the Hospital of the University of Pennsylvania. He is a nephrologist and implementation scientist dedicated to narrowing disparities in home dialysis use for patients with kidney failure. Dr. Reddy serves as a core investigator at the VA Center for Health Equity Research and Promotion (CHERP) and is a physician at the Philadelphia VA Medical Center. He also co-directs the Building Leadership Opportunities in Medicine for Health Equity (BLOOM Health Equity) program and is the faculty director of the Healthcare Equity Curriculum at the Perelman School of Medicine. His research focuses on understanding and addressing barriers to home dialysis, evaluating the impact of health policy in kidney disease, and advancing health equity in nephrology. Dr. Reddy's work draws from methodologies in health services research, including mixed-methods and implementation science. He has received research funding from the NIH, AHRQ, VA, LDI, and the American Society of Nephrology. His educational background includes an MBBS from Sri Ramachandra Medical College & Research Institute and an MPH from Harvard T.H. Chan School of Public Health. He completed his internal medicine residency at Boston Medical Center and his nephrology fellowship at Mass General Brigham.

Research topics

• Medicine
• Internal medicine
• Intensive care medicine
• Gastroenterology
• Family medicine

Selected publications

• Understanding Barriers to Home Dialysis Within an Integrated Health Care System: A National Qualitative Study Within the Department of Veterans Affairs

  Kidney Medicine · 2026-04-14

  articleOpen access1st authorCorresponding
  PublisherDOI

• Bundled Payments—Looking Beyond the Episode

  JAMA Internal Medicine · 2026-04-27

  article1st authorCorresponding
  PublisherDOI

• Pill Burden: A Quality-of-Life Measure After Parathyroidectomy for Secondary Hyperparathyroidism

  Annals of Surgery Open · 2026-01-23

  articleOpen access

  INTRODUCTION Secondary hyperparathyroidism (SHPT), a condition that affects most dialysis patients, is associated with vascular calcifications and increased risk of cardiovascular mortality. While most cases are managed medically, many patients are referred to surgery because of high parathyroid hormone (PTH) levels refractory to medication or due to medication side effects or nonadherence. Both medical and surgical management are associated with high pill burdens that negatively impact quality of life in dialysis patients.1 To improve preoperative counseling and shared decision-making, the aim of this study was to compare the pre and postoperative daily pill burdens of patients on dialysis undergoing parathyroidectomy and to examine the relationship between preoperative PTH levels and postoperative pill burden. METHODS This retrospective cohort study used electronic health record data of adult patients with kidney failure on dialysis admitted after index parathyroidectomy (July 2017–April 2025) at a single, high-volume academic hospital. Patients were identified using the Complete Inpatient Record Using Comprehensive Electronic database—a platform within our health system designed to capture and share clinically validated healthcare data.2 A systematic approach to manual chart review was established (R.C.A., J.H., and R.R.K.) and performed by 1 author (R.C.A.) after agreement on the data definitions. Dialysis modality, age, sex, ethnicity, race, insurance status/payer, indication for parathyroidectomy, Elixhauser comorbidities,3 and lab values were extracted. Because the 2022 American Association of Endocrine Surgeons guideline lacks a biochemical threshold for parathyroidectomy,4 the primary exposure in this study was defined by the median preoperative PTH level (140.6 pmol/L or 1325.9 pg/mL). Day of surgery levels were used to compare patients off of calcimimetic treatment. Patients were stratified into 2 groups—high or low. The outcome was postoperative treatment-related daily pill burden—the number of pills prescribed per day for calcium homeostasis. The primary focus was pill burden at discharge. Secondarily, pill burden at 6 months was examined. Total pill burden included medications for other conditions. We used Welch T Test, χ2, Generalized Wilcoxon, and Fisher Exact tests for univariate analyses, R 4.41 (R Core Team, Austria, Vienna). This study was exempted by the University of Pennsylvania Institutional Review Board (protocol #857117). RESULTS Patients in the low and high PTH level groups (n = 64) had similar characteristics (Table 1). Preoperatively, there were no differences in the daily pill burdens between low and high PTH groups (Table 2). The median postoperative PTH level was 19.9 pmol/L (Interquartile range: 1.6, 74.8) (equivalent to 187.7 pg/mL). The median length of stay was 3.8 days (2.9, 5.5) without differences between groups (3.3 vs 4.2 days, P = 0.08). At discharge, the median treatment-related daily pill burden was 27 pills (23, 36; range: 4–69 pills) with a significantly lower burden in the low compared with high PTH group (24 vs 32 pills, P = 0.01). At 6 months (n = 33), the treatment-related daily pill burden was similar between groups (Table 2). Compared with preoperative regimens, daily pill burdens increased by a median of 23 (18, 31) pills at discharge and by 5 pills (−1, 11) 6 months after surgery. TABLE 1. - Patient Demographics and Laboratory Values by Low and High Preoperative Parathyroid Hormone (PTH) Levels Among Patients With Secondary Hyperparathyroidism (SHPT) Characteristic No. (%) All Patientsn = 64 Low Preoperative PTH, <140.6 pmol/Ln = 32 High PreoperativePTH, ≥140.6 pmol/Ln = 32 P Age median (IQI) 52 (42, 59) 53 (46, 60) 49 (39, 55) 0.20 Dialysis type Peritoneal dialysis 10 (16) 6 (19) 4 (13) 0.73 Hemodialysis 54 (84) 26 (81) 28 (88) Operation (type of parathyroidectomy: subtotal or total with autotransplantation) Subtotal, yes 63 (98) 32 (100) 31 (97) 1.00 Sum of comorbidities median (IQI) 5 (4, 7) 6 (4, 8) 5 (4, 5) 0.08 Etiology of renal disease Hypertension 27 (42) 13 (41) 14 (44) 1.00 Diabetic nephropathy 13 (20) 9 (28) 4 (13) 0.21 Focal segmental glomerulosclerosis 8 (13) 3 (9) 5 (16) 0.71 Polycystic kidney disease 3 (5) 1 (3) 2 (6) 1.00 Glomerulonephritis 3 (5) 3 (9) 0 0.24 Other 17 (27) 8 (25) 9 (28) 1.00 Years on dialysis 6 (4, 7) 5 (3, 7) 6 (5, 8) 0.08 Indication for surgery Biochemical 40 (63) 17 (53) 23 (72) 0.20 Medication-related 14 (22) 9 (28) 5 (16) 0.36 Calciphylaxis 4 (6) 3 (9) 1 (3) 0.61 Other SHPT symptoms 17 (27) 7 (22) 10 (31) 0.57 Preoperative labs (mg/dL) median (min, max) Calcium 9.0 (6.4, 10.8) 9.0 (6.4, 10.5) 9.0 (7.6, 10.8) 0.52 Phosphate 6.5 (2.7, 10.8) 6.7 (2.7, 10.8) 6.1 (2.8, 10.1) 0.58 Alkaline phosphatase 199 (30, 1953) 140 (30, 579) 286 (91, 1953) 0.001 Intraoperative labs (pmol/L) median (min, max) Starting PTH value 140.6 (23.9, 349.9) 106.6 (23.9, 140.3) 174.7 (140.8, 349.9) <0.001 Ending PTH 19.9 (1.6, 74.8) 17.1 (1.6, 45.2) 22.7 (6.0, 74.8) 0.01 Change in PTH (Absolute value) 113.7 (18.7, 334.3) 85.0 (18.7, 117.5) 157.3 (117.4, 334.3) <0.001 Postoperative labs (mg/dL) Median (min, max) Calcium 0–24 hours 8.0 (6.5, 9.9) 8.1 (6.5, 9.9) 7.8 (6.7, 9.5) 0.14 Calcium 24–48 hours 8.3 (6.7, 11.0) 8.6 (7.0, 11.0) 8.1 (6.7, 9.8) 0.003 Calcium 48–72 hours 8.4 (6.7, 10.7) 8.5 (7.4, 10.6) 7.6 (6.7, 10.7) 0.08 Calcium ≥72 hours 8.3 (6.8, 11.3) 8.7 (7.2, 11.3) 8.0 (6.8, 11.1) 0.20 There were no significant differences in the proportion of patients by sex, race, BMI, ethnicity, or insurance status between groups. Out of 31 comorbidities examined, the only significant difference between groups was diabetes with a complication (low PTH: 47% vs high PTH: 17%, P = 0.02). There were no differences in postoperative phosphate or alkaline phosphatase between groups. IQI, Interquartile Interval.Bolded values represent P-values <0.05. TABLE 2. - Selected Pre and Postoperative Medication and Doses Median [IQI] (min, max) All Patientsn = 64 Low Preoperative PTHn = 32 High Preoperative PTHn = 32 P Preoperative Medications Cinacalcet (mg) 90 [60, 90] (30, 180) 90 [60, 90] (30, 180) 90 [60, 120] (30, 180) 0.98 Sevelamer (mg) 2400 [2400, 2400] (800, 7200) 2400 [2400, 2400] (800, 4800) 2400 [2400, 2400] (1600, 7200) 1.00 Calcium acetate (mg) 2001 [1334, 4002] (60, 6003) 1334 [667, 4002] (60, 6003) 2335 [2001, 4002] (667, 6003) 0.35 Pill Burden (number of pills per day) Treatment-related 4 [2, 7] (6, 11) 3 [2, 6.5] (6, 11) 5 [3, 7] (8, 11) 0.16 Other 8 [6, 11] (2, 20) 10 [7, 11] (2, 20) 8 [6, 10] (2, 18) 0.34 Total 13 [10, 18] (0, 14) 14 [11, 18] (0, 14) 12 [10, 18] (0, 13) 0.75 Postoperative Medications at discharge Calcitriol (µg) 4.5 [4, 6] (0.5, 14.0) 4 [3.8, 5.1] (0.5, 14.0) 5.0 [4.0, 7.0] (1.0, 11.0) 0.01 Calcium Carbonate (g) 7.5 [4.5, 9.0] (1.5, 20.0) 6.0 [4.1, 8.0] (1.5, 14.0) 8.0 [6.0, 12.0] (3.0, 20.0) 0.05 Sevelamer (mg) 2400 [2400, 4800] (2400, 12000) 2400 [2400, 6000] (2400, 12000) 2400 [2400, 3600] (2400, 7200) 0.75 Calcium acetate (mg) 4002 [2001, 4002] (667, 6003) 2001 [2001, 2001] (2001, 4002) 4002 [4002, 4002] (667, 6003) 0.03 Pill Burden at discharge (number of pills per day) Treatment-related 27 [23, 36] (4, 69) 24 [16, 33] (4, 49) 32 [26, 37] (12, 69) 0.01 Other 8 [6, 11] (2, 20) 10 [7, 11] (2, 20) 8 [6, 10] (2, 18) 0.34 Total 35 [30, 44] (10, 85) 32 [27, 41] (10, 60) 42 [34, 45] (20, 85) 0.04 Pill Burden at 6 months (number of pills per day) Number of patients with 6 month follow up data n = 33 n = 18 n = 15 Treatment-related 10 [4, 21] 9 [3, 23] 10 [5, 16] 0.71 Other 10 [7, 12] 10 [7, 13] 9 [7, 11] 0.65 Total 20 [13, 28] 19.5 [14, 27] 20 [14, 28] 0.71 There were no differences in the proportion of patients prescribed each type of medication between groups. Postoperative medications were captured at the time of discharge. P values compare median daily pill burdens between low and high PTH groups using Generalized Wilcoxon tests. A total of 33 patients (52%) had encounters in our health system 6 months after surgery with medication reconciliations. IQI, Interquartile interval; Min, minimum; Max, maximum. Bolded values indicate statistically significant P values. DISCUSSION After parathyroidectomy for SHPT, median treatment-related daily pill burden increases by 23 pills at discharge and 5 pills by 6 months. At discharge, patients with lower compared with higher preoperative PTH have smaller pill burden increases. This difference resolves by 6 months. Similar to published studies, the preoperative PTH levels in our cohort were significantly higher than the historical biochemical threshold for parathyroidectomy (PTH ≥84.8 pmol/L, equivalent to 800 pg/mL).4,5 While the preoperative daily pill burden in our study was comparable to others,1,6 this is the first study to quantify the postoperative pill burden. Although the excessive postoperative pill burden decreases over time, there is still a modest increase at 6 months. Our study is limited by (1) a substantially higher preoperative PTH level in our patient population than previously recommended biochemical thresholds, which may impact the severity of postoperative hypocalcemia, and (2) inconsistent medication reconciliation documentation after discharge. Higher preoperative PTH values may be associated with greater challenges with calcium homeostasis postoperatively and warrant additional study. In conclusion, this study highlights the substantial postoperative pill burden after parathyroidectomy for SHPT. To alleviate some of the excessive pill burden, providers should consider dose consolidation. This new knowledge on pill burden should enhance shared decision-making conversations between patients and clinicians to help set postoperative expectations.

  PublisherDOI

• Association of Stratified Benchmarks With Financial Penalties in the ESRD Treatment Choices Model

  JAMA · 2025-05-07

  articleOpen access

  This study compares proportions of facilities receiving penalties based on stratified benchmarks in the Centers for Medicare &amp;amp;amp; Medicaid Services’ End-Stage Renal Disease Treatment Choices (ETC) model, a pay-for-performance program incentivizing home dialysis and kidney transplant waitlisting.

  PublisherOA PDFDOI

• Through the Looking Glass: Characterizing the Complexity of Outsourcing Veterans Affairs Home Dialysis

  Journal of the American Society of Nephrology · 2025-10-01

  article1st authorCorresponding
  PublisherDOI

• Transplantation in Mandatory Kidney Payment Models: Understanding the Potential Influence of the ESRD Treatment Choices Model on the Increasing Organ Transplant Access Model

  Kidney Medicine · 2025-11-06

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• How to Leverage Implementation Science to Achieve Equity in Nephrology Care Delivery

  American Journal of Kidney Diseases · 2025-06-21

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Readmission and Cost of Parathyroidectomy By Admission Status in Secondary Hyperparathyroidism

  Clinical Journal of the American Society of Nephrology · 2025-11-14

  articleOpen access

  Key Points Among patients with kidney failure treated with dialysis, 37% underwent parathyroidectomy in the outpatient setting. Significant differences exist between patients selected for inpatient versus outpatient parathyroidectomy. Risk-adjusted readmission rates are similar after inpatient or outpatient parathyroidectomy for secondary hyperparathyroidism. Background Outpatient parathyroidectomy for secondary hyperparathyroidism of kidney disease is increasing. Reduced length of stay is often associated with higher rates of readmission. The safety of outpatient parathyroidectomy in this population must be evaluated given the morbidity and higher risk of post-parathyroidectomy hungry bone syndrome associated with kidney failure. In this study, we compare parathyroidectomy outcomes and costs by admission status in dialysis-dependent patients with secondary hyperparathyroidism. Methods Adult patients on dialysis who underwent elective parathyroidectomy for secondary hyperparathyroidism were identified in the Healthcare Cost and Utilization Project State Inpatient and State Ambulatory Surgery Databases from five geographically diverse states (2013–2019). Patients were classified by admission status: inpatient and outpatient (overnight or same-day). The primary outcome was 30-day readmission. Secondary outcomes were parathyroidectomy-related complications and cost. Outcomes were compared by admission status using chi-squared tests and costs using median quantile regression. Balancing weights were used for adjustment. Forward selection with logistic regression was used to identify factors associated with readmission among outpatients. Results Among 1267 study participants, 63% were inpatients. Among outpatients, 40% underwent overnight stay and 42% underwent same-day discharge. Inpatients were more likely to be younger, Black race, have nonprivate insurance, and increased comorbidities than outpatients ( P &lt; 0.05). Overall readmission rate was 19%. Readmission was higher among inpatients (Inpatient: 22% versus Outpatient: 15%; P = 0.002). After balancing weights, adjusted 30-day readmission rate was similar between inpatients and outpatients (14% versus 15%; P = 0.79). Readmission was similar between overnight stay and same-day discharge (Unadjusted: 12% versus 15%; P = 0.47. Adjusted: 15% versus 15%; P = 0.97). Outpatients with parathyroid autotransplantation, anxiety disorder, autoimmune conditions, congestive heart failure, and moderate/severe liver failure had significantly increased odds of readmission after parathyroidectomy. Adjusted median costs varied significantly (Adjusted Inpatient: $9615 [Interquartile range (IQR), $6463–12,963] versus Outpatient: $6357 [IQR, $4966–8153]; P &lt; 0.001; Adjusted Overnight: $6453 [IQR, $5551–7850] versus Same-day: $5526 [IQR, $4346–7187]; P &lt; 0.001). Conclusions Select patients with secondary hyperparathyroidism may undergo outpatient parathyroidectomy safely with reduced costs.

  PublisherOA PDFDOI

• Is Assisted Home Dialysis Feasible in the United States? Addressing Legislative and Regulatory Levers

  Clinical Journal of the American Society of Nephrology · 2025-10-10

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Enhancing Community Engagement Through a New Combined Renal-Endocrine Screening Program in West Philadelphia

  Journal of the American Society of Nephrology · 2025-10-01

  article

  Background: Diabetic chronic kidney disease (CKD) disproportionately affects underserved populations who are less likely to receive optimal treatments. Early detection and patient education through screening events in underserved regions offers a simple, low-cost effort to address disparities. Kidney Disease Screening and Awareness Program (KDSAP) is a student-run organization dedicated to screening community members for CKD and providing CKD education nationally. Since 2016, KDSAP’s University of Pennsylvania chapter has screened 650 participants across 27 events for CKD. Given the intersection of diabetes and CKD in underserved areas, we aimed to expand KDSAP screenings to include diabetes education and screening in West Philadelphia through a novel combined Renal-Endocrine health screening program. Methods: KDSAP, Penn Renal, and Penn Endocrine developed an integrated CKD-Diabetes screening events in West Philadelphia. Screenings included vital signs, blood glucose + urine protein levels, nephrology consultation, endocrine consultation, and patient education. We tracked community participant attendance, student volunteers, physician volunteers, and number of new sites. Secondary endpoints included the addition of new stations and expansion of educational material into new languages (Arabic, Spanish, Mandarin). We conducted focus groups with community members to gauge the usefulness of educational material. Results: KDSAP held 10 screenings in West Philadelphia with 110 community participants, 100 student volunteers and 18 physician volunteers. Physician volunteers expanded to include endocrinologists and primary care physicians. Health screenings expanded to four new locations. We incorporated 3 additional stations to meet with diabetes health educators, nutrition health educators, and social workers. Five screening participants attended the focus groups. Additional data from health screenings/focus group will be available at time of presentation. Conclusion: Early data suggest that the KDSAP Renal-Endocrine health screening program meets the needs of community members, integrates a broader physician and volunteer workforce, and expands educational resources. While more data are needed to better understand its long-term impact, KDSAP should consider scaling an integrated program to other sites to broaden our impact on CKD and diabetes.

  PublisherDOI

Frequent coauthors

• Yogesh N.V. Reddy

  Mayo Clinic

  33 shared

• Georgi Abraham

  29 shared

• Mallika L. Mendu

  Inspira Medical Center Vineland

  24 shared

• Ann M. O’Hare

  VA Puget Sound Health Care System

  14 shared

• Eric D. Weinhandl

  Satellite Healthcare (United States)

  13 shared

• Milly Mathew

  12 shared

• Sri Lekha Tummalapalli

  Cornell University

  12 shared

• Georgi Abraham

  12 shared