Early Stand Out

Research Paper by First Author LSU Medical Student & Team Praised in Prestigious Journal Companion Editorial

Meet Hayden Torres. He’s a third-year student at LSU Health New Orleans School of Medicine. The findings of a research project he helped design and conduct have been published in the second oldest medical journal in the United States. So impressive was the peer-reviewed paper on which he was first author, it also motivated a companion editorial.

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This future physician-scientist’s passion for research has been growing and evolving.

“I had been involved in basic science research since my undergraduate education,” Torres says. “Following graduation, I worked as a research assistant at the Pennington Biomedical Research Center. Upon attending LSUHSC, I wanted to continue nurturing my passion for research but wanted to shift my focus to clinical research.”

The LSU Health New Orleans Summer Research Internship Program introduced the Thibodaux native to that. Torres was paired with Dr. Mihran Naljayan, Interim Chief of the Section of Nephrology and Hypertension, and Dr. Efrain Reisin, Professor of Medicine and immediate past Section Chief, and that’s when he began working on the dialysis research project.

And it was enlightening.

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LSU Health Study Finds Psychosocial Factors May Drive Peritoneal Dialysis Patient Dropout

“I thought it was an eye-opening experience to see what dialysis patients go through every single day, and it gave me further insight into the effects of chronic disease on not only the patients but their families,” Torres recalls. “As someone who knew nothing about dialysis prior to starting the project, all of it was interesting. I enjoyed seeing the dialysis facility, seeing Dr. Naljayan’s interaction with his patients, working with a passionate team of researchers, and learning about the various components a peritoneal dialysis patient has to manage to stay healthy.”

The research project yielded important new information.

“Patients choose to be on a home dialysis therapy like peritoneal dialysis (PD) for a multitude of reasons, and one of those main reasons is that they have more flexibility and the ability to spend time at home doing what they love and being around those that they love,” Torres explains. “A challenge for patients on PD is that there are various reasons why they drop out from therapy and ultimately switch to in-center hemodialysis. We found that of the individuals who dropped out of the peritoneal dialysis program and switched to hemodialysis in our program, the largest contributing factor was psychosocial (63%). This means that patients who left peritoneal dialysis did so due to the inability to keep up with the treatment schedule, loss of support networks, or decline in the patient’s mental health.”

The results weren’t so surprising to Torres.

“To me, it was not shocking as my mother suffers from Multiple Sclerosis, so I know from firsthand experience that the effects of chronic disease extend far past the disease itself, often affecting patients socially, emotionally, and financially. It seemed reasonable that this was probably applicable to patients with kidney disease.”

He already knows the importance of this kind of research.

“It is vital to collect data and analyze what may affect patients outside of their specific disease burden. This includes their home life, their socioeconomic status, and how their care partners are coping with the patients’ disease. Early intervention or identification of these problems will allow for physicians and care teams to improve not only patient outcomes but also improve the patient’s quality of life, ultimately keeping the patients on the therapy that they chose for themselves much longer. It also helps to set the groundwork for the development of tools for identifying patients who are at risk of dropout and the development of appropriate interventions.”

And he wants the public to understand its significance, too.

“I would like people to understand that how a patient is doing is also a reflection of how their family is doing. Chronic disease is complex in nature, and if a patient is doing poorly, often their family is negatively impacted. In addition, if a patient’s family is doing poorly, this can lead to a patient having a collapse of their support network leading to poor health outcomes. A patient’s support network is extremely important to one’s success in dealing with chronic disease.”

The authors of the companion editorial had high praise for the work.

“As Torres et al. have expertly illustrated, examining the reasons for technique failure is critical particularly in special populations because they have to reveal factors that may not be apparent and point to areas to focus further research and policy prescriptions. As the manuscript shows, psychosocial factors are a significant factor that has not received enough attention. Not surprisingly, their investigation found that when technique failure results from psychosocial factors, it does so in the first year, which is consistent with other reports. Torres et al. have effectively and poignantly highlighted a need for further research about how to retain racial minorities more effectively, who may not have robust social and emotional support.”

Torres is grateful that he could be part of the team of researchers. “I am thankful for the help provided by Dr. Naljayan for project conceptualization and management, Dr. Reisin with data analysis and manuscript preparation. Dr. Frontini with statistical analysis and revisions, Dr. Aguilar and Sean Barry for assistance with manuscript preparation. I am also thankful for the help provided by the staff of DaVita for assisting with data collection.”

“It is a great accomplishment for an LSU third-year medical student, publishing as leading author, a paper with the Nephrology faculty in a very prestigious journal, and that his paper was the inspirational source of the monthly editorial of the same journal,” notes Erwin Aguilar, PharmD, MSc, MPH, MA, Associate Professor of Research and Director of Clinical Research in the LSU Health New Orleans Section of Nephrology and Hypertension and a co-author on the paper.

So what’s up next for the blossoming clinical scientist?

“I am currently involved in a follow-up project with Dr. Naljayan evaluating objective tools to measure risk for psychosocial loss from PD and considering interventions that may decrease that risk.”