Physician Spotlight
Blog Date: March 8th 2025
Women in Nephrology:
A Conversation with Dr. Farida Migally
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Nephrology Today spotlight physician features. Dr. Farida Migally, a distinguished nephrologist from NANI South Chicago. She shares her journey in medicine, the evolution of nephrology, and the unique challenges and opportunities for women in this field.
The Journey into Nephrology
Dr. Migally grew up in Dayton, Ohio, pursued her undergraduate studies at the University of Michigan, and attended George Washington University for medical school. She later completed her residency and fellowship in nephrology at Rush University Medical Center. Coming from a family of physicians, she found inspiration in medicine and naturally gravitated towards nephrology during her training.
Her passion for problem-solving, diverse patient populations, and the intellectually stimulating nature of nephrology made the specialty a perfect fit for her. Unlike fields that rely heavily on memorization, nephrology provided the challenge of critical thinking, which she found deeply fulfilling.
How Nephrology Has Evolved
Since Dr. Migally completed her fellowship in 2017, nephrology has undergone significant advancements. One of the most impactful changes has been the introduction of new medications for patients with chronic kidney disease (CKD).
- SGLT2 inhibitors – Initially developed for diabetes, now showing significant benefits for CKD patients.
- Non-steroidal MRAs – Offering new treatment avenues.
- GLP-1 receptor agonists (like Ozempic and Monjaro) – Beneficial for kidney function in diabetic and non-diabetic patients.
In addition to pharmaceutical advancements, nephrology is shifting towards value-based care to improve patient outcomes while managing costs. Organizations like NANI actively participate in these efforts, ensuring high-quality, cost-effective care.
Advice for Women in Nephrology
For young women considering nephrology, Dr. Migally emphasizes the importance of passion and commitment. Medicine is a lifelong journey, and finding joy in your specialty is crucial.
Her key advice:
- Follow your passion – Choose a field that excites and inspires you.
- Explore different paths – Nephrology offers opportunities in academics, private practice, research, and pharma.
- Seek mentorship – Support from experienced professionals is invaluable.
- Don't compromise your aspirations – The field is evolving, and women have growing opportunities in leadership and innovation.
Challenges Women Face in Nephrology
Nephrology has historically been male-dominated. As of 2019, only 30% of practicing nephrologists in the U.S. were women, with 36% of trainees being female. These disparities extend to leadership roles, where only 6% of department chairs and 9% of division chiefs are women.
However, the landscape is changing. Women in academic nephrology have increased to 45%, and efforts are being made to improve mentorship, leadership opportunities, and work-life balance. Organizations like NANI have introduced maternity leave policies, supporting young female physicians in balancing career and family life.
Women and Chronic Kidney Disease (CKD)
Kidney disease affects 1 in 7 adults in the U.S., with a slightly higher prevalence in women (14% vs. 12% in men). Interestingly, more men progress to dialysis and receive kidney transplants, raising questions about sociocultural, genetic, and healthcare access factors.
Hormonal Changes and Kidney Health
Women face unique kidney health risks due to pregnancy, menopause, and hormonal fluctuations. Risk factors include:
- Preeclampsia and gestational hypertension – Can lead to CKD later in life.
- Higher UTI susceptibility – Due to anatomical differences.
- Postmenopausal changes – Affect kidney function and disease progression.
Pregnancy and Kidney Disease
Women with CKD or on dialysis can still have successful pregnancies, though it requires careful management:
- Preconception counseling – Assessing risks and adjusting medications.
- Medication review – Discontinuing ACE inhibitors, ARBs, and certain immunosuppressants.
- Specialized care – Collaboration between nephrologists and maternal-fetal medicine (MFM) specialists.
For transplant recipients, pregnancy is also possible. Live birth rates are around 73%, and post-transplant hormonal normalization can restore fertility. However, timing and medication adjustments are crucial for a healthy pregnancy.
Dr. Migally’s message is clear: women in nephrology and patients with CKD should never feel limited. Whether it’s pursuing a career in medicine or navigating kidney disease while planning a family, the opportunities for growth, success, and fulfillment are endless.
With continuous advancements, diversity in nephrology is increasing, and the field is evolving to better reflect our society. Women are making strides in leadership, mentorship, and patient care, ensuring a bright future for the next generation of nephrologists.
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