When kidney disease progresses or specialized intervention is required, East Tennessee Medical Associates offers advanced therapeutic modalities tailored to each patient's lifestyle and clinical needs. Our practice has been at the forefront of renal technology in upper East Tennessee for decades, ensuring you receive tertiary-level care close to home.

Comprehensive Dialysis Services

For patients whose kidneys can no longer adequately filter waste and maintain fluid balance, dialysis performs these life-sustaining functions. We oversee complete dialysis planning, initiation, and ongoing management across multiple modalities, giving patients control over their treatment journey.

• In-Center Hemodialysis Management: Direct physician oversight and personalized prescription management for patients receiving hemodialysis at outpatient units in Johnson City, Elizabethton, and Greeneville. We monitor access health, dialysis adequacy (Kt/V), dry weight, and blood chemistries during routine rounds.

• Home Dialysis Programs (Peritoneal Dialysis & Home Hemodialysis): Comprehensive training support and physician management for peritoneal dialysis (continuous ambulatory or automated cycler) and home hemodialysis. Home therapies offer greater flexibility, gentler continuous filtration, and reduced travel burden.

• Vascular & Dialysis Access Coordination: Collaboration with vascular surgeons and interventional radiologists to plan, create, and maintain long-term access—including arteriovenous (AV) fistulas, AV grafts, and peritoneal catheters—ensuring early access maturation and minimal complication rates.

• Dialysis Complication Oversight: Ongoing medical control of specialized dialysis challenges, including cardiovascular protection, fluid overload management, renal bone disease, and access-related infection prevention.

Renal Transplantation Care

Kidney transplantation offers many patients with end-stage renal disease the opportunity for a significantly improved quality of life and longer survival. While surgery takes place at major transplant centers, ETMA provides essential local management before and long after your transplant.

• Pre-Transplant Evaluation & Workup: Early identification of candidate eligibility, thorough medical clearance, and seamless referral coordination with regional transplant centers across the Southeast.

• Post-Transplant Follow-Up Care: Close, long-term monitoring after hospital discharge to evaluate graft function through routine lab work, physical exams, and diagnostic monitoring.

• Immunosuppressive Medication Management: Precise dosing and regular therapeutic drug level monitoring for anti-rejection medications (such as calcineurin inhibitors, anti-proliferatives, and steroids) to maintain optimal immunosuppression while minimizing drug toxicity.

• Infection & Rejection Surveillance: Early detection of organ rejection markers or opportunistic infections, coordinating prompt diagnostic biopsies or inpatient adjustments when needed.

Plasmapheresis (Therapeutic Plasma Exchange)

Plasmapheresis is an advanced procedure that separates and removes blood plasma containing harmful antibodies, abnormal proteins, or immune complexes, replacing it with donor plasma or albumin solution to treat severe or systemic conditions.

• Autoimmune & Glomerular Disease Treatment: Targeted therapy for acute immune-mediated kidney disorders, including ANCA-associated vasculitis, Anti-GBM disease (Goodpasture syndrome), and rapid-onset lupus nephritis.

• Transplant-Related Applications: Specialized plasma exchange protocols used to treat acute antibody-mediated rejection or to assist in desensitization for high-risk transplant candidates.

• Hematologic & Metabolic Conditions: Management of systemic plasma disorders with renal involvement, such as Thrombotic Thrombocytopenic Purpura (TTP), Hemolytic Uremic Syndrome (HUS), and focal segmental glomerulosclerosis (FSGS) recurrence.

• Inpatient & Procedure Oversight: Direct coordination and management of therapeutic plasma exchange protocols in hospital settings to ensure patient safety and optimal fluid shifts during therapy.