Recipients of AKF fellowship detail their goals, inspirations for research
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Key takeaways:
- Bicki intends to research barriers faced by pediatric patients with kidney disease.
- Subramanian plans to research outcomes during COVID-19 and vaccinations among patients with kidney disease.
The American Kidney Fund Clinical Scientist in Nephrology Fellowship has been granted to two women devoted to bettering nephrology through research.
“The American Kidney Fund’s (AKF) Clinical Scientist in Nephrology (CSN) Program has trained some of nephrology's brightest scholars who have gone on to become leaders in the field and mentors to new generations of scientists studying kidney disease,” LaVarne A. Burton, president and CEO of AKF, told Healio. “There are critical shortages within the nephrology workforce, and with the rapidly growing number of people being diagnosed with chronic kidney disease (CKD), we hope that our CSN program shows future generations the possibilities of improving and saving people’s lives by going into this specialty.”
This year, the fellowships have been awarded to Alexandra Bicki, MD, MPH, a pediatric nephrology fellow at the University of California, and Nivetha Subramanian, MD, a nephrology fellow at Stanford Medicine.
Barriers faced by pediatric patients
From an early age, Bicki has known that she wanted to be a doctor and improve the lives of others. Looking back now, she notices a pattern within her research projects and clinical pursuits that emphasizes caring for underserved populations.
“I’ve always had an interest in caring for those who may not be able to speak for themselves and those who have difficulty advocating for themselves in various ways, whether that be children or other populations who have been minoritized,” Bicki told Healio.
After earning her medical degree from the University of Miami, where she primary focused on Hispanic and Spanish-speaking populations, Bicki began to explore the barriers faced by pediatric patients during her clinical year in fellowship.
Having now received the CSN fellowship, Bicki is excited to study the barriers to home dialysis and living kidney donor transplantation faced by pediatric patients. According to Bicki, her research will consist of two parts.
In the first part of the project, Bicki intends to use data from the U.S. Renal Data System to study how system-level factors of dialysis facilities may associate with kidney transplantation among adolescents and young adults. These factors may include facility location or staffing ratios. The second part of the project will involve in-person and virtual interviews to determine the lived experiences and barriers faced by English- and Spanish-speaking adolescents and young adults with CKD, but who have not yet begun dialysis.
“We want to be able to combine the population-level data from those on dialysis, with the narratives of those who are not yet on dialysis and see if we can kind of meet in the middle to design an intervention in the future to help this population,” Bicki said.
COVID-19 outcomes and improved policy
Inspired by her parents’ experience with end-stage kidney disease, Subramanian also took an interest in nephrology at a young age.
“I felt helpless watching a loved one experience a life changing condition. I wanted to help other individuals and their families navigate kidney disease,” Subramanian told Healio.
While earning her Bachelor of Science degree in human biology, health and society from Cornell University, Subramanian found herself pulled toward health policy and the humanities. She dove deeper into nephrology research while studying at Case Western Reserve University School of Medicine.
Through the CSN fellowship, Subramanian intends to compare the rates of COVID-19 cases, hospitalizations and death among patients undergoing dialysis since 2020 to that of the general population. Further, her work is designed to identify rates and predictors of booster updates among patients on dialysis.
According to Subramanian, patients on dialysis are often not prioritized for therapies early in pandemics despite being immunocompromised, experiencing worse outcomes from respiratory illnesses, often having comorbidities and spending a lot of time close to other patients in dialysis centers. By exploring the disparities seen during the COVID-19 pandemic, Subramanian plans to apply the findings to other vaccination roll-out policies and pandemic preparations.
“My hope is that, ultimately, we can use this to help create future policies that will prioritize patients on dialysis to get treatments earlier,” Subramanian said.
“[D]espite CKD affecting far more Americans than many other diseases, federally funded kidney disease research lags compared to other chronic diseases,” Burton told Healio. “Our CSN program helps fill this void and accelerates innovation in diagnosing and treating CKD. We look forward to seeing the impact of Dr. Alexandra Bicki and Dr. Nivetha Subramanian’s work among the kidney community.”
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