NYMC Student Theses and Dissertations
Date of Award
5-28-2025
Document Type
Doctoral Dissertation - Restricted (NYMC/Touro only) Access
Degree Name
Doctor of Public Health
Department
Public Health
First Advisor
Dr. Adam Block
Second Advisor
Dr. Savneek Chugh
Third Advisor
Dr. Kenneth Knapp
Abstract
Background: Kidney diseases are a growing public health concern, often underdiagnosed and influenced by systemic and social factors. Timely recognition of acute kidney injury (AKI) in critical care remains challenging. Dialysis-dependent populations faced elevated risks during the COVID-19 pandemic, while non-traditional factors like poor sleep health are increasingly linked to chronic kidney disease (CKD). This dissertation includes three related studies examining diagnostic accuracy in AKI, disparities in COVID-19 outcomes among dialysis patients, and associations between sleep disturbances and CKD.
Methods: Study 1 is a retrospective cohort analysis comparing physician-diagnosed AKI to KDIGO-based diagnoses in ICU patients. Study 2 examines COVID-19 trends and mortality among urban and suburban outpatient dialysis populations in New York during two pandemic waves. Study 3 uses NHANES 2017–2020 data to assess associations between sleep disturbances (excessive daytime sleepiness, snoring, apnea-like symptoms) and CKD in U.S. adults.
Results:In Study 1, 54% of AKI cases meeting KDIGO criteria were missed by physicians, especially early-stage cases. Study 2 found ongoing mortality disparities, with COVID-positive status strongly linked to death, despite lower infection rates. In Study 3, excessive daytime sleepiness remained significantly associated with CKD (OR = 1.33; p = 0.018), while snoring and apnea-like symptoms showed weaker associations.
Conclusions:These studies highlights the need for standardized AKI diagnosis, targeted responses to dialysis disparities during emergencies, and recognition of sleep health as a CKD risk factor. Aligning clinical practice with public health policy can enhance kidney disease detection and care
Recommended Citation
Kore, Shruti, "Nephrology Research in Focus: Insights From Acute Kidney Injury in ICU Patients, Covid-19 in the Dialysis Population, and Chronic Kidney Disease From the NHANES Dataset" (2025). NYMC Student Theses and Dissertations. 81.
https://touroscholar.touro.edu/nymc_students_theses/81
Keywords
acute kidney injury, chronic kidney disease, KDIGO, COVID-19, dialysis, excessive daytime sleepiness, NHANES, public health, nephrology
Disciplines
Clinical Epidemiology | COVID-19 | Medicine and Health Sciences | Nephrology
