(From left) Michelle Estrella, MD (NKF Program Committee Co-Chair 2023); Isabella Tabora; Bernard Jaar, MD, MPH, FASN (NKF Program Committee Chair 2023); and Dr. Lerma during the poster session at the NKF Spring Clinical Meetings on April 12, 2023. Courtesy of Edgar Lerma.
Citation: Kidney News 16, 4
Lerma: Tell us something about yourself.
Tabora: Currently, I attend Tufts University and plan on pursuing a major in biology and community health. I am also beginning to research the inter-organ crosstalk between the kidney and heart using extracellular vesicles and fluorescence microscopy, with the help of Tufts faculty. In my free time, I enjoy exploring Boston, hanging out with friends, and trying new foods!
Lerma: What was your experience attending the 2023 NKF Spring Clinical Meetings?
Tabora: Last year, I was both thrilled and nervous when I found out I had been invited to the 2023 NKF Spring Clinical Meetings. The idea of being able to present this project to experts in the field was quite captivating, and it made me feel like a real professional. At the same time, however, I was worried that the research would not be taken seriously if I did not present properly, which would not be a very favorable outcome considering the work put into this project by not just me but also others with the Advocate Christ Medical Center: Dr. Lerma, Section of Nephrology educational coordinator, and Angela Pauline Calimag, MD, and Tazeen Rizvi, DO, internal medicine residents.
Fortunately, my anxiety had transformed into relief during my time at the conference. Everyone who I encountered was welcoming and genuinely interested in what I had to offer. I was able to engage in conversations not only about my research but about other people's research as well. Observing and analyzing other posters at the conference enabled me to see nephrology from an entirely new perspective. In addition to this, I had the wonderful opportunity to meet and discuss my project with medical students, nephrologists, and even leaders of the NKF. This was truly an unforgettable experience, and I can confidently say that it is the first of many more research conferences to come.
Lerma: Tell us about your poster, how you developed the idea for doing the research, and what you learned.
Tabora: Before elaborating upon the contents of my poster, I want to express my immense gratitude to you, Dr. Lerma, for guiding me throughout the entire process. Prior to this project, I had never even heard about the underlying dangers of chronic kidney disease (CKD) in patients with type 2 diabetes, so I was shocked to learn that progression to diabetic kidney disease (DKD) remains rampant in 20% to 40% of [patients with diabetes]. I felt compelled to learn about ways to improve the pre-existent secondary prevention approaches and to mitigate these negative health outcomes. Assembling a quality improvement initiative to not only understand the root of the issue but to also find solutions on a local level was necessary.
My poster depicted the research I conducted on a primary care clinic in Las Vegas, with the goal of gaining more insight regarding the success rate at which primary care clinics in Nevada test their [patients with diabetes] for CKD. By using Practice Fusion to collect patient data, I was able to determine that a majority of patients diagnosed with diabetes and CKD did not obtain annual eGFR [estimated glomerular filtration rate] or UACR [urine albumin-creatinine ratio] tests, which are screenings recommended by the American Diabetes Association (ADA) intended to detect DKD early and prevent disease progression. The unfortunate reality of the situation was consistent with the fact that on a national level, less than 20% are tested annually for the screenings recommended by the ADA's 2021 guidelines.
Ultimately, it was determined that the clinic in this study was not at par with national ADA guidelines. Solutions to better the quality of patient treatment in this practice included flagging patient charts for the population at risk and enhancing education toward staff and patients. When looking at the social factors of the issue with approaches that are more preventative or upstream, more awareness could be spread about this issue on a community level through health advocacy, while individual health education could be improved through the development of informational brochures.
Lerma: Who or what influenced your decision to pursue a career in the field of medicine?
Tabora: My mother is a pediatrician, and my father is an internist, so I was exposed to the medical field at a very young age. As a young child, I would follow my mother around the clinic, observing everything she did and even pretending I was the one administering care to her patients. Being able to perceive my parents’ unending thoughtfulness inside and outside the workplace caused me to mirror their kindhearted actions in my everyday life. My parents are my idols, my inspiration, and most of all, my biggest supporters. They have spent their entire careers giving back to the community despite all the hardships they have undergone. The morals they have instilled and the example they have set for me have influenced me to pursue a career in health care, in which I can provide a place of safety for those suffering, listen to their problems with an open mind, and encourage them to take charge of their lives despite any health obstacles.
Lerma: Where do you envision yourself 10 years from now?
Tabora: In the next 10 years, I see myself having graduated from Tufts University with a degree in biology and community health. I hope to have made it through medical school by then, pursuing a residency in a specialty that I am truly intrigued by. Additionally, I hope to have implemented public health interventions that have made lasting impacts in several communities, especially when it comes to alleviating the severity of the health outcomes of DKD. I also hope to have expanded my research on the mechanisms that influence kidney and heart damage. At the same time, I hope to have pursued some of my personal aspirations in 10 years, like seeing the northern lights and visiting my family in the Philippines. For the most part, I look forward to being more involved in the field of health care in the future and to having attended many more health conferences, including the NKF Spring Clinical Meetings.
Lerma: What advice would you give to others in your age group?
Tabora: A piece of advice I can give is to avoid comparing yourself to others and to start comparing yourself to your past self. Most people my age likely grew up using social media, and although it enhances our lives in many ways, it also makes it very easy to compare other people's possessions, achievements, and capabilities to our own. But each person has different goals, personalities, and experiences, which essentially make everyone's lives incomparable. In the end, I find that it is beneficial to be the best version of yourself every day and take note of how we can improve from the past.
In fact, think of yourself like a flower. When life is difficult, drink water, get some sunshine, and surround yourself with a warm, loving environment full of other lovely flowers. Remember that you don't need to compete with other flowers, and instead, focus on your own growth.
Lerma: How would you like to see nephrology organizations and leaders engage youths and cultivate interest in nephrology?
Tabora: I believe that nephrology organizations, such as the NKF or the ASN, should contemplate establishing a summer research program that is directed toward high school students with an interest in the field of nephrology. These programs could educate students about kidney function, spark engaging discussions about prevalent issues within the community, and encourage students to give presentations on a research topic at the end of the program.
Additionally, this program could advertise the NKF Spring Clinical Meetings to students who intend to continue their research for the rest of the year. Having students attend the Spring Clinical Meetings will have myriad benefits for not only the students but for the conference as a whole. Students will have the ability to share their own project, expand their knowledge regarding other research methods and topics, make connections with professionals in the field, and actively converse with individuals who share the same yearning to develop solutions to urgent health issues. Most importantly, having the youth be involved in these meetings will spur proactive behavior within the nephrology community and can ultimately benefit the kidney health of many more populations. If this is done, however, it may be helpful to connect these students to mentors who are able to guide students with the entire process of researching, applying to, and attending the meetings.
One of the first steps to allow this idea to come to fruition is to get nephrology organizations to expand their social media presence on platforms like Instagram or TikTok. By doing this, organizations can get the attention of the youth and motivate them to make a difference in the field of nephrology early on.
