Scholars@Duke
Dinushika Mohottige

Dinushika Mohottige

Adjunct Assistant Professor in the Department of Medicine
Medicine, Nephrology
dm26@dm.duke.edu
Box 90239, Durham, NC 27708-0239
200 Morris Street, 3rd Floor, Durham, NC 27701

Selected Publications

Sex and Gender Identification and Implications for Disability Evaluation

Book · June 16, 2025 The resulting report offers conclusions in key areas including (1) the collection of data on sex and gender identity, (2) disability considerations for SSA' Listings of Impairments (medical criteria that apply to the evaluation of ... ... Cite

Natural Language Processing Identifies Under-Documentation of Symptoms in Patients on Hemodialysis.

Journal Article Kidney360 · January 29, 2025 BACKGROUND: Patients on hemodialysis (HD) have a high burden of emotional and physical symptoms. These symptoms are often under-recognized. NLP can be used to identify patient symptoms from the EHR. However, whether symptom documentation matches patient re ... Full text Link to item Cite

Interaction Between Apolipoprotein L1 Genetic Risk and Neighborhood Socioeconomic Status for Kidney Outcomes in a United States Cohort

Journal Article Kidney International Reports · January 1, 2025 Introduction: Apolipoprotein L1 (APOL1) risk alleles G1 and G2, confer a higher risk of kidney outcomes but are influenced by other genetic and environmental factors. The interaction between neighborhood socioeconomic status (SES) and APOL1 associated risk ... Full text Cite

Embedding Equity and Inclusion Principles Into Nephrology Board Examinations: An Essential Part of Our Path Toward Kidney Health Justice.

Journal Article Advances in kidney disease and health · January 2025 Recognition of widespread health inequalities across disease conditions and their startling impact on morbidity and health care costs have motivated multiple professional societies to ensure board examinations reflect and enhance inclusive, anti-biased, an ... Full text Cite

Testing Interventions that Address Kidney Health Disparities.

Journal Article J Am Soc Nephrol · December 23, 2024 Full text Link to item Cite

Enhancing Clinical Decision Support in Nephrology: Addressing Algorithmic Bias Through Artificial Intelligence Governance.

Journal Article Am J Kidney Dis · December 2024 There has been a steady rise in the use of clinical decision support (CDS) tools to guide nephrology as well as general clinical care. Through guidance set by federal agencies and concerns raised by clinical investigators, there has been an equal rise in u ... Full text Link to item Cite

Championing Civility in the Clinical Learning Environment: Evaluation of a Novel Training Program.

Journal Article Acad Med · December 1, 2024 PROBLEM: Incivility in the health care workplace is increasing and negatively impacts everyone in the environment, including health care team members and the patients and families they serve. This study examined the efficacy and impact of Civility Champion ... Full text Link to item Cite

Racial Differences in Over-the-Counter Non-steroidal Anti-inflammatory Drug Use Among Individuals at Risk of Adverse Cardiovascular Events.

Journal Article J Racial Ethn Health Disparities · October 2024 PURPOSE: Black Americans are disproportionately affected by adverse cardiovascular events (ACEs). Over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs) confer increased risk for ACEs, yet racial differences in the use of these products rema ... Full text Link to item Cite

What Should Clinicians in Organizations Without Established MLP Programs Do When Their Patients Need Lawyers to Meet Their Health Needs?

Journal Article AMA J Ethics · August 1, 2024 Undocumented people in the United States face innumerable legal and structural barriers to health and health care services, including for kidney failure. Their experiences vary across states and regions due to wide variation in insurance coverage and unrel ... Full text Link to item Cite

A systematic review of psychosocial and sex-based contributors to gender disparities in the United States across the steps towards kidney transplantation.

Journal Article Transplant Rev (Orlando) · July 2024 INTRODUCTION: Persistent findings suggest women and patients identified as "female" are less likely to receive a kidney transplant. Furthermore, the limited research on transplantation among transgender and gender diverse people suggests this population is ... Full text Link to item Cite

Components of Residential Neighborhood Deprivation and Their Impact on the Likelihood of Live-Donor and Preemptive Kidney Transplantation.

Journal Article Clin Transplant · July 2024 INTRODUCTION: Adults residing in deprived neighborhoods face various socioeconomic stressors, hindering their likelihood of receiving live-donor kidney transplantation (LDKT) and preemptive kidney transplantation (KT). We quantified the association between ... Full text Link to item Cite

Paving a Path to Equity in Cardiorenal Care.

Journal Article Semin Nephrol · March 2024 Cardiorenal syndrome encompasses a dynamic interplay between cardiovascular and kidney disease, and its prevention requires careful examination of multiple predisposing underlying conditions. The unequal distribution of diabetes, heart failure, hypertensio ... Full text Link to item Cite

Improving Health Equity in Living Donor Kidney Transplant: Application of an Implementation Science Framework.

Journal Article Transplant Proc · 2024 BACKGROUND: Interventions to improve racial equity in access to living donor kidney transplants (LDKT) have focused primarily on patients, ignoring the contributions of clinicians, transplant centers, and health system factors. Obtaining access to LDKT is ... Full text Link to item Cite

The PhenX Toolkit: Recommended Measurement Protocols for Social Determinants of Health Research.

Journal Article Curr Protoc · January 2024 Health disparities are driven by unequal conditions in the environments in which people are born, live, learn, work, play, worship, and age, commonly termed the Social Determinants of Health (SDoH). The availability of recommended measurement protocols for ... Full text Link to item Cite

SEED: A novel web-based data visualization platform to visualize, communicate, and explore social, environmental, and equity drivers of health.

Journal Article J Clin Transl Sci · 2024 Multisector stakeholders, including, community-based organizations, health systems, researchers, policymakers, and commerce, increasingly seek to address health inequities that persist due to structural racism. They require accessible tools to visualize an ... Full text Link to item Cite

Exploring the relationship between website quality and equity in living donor kidney transplant.

Journal Article Front Transplant · 2024 BACKGROUND: Health system websites are important resources to guide health care decisions and may be useful tools to improve racial equity in access to living donor kidney transplant (LDKT). METHODS: We performed a cross-sectional study of adult LDKT progr ... Full text Link to item Cite

Association of Age and Gender With Concerns About Live Donor Kidney Transplantation Among Black Individuals.

Conference Transplant Proc · December 2023 Black individuals are less likely to receive live donor kidney transplantation (LDKT) compared to others. This may be partly related to their concerns about LDKT, which can vary based on age and gender. We conducted a cross-sectional, secondary analysis of ... Full text Link to item Cite

Racial Equity in Living Donor Kidney Transplant Centers, 2008-2018.

Journal Article JAMA Netw Open · December 1, 2023 IMPORTANCE: It is unclear whether center-level factors are associated with racial equity in living donor kidney transplant (LDKT). OBJECTIVE: To evaluate center-level factors and racial equity in LDKT during an 11-year time period. DESIGN, SETTING, AND PAR ... Full text Link to item Cite

Residential Structural Racism and Prevalence of Chronic Health Conditions.

Journal Article JAMA network open · December 2023 ImportanceStudies elucidating determinants of residential neighborhood-level health inequities are needed.ObjectiveTo quantify associations of structural racism indicators with neighborhood prevalence of chronic kidney disease (CKD), diab ... Full text Cite

Association of Acute Kidney Injury and Cardiovascular Disease Following Percutaneous Coronary Intervention: Assessment of Interactions by Race, Diabetes, and Kidney Function.

Journal Article Am J Kidney Dis · June 2023 RATIONALE & OBJECTIVE: Black patients and those with diabetes or reduced kidney function experience a disproportionate burden of acute kidney injury (AKI) and cardiovascular events. However, whether these factors modify the association between AKI and card ... Full text Link to item Cite

A comparison of deprivation indices and application to transplant populations.

Journal Article Am J Transplant · March 2023 The choice of deprivation index can influence conclusions drawn regarding the extent of deprivation within a community and the identification of the most deprived communities in the United States. This study aimed to determine the degree of correlation amo ... Full text Link to item Cite

Supermarket Proximity and Risk of Hypertension, Diabetes, and CKD: A Retrospective Cohort Study.

Journal Article Am J Kidney Dis · February 2023 RATIONALE & OBJECTIVE: Living in environments with low access to food may increase the risk of chronic diseases. We investigated the association of household distance to the nearest supermarket (as a measure of food access) with the incidence of hypertensi ... Full text Link to item Cite

Association of Perceived Neighborhood Health With Hypertension Self-care.

Journal Article JAMA Netw Open · February 1, 2023 IMPORTANCE: Hypertension self-management is recommended for optimal blood pressure (BP) control, but self-identified residential contextual factors that hinder hypertension self-care are understudied. OBJECTIVE: To quantify perceived neighborhood health an ... Full text Link to item Cite

Association of the Affordable Care Act on Access to and Outcomes After Kidney or Liver Transplant: A Transplant Registry Study.

Journal Article Transplant Proc · 2023 BACKGROUND: To evaluate the effect of the Affordable Care Act (ACA) Medicaid expansion on payor mix among patients on the kidney and liver transplant waiting list as well as waiting list and post-transplant outcomes. DESIGN: Using the Scientific Registry o ... Full text Link to item Cite

Use of Race in Kidney Function Estimation: Lessons Learned and the Path Toward Health Justice.

Journal Article Annual review of medicine · January 2023 In 2020, the nephrology community formally interrogated long-standing race-based clinical algorithms used in the field, including the kidney function estimation equations. A comprehensive understanding of the history of kidney function estimation and racia ... Full text Cite

PATTERNS OF 'HIGH-POTENCY LOW-COST' NSAID ANALGESIC POWDER PURCHASING IN THE US

Conference AMERICAN JOURNAL OF KIDNEY DISEASES · 2023 Cite

Primary Care Clinician Perspectives on APOL1 Testing for Kidney Diseases

Conference JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY · 2023 Cite

Association between Gentrification and Health and Healthcare Utilization.

Journal Article J Urban Health · December 2022 There is tremendous interest in understanding how neighborhoods impact health by linking extant social and environmental drivers of health (SDOH) data with electronic health record (EHR) data. Studies quantifying such associations often use static neighbor ... Full text Link to item Cite

Receipt and Sharing of Information to Improve Knowledge About Living Donor Kidney Transplant among Transplant Candidates with Advanced Chronic Kidney Disease.

Journal Article Prog Transplant · September 2022 Introduction: Knowledge about living donor kidney transplant (LDKT) is associated with greater access. Yet, little is known about factors associated with high living donor transplant knowledge. Research Questions: Is receipt of LDKT information from health ... Full text Link to item Cite

Decisional Conflict About Kidney Failure Treatment Modalities Among Adults With Advanced CKD.

Journal Article Kidney medicine · September 2022 Rationale & objectiveChoosing from multiple kidney failure treatment modalities can create decisional conflict, but little is known about this experience before decision implementation. We explored decisional conflict about treatment for kidney fa ... Full text Cite

What Do Acute Kidney Injury Survivors Want to Know About Their Condition: A Qualitative Study.

Journal Article Kidney medicine · April 2022 Rationale & objectiveAcute kidney injury (AKI) in the hospital often occurs with other serious illnesses that take medical priority. Despite a persistent risk of adverse outcomes following hospital discharge, AKI survivors often receive inadequate ... Full text Cite

Abstract EP66: Racial Differences In The Use Of Over-the-counter Non-steroidal Anti-inflammatory Drugs Among Individuals At Risk Of Adverse Cardiovascular Events

Journal Article Circulation · March 2022 Introduction: Over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used despite conferring risk for adverse cardiovascular events (ACEs). ACEs disproportionately affect B ... Full text Cite

Use of Race in Kidney Research and Medicine: Concepts, Principles, and Practice.

Journal Article Clinical journal of the American Society of Nephrology : CJASN · February 2022 Black Americans and other racially and ethnically minoritized individuals are disproportionately burdened by higher morbidity and mortality from kidney disease when compared with their White peers. Yet, kidney researchers and clinicians have struggled to f ... Full text Cite

Staying on track to achieve racial justice in kidney care.

Journal Article Nat Rev Nephrol · February 2022 The dramatic increase in advocacy and scholarly work on the impact of structural racism on health inequities that began in 2020 has been sustained in the past year. In response to the call for action on these issues, the nephrology community has developed ... Full text Link to item Cite

Disparities in Discussions about Kidney Replacement Therapy in CKD Care.

Journal Article Kidney360 · January 2022 Participants who identified as female and Black reported more thorough discussions of dialysis than transplant.Participants with low incomes and education reported more thorough discussions of dialysis than transplant. ... Full text Cite

METFORMIN ASSOCIATED LACTIC ACIDOSIS

Conference AMERICAN JOURNAL OF KIDNEY DISEASES · 2022 Cite

A Cascade of Structural Barriers Contributing to Racial Kidney Transplant Inequities.

Journal Article Advances in chronic kidney disease · November 2021 Stark racial disparities in access to and receipt of kidney transplantation, especially living donor and pre-emptive transplantation, have persisted despite decades of investigation and intervention. The causes of these disparities are complex, are inter-r ... Full text Cite

Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review.

Journal Article Kidney360 · September 30, 2021 Due to age and impaired kidney function, older adults with kidney disease are at increased risk of medication-related problems and related hospitalizations. One proa ctive approach to minimize this risk is deprescribing. Deprescribing refers to the systema ... Full text Link to item Cite

Transplant social worker and donor financial assistance to increase living donor kidney transplants among African Americans: The TALKS Study, a randomized comparative effectiveness trial.

Journal Article Am J Transplant · June 2021 Lack of donors hinders living donor kidney transplantation (LDKT) for African Americans. We studied the effectiveness of a transplant social worker intervention (TALK SWI) alone or paired with living donor financial assistance to activate African Americans ... Full text Link to item Cite

Racism and Kidney Health: Turning Equity Into a Reality.

Journal Article Am J Kidney Dis · June 2021 Kidney disease continues to manifest stark racial inequities in the United States, revealing the entrenchment of racism and bias within multiple facets of society, including in our institutions, practices, norms, and beliefs. In this perspective, we synthe ... Full text Link to item Cite

African Americans' discussions about living-donor kidney transplants with family or friends: Who, what, and why not?

Journal Article Clin Transplant · April 2021 BACKGROUND: Although discussions with family or friends can improve access to living-donor kidney transplantation (LDKT), they remain an understudied step in the LDKT process. METHODS: Among 300 African American transplant candidates, we examined how socio ... Full text Link to item Cite

Resident Physician Experiences With and Responses to Biased Patients.

Journal Article JAMA Netw Open · November 2, 2020 IMPORTANCE: Biased patient behavior negatively impacts resident well-being. Data on the prevalence and frequency of these encounters are lacking and are needed to guide the creation of institutional trainings and policies to support trainees. OBJECTIVE: To ... Full text Link to item Cite

Fragmentation of care as a barrier to optimal ESKD management.

Journal Article Semin Dial · November 2020 Caring for patients with end-stage kidney disease (ESKD) in the United States is challenging, due in part to the complex epidemiology of the disease's progression as well as the ways in which care is delivered. As CKD progresses toward ESKD, the number of ... Full text Link to item Cite

The Nephrology Immersion Classroom for Internal Medicine Residents.

Journal Article Kidney360 · October 29, 2020 BACKGROUND: In graduate medical education (GME), there are many barriers to achieving a personalized learning process with standardized learning outcomes. One way to support this is through mobile-friendly digital blackboard videos. We sought to measure th ... Full text Link to item Cite

Risk for Nephrogenic Systemic Fibrosis After Exposure to Newer Gadolinium Agents: A Systematic Review.

Journal Article Ann Intern Med · July 21, 2020 BACKGROUND: The risk for nephrogenic systemic fibrosis (NSF) after exposure to newer versus older gadolinium-based contrast agents (GBCAs) remains unclear. PURPOSE: To synthesize evidence about NSF risk with newer versus older GBCAs across the spectrum of ... Full text Link to item Cite

Life Course Socioeconomic Status, Allostatic Load, and Kidney Health in Black Americans.

Journal Article Clin J Am Soc Nephrol · March 6, 2020 BACKGROUND AND OBJECTIVES: Low socioeconomic status confers unfavorable health, but the degree and mechanisms by which life course socioeconomic status affects kidney health is unclear. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined the associa ... Full text Link to item Cite

Associations of perceived information adequacy and knowledge with pursuit of live donor kidney transplants and living donor inquiries among African American transplant candidates.

Journal Article Clin Transplant · March 2020 We studied associations between perceived adequacy of live donor kidney transplant (LDKT) information or knowledge with pursuit of LDKT or receipt of live donor inquiries among 300 African American kidney transplant candidates. Participants reported via qu ... Full text Link to item Cite

Trust in American Medicine: A Call to Action for Health Care Professionals.

Journal Article Hastings Cent Rep · January 2020 Medical mistrust has a well-documented harmful impact on a range of patients' health behaviors and outcomes. It can have such egregious downstream effects on so many aspects of medicine-from clinical trial participation to health care use, timely screening ... Full text Link to item Cite

When Words Are All We Have.

Journal Article J Palliat Med · October 2019 Full text Link to item Cite

Hypovolemic Hyponatremia.

Journal Article Front Horm Res · 2019 The etiology of hyponatremia is often multifactorial. The most common causes include hypovolemia from gastrointestinal (GI) or other fluid losses, thiazide diuretics, and SIAD [1]. In this chapter, we will discuss hypovolemic ... Full text Link to item Cite

Medical Mistrust, Racism, and Delays in Preventive Health Screening Among African-American Men.

Journal Article Behav Med · 2019 The contribution of medical mistrust to healthcare utilization delays has gained increased public health attention. However, few studies examine these associations among African-American men, who delay preventive healthcare more often and report higher lev ... Full text Link to item Cite

What Unites Us in Death.

Journal Article J Palliat Med · June 2016 Full text Link to item Cite

CKD of Uncertain Etiology: A Systematic Review.

Journal Article Clin J Am Soc Nephrol · March 7, 2016 BACKGROUND AND OBJECTIVES: Epidemics of CKD of uncertain etiology (CKDu) are emerging around the world. Highlighting common risk factors for CKD of uncertain etiology across various regions and populations may be important for health policy and public heal ... Full text Link to item Cite

Tools to Promote Shared Decision Making in Serious Illness: A Systematic Review.

Journal Article JAMA internal medicine · July 2015 ImportanceSerious illness impairs function and threatens survival. Patients facing serious illness value shared decision making, yet few decision aids address the needs of this population.ObjectiveTo perform a systematic review of evidenc ... Full text Cite

Systematic Review of Decision Aids for the Seriously Ill

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · March 1, 2014 Link to item Cite

Primary care vs. Specialization

Chapter · September 27, 2012 In light of the need to keep students, researchers, and other interested readers informed and up-to-date on the issues surrounding health care in the U.S., this volume uses introductory essays followed by point/counterpoint articles to ... ... Cite

Determinants of usual source of care disparities among African American and Caribbean Black men: findings from the National Survey of American Life.

Journal Article J Health Care Poor Underserved · February 2011 PURPOSE: The Aday-Andersen model was used as a framework for investigating the contribution of immigration status (i.e., nativity and acculturation), socioeconomic factors, health care access, health status, and health insurance to usual source of health c ... Full text Link to item Cite

Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men.

Journal Article J Gen Intern Med · December 2010 BACKGROUND: The contribution of masculinity to men's healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently ... Full text Link to item Cite