Laura M Dember
VerifiedUniversity of Pennsylvania · Rehabilitation Medicine
Active 1986–2026
About
Laura M Dember, MD, is a Professor of Medicine in the Renal-Electrolyte and Hypertension division at the Hospital of the University of Pennsylvania and a faculty member at the Perelman School of Medicine. She serves as the Director of the Clinical Research Certificate Program at the Center for Clinical Epidemiology and Biostatistics. Dr. Dember has over 25 years of experience as a general nephrologist and is recognized internationally for her expertise in systemic amyloidoses, a group of rare disorders that often affect the kidneys. She has been involved in developing novel treatments for AL and AA amyloidosis and is part of the multidisciplinary amyloidosis program at the University of Pennsylvania, which evaluates and treats patients with various types of amyloidosis and paraprotein disorders.
Research topics
- Internal medicine
- Medicine
- Radiology
- Cardiology
- Surgery
- Pathology
- Intensive care medicine
Selected publications
Repository@Nottingham (University of Nottingham) · 2026-04-07
articleOpen accessChronic Kidney Disease Severity and Risk of Cognitive Impairment
JAMA Network Open · 2026-02-17 · 1 citations
articleOpen accessImportance: Associations between chronic kidney disease (CKD) severity and incident cognitive impairment have not been evaluated in a cohort of patients with CKD. Objective: To investigate associations between CKD severity, based on the estimated glomerular filtration rate (eGFR) and urinary protein to creatinine ratio (UPCR), and incident cognitive impairment in a cohort of patients with CKD. Design, Setting, and Participants: This cohort study investigated 5607 participants with CKD from the ongoing Chronic Renal Insufficiency Cohort (CRIC) Study who were enrolled between 2003 to 2008 and 2013 to 2015. Statistical analysis was conducted from August 2024 to December 2025. Exposure: Estimated glomerular filtration rate and UPCR. Main Outcomes and Measures: Global cognition and domains of verbal memory and delayed recall, attention and processing speed, and executive function were evaluated using the Modified Mini-Mental Status Examination, Buschke Selective Reminding test, and Trail Making Tests A and B, respectively. For each test, impairment was defined as a score at least 1 SD worse than the baseline cohort mean. After those with cognitive impairment at baseline were excluded, Cox proportional hazards regression models tested associations of baseline eGFR and UPCR, individually and together, with time to cognitive impairment after adjusting for demographic, lifestyle, and clinical risk factors. Results: The 5607 CRIC participants included 3159 men (56.3%), the mean (SD) cohort age was 59.6 (10.8) years at baseline, and the median follow-up was 6 years (range, 0.5-16 years) for the Modified Mini-Mental State Examination, 4 years (range, 0.5-13 years) for the Buschke Selective Reminding Test, and 4 years (range, 0.5-13 years) for Trail Making Tests A and B. In multivariable-adjusted analyses, each 1 SD higher log-transformed UPCR was associated with 21% increased risk of impairments in attention and processing speed (hazard ratio [HR], 1.21; 95% CI, 1.05-1.41; P = .01) and 16% increased risk of impairment in executive function (HR, 1.16; 95% CI, 1.02-1.31; P = .02). Each 1 SD lower eGFR was associated with 21% increased risk of impairment in attention and processing speed (HR, 1.21; 95% CI, 1.05-1.38; P = .006). Findings for UPCR remained nominally significant after further adjustment for eGFR, while eGFR findings were attenuated on adjustment for UPCR. Patients with a combined eGFR less than 60 mL/min/1.73 m2 and UPCR of 150 mg/g or more had a significant 38% increased risk of impairment in global cognition (HR, 1.38; 95% CI, 1.05-1.82; P = .003) compared with those with an eGFR of 60 mL/min/1.74 m2 or more and UPCR less than 150 mg/g. Conclusions and Relevance: This cohort study of patients with CKD suggests that a more advanced CKD stage was associated with increased incidence of cognitive impairment. These findings underscore CKD severity as a risk factor for cognitive decline across the CKD spectrum.
Kidney International Reports · 2026-03-25
articleOpen accessAmerican Journal of Kidney Diseases · 2026-01-15 · 1 citations
articleOpen accessKidney International Reports · 2026-04-16
articleOpen accessProspective cohort studies are important for understanding epidemiology, associations and incidence of adverse outcomes of long-term conditions, including chronic kidney disease (CKD). Here, we draw on the combined expertise of the leaders of cohort studies within the International Society of Nephrology’s International Network of CKD Cohorts (iNET-CKD) to provide insights into the design and conduct of prospective cohort studies in people with CKD. Formulating research questions that will remain relevant years after the cohort launch, when data will be available, is the first, and perhaps most challenging step of the study design. These questions will inform participant selection, sample size, duration of follow-up, outcome definitions and frequency of encounters and data collection. Consideration should be given to the data elements to be collected, balancing burden with data value. At least one marker of glomerular filtration rate (preferably both serum creatinine and cystatin C concentrations) and a measure of proteinuria (preferably urine albumin to creatinine ratio) are essential. Standard operating procedures should be developed for all assessments and for biosample collection and storage. Robust governance arrangements should be established to ensure effective management and sustainability of these complex projects, along with sufficient funding for the proposed study duration. Facilitating future collaboration with other cohort studies should be born in mind, in order to expand scientific output. This includes adoption of standard definitions and assessments, and making provisions for sharing of data and biosamples. A clear communication strategy that includes all stakeholders is essential to ensure maximum clinical impact.
Utrecht University Repository (Utrecht University) · 2026-01-01
articleBackground: Urinary albumin–creatinine ratio (UACR) and urinary protein–creatinine ratio (UPCR) are both used in clinical practice to diagnose and monitor chronic kidney disease (CKD). Which measure exhibits stronger associations with clinical outcomes and whether this varies by patient characteristics are unknown. Objective: To assess and compare the performance of UACR and UPCR across CKD-related clinical outcomes. Design: Individual patient–level meta-analysis. Setting: 38 research and clinical cohorts. Participants: 148 994 participants with same-day measurements of UACR and UPCR. Measurements: We quantified the associations of UACR and UPCR with subsequent clinical outcomes, including kidney failure and cardiovascular events, using Cox proportional hazards regression. Analyses were done in each cohort, followed by random-effects meta-analysis. Subgroups included those based on severity of proteinuria, type 2 diabetes, estimated glomerular filtration rate (eGFR) less than 60 mL/min/ 1.73 m2, and glomerular disease. Results: There were 148 994 participants and 9773 kidney failure events during a median of 3.8 years of follow-up. Higher UACR and UPCR both had a log-linear association with increased risk for kidney failure. The association with kidney failure was somewhat stronger for UACR (adjusted hazard ratio [HR] per SD increment, 2.55 [95% CI, 2.36 to 2.74]) than UPCR (HR, 2.40 [CI, 2.28 to 2.53]; P for comparison <0.001). Results were consistent to slightly stronger in subgroups with UACR greater than 30 mg/g, UPCR greater than 500 mg/g, eGFR less than 60 mL/min/1.73 m2, diabetes, and glomerular disease. Associations between UACR and UPCR were generally similar for cardiovascular outcomes but favored UACR in subgroups with moderately to severely elevated UACR. Limitation: Assessment of UACR and UPCR in spot urine samples. Conclusion: Overall, UACR was more strongly associated with kidney failure than UPCR (particularly in subgroups with higher UACR), supporting the use of UACR rather than UPCR to diagnose and risk-stratify patients. Primary Funding Source: National Kidney Foundation and National Institute of Diabetes and Digestive and Kidney Diseases.
Kidney Medicine · 2026-01-30
articleOpen access<h2>Abstract</h2><h3>Rationale & Objective</h3> Quantifying the change in proteinuria after acute kidney injury (AKI) may shed light on the pathway through which AKI contributes to kidney disease progression. <h3>Study Design</h3> Prospective cohort study of patients with chronic kidney disease (CKD) <h3>Settings & Participants</h3> 3,197 participants who were enrolled in the multicenter, prospective Chronic Renal Insufficiency Cohort (CRIC) between 7/1/2013 and 12/1/2021 <h3>Exposure</h3> AKI was defined as ≥1.5 peak to nadir inpatient serum creatinine (SCr) ascertained during a hospital admission <h3>Outcome(s)</h3> Natural log-transformed urine protein to creatinine ratio (uPCR) ascertained at annual CRIC research study visits <h3>Analytical Approach</h3> Mixed effects regression <h3>Results</h3> Among 3,197 participants, the mean age was 65 years, 44% were female, and 42% self-identified as non-Hispanic Black. The median baseline estimated glomerular filtration rate (eGFR) was 52 mL/min/1.73m<sup>2</sup> and uPCR was 0.14 g/g. 560 patients experienced 861 episodes of AKI over a median of 6 years with most being stage 1 (68%). In the multivariable model that adjusted for blood pressure and renin angiotensin system inhibitor (RASi) use, each AKI episode was associated with a 3% increase in uPCR (relative change ratio of 1.03, [95% CI 1.01-1.05, p<0.01). <h3>Limitations</h3> Hospitalized AKI with baseline CKD only, predominance of stage 1 AKI, timing of proteinuria collection was limited to annual visits, residual confounding <h3>Conclusions</h3> Among CKD patients, AKI was independently associated with worsening proteinuria (independent of changes in blood pressure or RASi use) and may reflect residual structural damage to the kidneys. However, the increase in proteinuria among patients with CKD after AKI was small.
Kidney Medicine · 2026-04-03
articleOpen accessRationale & Objective: Patients with chronic kidney disease (CKD) have an increased risk of peripheral artery disease (PAD), yet no PAD risk-prediction models currently exist for this population. We developed and internally validated 5-year PAD risk-prediction models for individuals with CKD. Study Design: Prospective cohort study. Setting & Participants: 3,076 patients with CKD without PAD from the Chronic Renal Insufficiency Cohort (CRIC) study. Exposure: Clinically available variables, ankle-brachial index (ABI), and non-routinely measured cardiovascular disease biomarkers assessed at baseline. Outcomes: New-onset adjudicated clinical PAD event or an ABI ≤0.9 at an annual follow-up visit. Analytical Approach: Cox proportional hazards models were applied to estimate 5-year risk of incident PAD from baseline. Model performance was assessed by discrimination, calibration, and net reclassification improvement. All models were internally validated using Monte Carlo cross-validation. Results: <0.001). The biomarker-enhanced model achieved an AUC of 0.724 (95% CI, 0.711-0.745), which was not significantly different from the clinical model with ABI. Both the clinical model with ABI and the biomarker-enhanced model were well calibrated and improved reclassification of non-events compared with the ABI model (19.7%; 95% CI, 17.5-22.0% and 22.2%; 95% CI, 19.8-24.5%, respectively). Limitations: Lack of external validation. Conclusions: A PAD risk prediction model that combines clinical variables with ABI improves the identification of patients with CKD at high risk for PAD better than ABI alone.
British Journal of Clinical Pharmacology · 2026-05-03
articleOpen accessAIM: A prior non-randomized study suggests that potassium supplementation may improve survival among furosemide initiators, and a randomized trial suggests that salt substitutes containing potassium might lower stroke risk. We conducted a retrospective cohort study using health-care data to confirm or refute these associations among new users of furosemide. METHODS: The exposure of interest was empiric potassium dispensing (yes/no) concurrent with furosemide initiation. Outcomes were all-cause mortality, sudden cardiac arrest/ventricular arrhythmia (SCA/VA), and stroke. Primary as-started and secondary as-treated analyses were performed with Cox proportional hazards regression. We used inverse probability of treatment weighting (IPTW) to control for confounding, with weights calculated from high-dimensional propensity scores. RESULTS: We identified 511 462 and 320 703 initiators of furosemide <40 and ≥40 mg/day with 21.5% and 35.3%, respectively, starting empiric potassium supplementation. In initiators of furosemide <40 mg/day with (vs. without) empiric potassium, as-started IPTW-hazard ratios (HRs) were 1.02 (95%CI 1.01-1.04) for death, 1.00 (0.94-1.04) for SCA/VA, and 1.03 (1.00-1.06) for stroke. Similarly, in initiators of furosemide ≥40 mg/day with (vs. without) empiric potassium, as-started IPTW-HRs were 1.02 (1.00-1.03) for death, 0.98 (0.94-1.03) for SCA/VA, and 1.01 (0.98-1.04) for stroke. CONCLUSION: We did not observe associations suggesting a clinically meaningful effect of empiric potassium supplementation among furosemide users. However, given the high prevalence of furosemide use among highly heterogeneous patient populations, a large pragmatic trial may be warranted to more definitively evaluate the potential benefits and harms of empiric potassium supplementation among furosemide initiators.
Patient Engagement in the Design and Conduct of the HOPE Trial
Clinical Journal of the American Society of Nephrology · 2025-08-18 · 5 citations
articleThe HOPE Consortium Trial to Reduce Pain and Opioid Use in Hemodialysis was a randomized, controlled trial funded by the National Institute of Diabetes and Digestive and Kidney Diseases. Patients on hemodialysis suffering from chronic pain were randomly assigned to receive usual care or a 12-week pain coping skills training program delivered remotely by trained coaches followed by 12 weeks of skills reinforcement via interactive voice response. Patient advisors participated in all stages of the study, including study design and development of recruitment materials. During the trial, patient advisors met monthly as an Advisory Board. In addition, patient advisors participated in all Steering Committee meetings, including in-person meetings and biweekly remote meetings. Patient advisors were represented on all study committees, with particularly extensive involvement in the Recruitment and Retention Committee. Patient advisors made important contributions to study design and conduct. Their involvement was critical to the study's successful enrollment and retention of study participants. Patient advisors characterized their involvement positively. They attributed their satisfaction with the experience to their full integration into in all aspects of the study and their treatment as equal partners. Several patient advisors have subsequently taken on other research, patient advocacy, or leadership roles, facilitated in part through their participation in the HOPE Trial. This study details the ways patient advisors were enlisted and decided to participate; outlines their many contributions; describes their experience; and provides guidance on how researchers can successfully incorporate patient advisors into future studies.
Recent grants
Pragmatic Trials in Maintenance Hemodialysis
NIH · $1.4M · 2012–2017
NIH · $851k · 2013
NIH · $2.4M · 2016
Pragmatic Trials in Maintenance Hemodialysis
NIH · $4.5M · 2012–2020
NIH · $5.2M · 2022
Frequent coauthors
- 95 shared
Miguel A. Vazquez
Hospital General Universitario Gregorio Marañón
- 94 shared
Susan S. Huang
London Health Sciences Centre
- 93 shared
Gloria D. Coronado
- 93 shared
Edward Septimus
Memorial Hermann
- 92 shared
Lynn DeBar
Kaiser Permanente Center for Health Research
- 92 shared
Vincent Mor
Providence College
- 91 shared
Adrian F. Hernandez
Clinical Research Institute
- 91 shared
Jeffrey G. Jarvik
Education
- 1988
M.D.
Yale School of Medicine
- 1984
B.A.
Yale College
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