LaTonya Hickson, M.D.

Photo of LaTonya Hickson, M.D.

"The work that we do can advance our knowledge, improve our practice patterns and, most importantly, optimize patient outcomes. This makes the hard work worthwhile."

Investigating ways to improve outcomes for patients with hypertension and renal disease

LaTonya Hickson, M.D., a Mayo Clinic nephrologist, treats patients with chronic kidney disease and hypertension (high blood pressure), as well as those who have undergone kidney transplantation.

She knows that the statistics are discouraging for kidney failure patients who are on dialysis. In many cases, the five-year survival rate is only 20 percent, and cardiovascular disease is among the most common causes of death. If clinicians had reliable ways to predict which patients are at a higher risk of death, they could effectively work to mitigate risk factors and improve outcomes.

Work done by Dr. Hickson and colleagues on this topic is already changing Mayo Clinic's practice standards for these patients. Now, with biostatistical guidance from the Mayo Clinic Center for Translational Science Activities (CTSA), she is looking at ways to predict risk of renal failure and death in the hypertensive population.

Finding biomarkers, improving outcomes

In collaboration with Fernando Cosio, M.D., one of her research mentors in the Division of Nephrology & Hypertension and the Mayo Clinic Transplant Center, Dr. Hickson investigated whether the use of a particular biomarker — in combination with other risk factors — prior to kidney transplantation could predict the risk of death in patients after transplantation.

Results from that study, says Dr. Hickson, have helped optimize Mayo's practice — physicians, based on clinical parameters prior to transplantation, are now better able to identify patients at the highest risk of death in the years following transplantation. Additionally, clinicians can now begin to aggressively target the modifiable risk factors in these patients in the hope of improving outcomes.

Funding through a three-year, benefactor-sponsored Mayo Clinic research career development award has allowed Dr. Hickson to initiate a new project extending this line of research. This project — which began in 2009 and is being conducted with mentor Stephen Turner, M.D. — focuses on finding predictors of all-cause mortality, cardiovascular mortality and end-stage renal disease in hypertensive patients.

CTSA biostatistical support

During her clinical fellowship in nephrology/hypertension from 2005-2008, Dr. Hickson opted to pursue advanced training in clinical transplantation. This training took the place of a focused year of research (the traditional route), during which she could have obtained a certificate in clinical/translational science.

While satisfied with her clinical exposure, Dr. Hickson feels her epidemiology and statistics background is somewhat limited. Enter the CTSA, which she first heard about during her clinical fellowship.

Dr. Hickson credits regular meetings in early 2010 with Tanya Hoskin, a Mayo statistician who consults through the CTSA's Biostatistics, Epidemiology and Research Design (BERD) Resource, with dramatically improving her understanding of statistical concepts. Together, they reviewed study outcomes, worked on analyses and optimized her use of JMP statistical software.

Previously, Dr. Hickson relied heavily on her research mentors for statistical guidance. Now, she can independently perform many of her calculations, something she says has accelerated the pace of her research.

"All junior faculty should visit the CTSA for biostatistics assistance," says Dr. Hickson. "Just bring what you already know — however little that is — and get started. You'll learn a ton from the experience."

Since joining the Mayo staff in 2008, Dr. Hickson has also completed several online Mayo Graduate School courses. She plans to utilize time from her career development award to work toward completing the certificate program.

Her motivation: patients

Dr. Hickson says that her patients inspire her to better understand disease. From those patients come questions — and she hopes her research provides answers.

"I enjoy clinical research because issues and dilemmas we encounter on a daily basis can be molded into valid research questions and pursued," says Dr. Hickson. "The work that we do can advance our knowledge, improve our practice patterns and, most importantly, optimize patient outcomes. This makes the hard work worthwhile."

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