Institution: University of California, San Francisco
Grant: Donald E. Wesson Research Fellowship Award (2018)
Project Title: Identification of Sub-phenotypes in Sepsis Associated Acute Kidney Injury
How would you sum up your research in one sentence?
My project applies latent class analysis to identify new subgroups of sepsis-associated acute kidney injury and evaluates whether this classification method may predict patient outcomes.
Provide a brief overview of the research you will conduct with help from the grant.
I will be using data from the Early Assessment of Renal and Lung Injury (EARLI), a large prospective cohort of patients admitted to the intensive care unit from the emergency room at two University of California San Francisco (UCSF) affiliated hospitals. This population has a large proportion of patients with physician-adjudicated sepsis and acute kidney injury, and we have clinical and biomarker data available. I will be applying a novel statistical method known as latent class analysis, which uses mixture models to identify subpopulations within a heterogenous entity. Unlike conventional regression approaches, latent class analysis does not examine classifier variables with outcomes but once the subpopulations are identified, the clinical relevance of these new “sub-phenotypes” will be evaluated.
What impact do you hope your research will have on patients?
My hope is that this project opens up a novel way for nephrologists to classify sepsis-associated acute kidney injury and improves upon our current diagnostic and prognostic measures. Our hypothesis is that a combination of clinical factors and novel biomarkers will distinguish particular profiles of subjects with sepsis-associated acute kidney injury that tend to have worse outcomes. This analysis may also elucidate the specific biological pathways that portend adverse outcomes and provide opportunity for the identification of targeted therapies.
What are your short- and long-term career goals?
At the end of the grant period, I hope to have identified sub-phenotypes of sepsis associated acute kidney injury that have distinct clinical outcomes. In 5 years, I would like to be conducting a clinical trial that evaluates whether particular sub-phenotypes benefit from fluid liberal versus fluid restrictive therapies or intensive versus standard dialysis dosing. Ten years out, I would like to be able to leverage the knowledge gained through a decade of research on the current novel biomarkers for development of molecular targeted therapies for patients at risk for acute kidney injury.
What inspired you to focus your research in kidney diseases?
I was fortunate to have phenomenal mentorship in nephrology research throughout my career, starting as an undergraduate college student at Johns Hopkins up to my training as a renal fellow at UCSF. Through my mentors, I learned about the burgeoning field of blood and urinary biomarkers that could be leveraged for development of targeted therapies. Currently, there are limited options for patients with kidney disease. As we move into the age of precision medicine, I think nephrology is a field prime for significant advances, and the opportunity to participate in the development of these advances for my patients motivates my research.
In one sentence, please describe the importance of having grant funding available through the ASN Foundation.
As a Ben J. Lipps fellow, I now have protected time and financial stability to prepare for career path that is focused not only on providing excellent care at the bedside but also on developing the research skills necessary to innovate nephrology care.
What advice would you give to others to encourage them to apply for this grant funding?
During my first year of nephrology fellowship, I found a very supportive mentor, Dr. Kathleen Liu, and worked closely with her to identify a project that I would be extremely passionate about. I would encourage applicants to start thinking about ideas early as possible because the study design may evolve significantly over time. The process of grant writing can be very gratifying as it provides applicants with the opportunity to be innovative and a platform to elucidate a feasible plan using the available resources and funding mechanisms.
Something you may not know about me is…
Growing up, I took piano and ballet lessons. I was certified up to grade 5 with the Royal School of Music and grade 8 with the Royal Academy of Dance.