About

Dr. Rula Abdulrahman, MD is a board-certified nephrologist dedicated to providing comprehensive kidney care with a strong focus on patient education and empowerment. She earned her medical degree from the University of Baghdad, Iraq, completed her Internal Medicine residency at St. John’s Episcopal Hospital, NY, where she served as Chief Resident during her training. Dr. Abdulrahman pursued her Nephrology Fellowship at UT Southwestern Medical Center, TX, where she developed a strong interest in chronic kidney disease management and home dialysis therapies. She joined Stony Brook Medicine in 2019, where she has been actively involved in advancing patient-centered kidney care. Her clinical and academic interests include chronic kidney disease (CKD), home dialysis modalities, and patient education. She has played a key role in developing home dialysis education within the nephrology fellowship curriculum and has been a strong advocate for empowering patients to actively participate in their care. In 2021, she was appointed Medical Director of the Stony Brook Kidney Center. Dr. Abdulrahman sees patients at the Nephrology Clinics in East Setauket and Commack, providing care across all aspects of nephrology, with particular expertise in CKD management and home dialysis options.

Research topics

• Internal medicine
• Medicine
• Intensive care medicine
• Psychiatry
• Pediatrics
• Endocrinology
• Urology
• Gastroenterology
• Chemistry

Selected publications

• Paraneoplastic Minimal Change Disease Revealing an Underlying High-Grade Neuroendocrine Carcinoma: A Case Report

  Journal of the American Society of Nephrology · 2025-10-01

  articleSenior author

  Introduction: Paraneoplastic syndromes are clinical manifestations resulting from malignancy-associated factors such as cytokines, hormones, and tumor antigens. Among these, paraneoplastic glomerulopathies represent a significant yet under-recognized group, commonly presenting with nephrotic syndrome. The actual incidence of paraneoplastic nephropathy is likely underestimated. Early recognition is vital, as nephrotic syndrome can precede the diagnosis of an underlying malignancy and prompt earlier oncologic evaluation. Here we present a case of podocytopathy secondary to a neuroendocrine tumor. Case Description: A 68-year-old male with HIV in remission, Hepatitis C treated with Harvoni, hyperlipidemia, CAD, and CKD presented with hypertensive urgency and AKI. BP was 174/81 mmHg; creatinine 6.35 mg/dL (baseline ~1.6–1.8); albumin 3.0 g/dL. A 24-hour urine collection showed 6.6 g of protein. Serologies were positive for Hepatitis C and ANA (1:320). Serum immunofixation revealed faint IgM-lambda restriction. CT chest and PET scan showed abnormal mediastinal lymphadenopathy (MLN). Urine toxicology was positive for cocaine, methadone, and opiates. Renal biopsy showed changes of acute tubular injury/necrosis and negative Congo red staining for amyloid. Electron microscopy identified moderate foot process effacement (~40-50%). The extent of effacement was unconvincing for a primary podocytopathy, more likely secondary forms of podocyte injury. The patient was started on dialysis, lung biopsy done with findings consistent with a high grade small cell type neuroendocrine carcinoma. Patient is planned to initiate treatment. Discussion: Paraneoplastic glomerulopathies are clinically significant but often under-recognized. Minimal change disease (MCD), though classically linked to Hodgkin lymphoma, is increasingly associated with solid tumors. Unlike primary MCD, secondary forms may show partial or atypical foot process effacement on electron microscopy. Recognizing this distinction is crucial to its therapeutic implications: remission of nephrotic syndrome has been observed following successful treatment of the underlying condition. In this case, nephrotic syndrome with abnormal MLN and remission of HIV and hepatitis B raised concern for malignancy, prompting a lung mass biopsy that confirmed the diagnosis.

  PublisherDOI

• An Unusual Case of Vaginal Dialysate Leak After Peritonitis in a Patient on Peritoneal Dialysis (PD)

  Journal of the American Society of Nephrology · 2025-10-01 · 1 citations

  article1st authorCorresponding

  Introduction: Patients undergoing peritoneal dialysis (PD) are at increased risk of hernia formation and dialysate leakage due to elevated intraperitoneal pressure. Vaginal leakage of peritoneal dialysate is a rare but recognized complication. In this report, we present a case of vaginal dialysate leakage secondary to peritoneal adhesions and catheter positioning near the left fallopian tube, following an episode of peritonitis. Case Description: 28 year old female with SLE, ESRD on PD for 5 years presented with abdominal pain while being treated for peritonitis for the past 2 weeks. She was unable to perform PD due to pain. Effluent cell count was checked upon presentation and persistent peritonitis was roled out. Central venous catheter was placed and initiated on hemodialysis. Upon trial to flash PD catheter a few days later, fluid was seen coming out of her vagina and wetting her clothes. Abdominal image was obtained after injecting Tc-99m sulfur colloid through PD catheter, the injected material remained confined to the left lower quadrant of the abdomen/the left upper pelvis, findings favor a loculated fluid collection in the left lower quadrant of the abdomen/upper pelvis, and adhesion around the PD catheter. No vaginal fistula noted. PD catheter was removed and the patient continued on hemodialysis. Discussion: Vaginal fluid leakage during peritoneal dialysis (PD) is a complex and uncommon complication. Most cases are associated with peritoneo-vaginal fistulas and/or follow episodes of bacterial peritonitis. In our case, the leak occurred during flushing of the PD catheter, which was performed twice. Initially, a vaginal fistula was suspected; however, abdominal imaging revealed fluid collection and adhesions localized to the left pelvic region. These findings suggest that the leak may have occurred via the fallopian tubes, rather than through a fistulous tract. No evidence of a fistula was seen on abdominal peritoneography. This serious complication developed following an episode of peritonitis. It has been documented that dialysate can leak into the vagina as a rare PD complication, sometimes resulting from fallopian tube capture of the catheter tip. It is crucial to differentiate between this mechanism and a true peritoneo-vaginal fistula, the latter often necessitating laparotomy for tract debridement and surgical repair

  PublisherDOI

• Estimating the Amount of Glucose Absorbed in Patients on Peritoneal Dialysis (PD) and Evaluating Its Influence on Serum Lipids and Glucose

  Journal of the American Society of Nephrology · 2025-10-01

  article1st authorCorresponding

  Background: Glycemic control is a predictor of cardiovascular complications, PD patients use dialysis solutions that contain high concentrations of glucose (g) daily. Glucose absorbtion (GA) in PD patients may contribute to adverse metabolic effects. In this study, we utilized data from the peritoneal equilibration test (PET) to estimate GA. We assessed glycemic control and lipid profiles at the initiation of PD and again after a minimum of 6 months & we Analyzed the association between the degree of GA & the characteristics of peritoneal membrane transport. Methods: we reviewed 10 pateints, from PET we extracted the D/D0 values corresponding to the dwell time specified in each patient’s PD prescription. The g amount for each dialysis cycle was calculated using the initial g concentration D0. The estimated GA in each cycle was calculated by multiplying the initial g by (1 - D/D0). This value was then multiplied by the number of cycles to obtain the total estimated GA per day.The amount of GA from last fill calculated using the 4-hour D/D0 value from the PET we collected data on HbA1c, LDL, TG at the initiation of dialysis and at least 6 months thereafter. Information regarding the use of glucose-lowering and lipid-lowering medications was obtained, We obtained data from PET test to assess the relation between the amount of GA and the membrane transport character Results: see image Conclusion: Estimated GA did not exceed 115 grams per day, with an average of 78 grams. The majority of patients did not require adjustments to their glucose-lowering medications. no significant changes in HbA1C or lipid profiles noted.The highest amount of GA at 2 hours from PET was among the high and high average transporters. few labs are not avialable as this is a chart review study.larger studies are needed to confirm these findings

  PublisherDOI

• A Matter of Fluid: Managing a Rare Case of Diabetes Insipidus and Multiple Sclerosis-Driven Hypernatremia

  Journal of the American Society of Nephrology · 2024

  Senior authorCorresponding
  • Medicine
  • Pediatrics
  • Endocrinology
  PublisherDOI

• Unique Case of Hemosiderosis-Induced Ascites in Kidney Transplant Recipient

  Journal of the American Society of Nephrology · 2024

  • Medicine
  • Urology
  • Internal medicine

  Introduction: Iron overload or hemosiderosis is often a frequent complication from intermittent blood transfusions. Anemia of end stage kidney disease (ESKD) is managed with IV iron and erythropoietin stimulating agents (ESAs) and these patients are at risk of iron overload, especially those with increased dialysis vintage. Here we describe a unique case of recurrent ascites caused by secondary hemosiderosis in a kidney transplant recipient who was on Peritoneal Dialysis (PD) for 12 years. Case Description: A 61-year-old female with ESKD secondary to presumed Hypertension underwent 2nd deceased donor renal transplant(DDRT) in 2023. She was on PD from 2011 to 2023. She required 8 units of PRBC’s peri-operatively. Nadir creatinine 0.77 mg/dl. Post-transplant course complicated with COVID PNA, transplant renal artery stenosis requiring stent placement. She developed ascites three months post-transplant requiring frequent large volume paracentesis which was contributed to hepatic congestion in setting of heart failure with preserved ejection fraction (HFpEF). Seven months post-transplant she developed AKI in setting of E.coli bacteremia, CMV viremia and a transplant renal biopsy was performed showing focal endothelialitis, suggesting T cell mediated rejection, CMV nephritis and renal hemosiderosis and about 40% IFTA. Labs also showed iron levels of 15, Ferritin of 1400, TSAT 27%, AST/ALT normal, with elevated ALP 130. MRI liver was done which showed mild diffuse gain of signal in liver and spleen. A liver Biopsy was also performed which showed nodular regenerative hyperplasia and 1-2+ iron staining in Kupffer’s cells + hepatocytes and no evidence of fibrosis. Given liver biopsy findings and multiple transfusion history, it can be hypothesized that recurrent ascites was likely to secondary hemosiderosis rather than HFpEF. Patient’s AKI recovered with treatment of underlying infection. Of recent, she has not required paracentesis. Discussion: Here we describe an interesting case of a transplant patient with high dialysis vintage who developed recurrent ascites due to renal hemosiderosis. It is possible that long term IV iron exposure and multiple transfusions immediately post-transplant lead to secondary hemosiderosis. Long term PD could be contributing to development of ascites as well.

  PublisherDOI

• Predictability of GFR with Cystatin C: A Case Report

  Journal of the American Society of Nephrology · 2023-11-01

  articleSenior author
  PublisherDOI

• The Role of Patients' Education in Improving Quality Outcomes in CKD

  Journal of the American Society of Nephrology · 2023

  1st authorCorresponding
  • Medicine
  • Intensive care medicine
  • Internal medicine

  Background: CKD prevalence in US is ˜ 14%. The measures to delay CKD progression are well known to providers but not to most patients with CKD, specifically minorities and patients in the lower socioeconomic class. Providing intense CKD education can improve quality outcome in this population and delays dialysis requirement. Home dialysis (HoD) therapies have been associated with improved quality of life and reduced costs, in US HoD percentage is ˜13%. Currently most patients start dialysis with central venous catheter (CVC) ˜ 83%in US, our goal is to increase HoD, efficiency of arteriovenous fistula (AVF) or arteriovenous graft (AVG) placement, and to increase referrals and listing for kidney transplantations (KT), as suggested in ESRD treatment choice model. Methods: We initiated a CKD education clinic (CKDEC) with 3 aims: delay the progression of CKD and onset of dialysis, increase the number of HoD, improve access and timely referral to KT. Individuals who attend the clinic will be educated to avoid the factors and behaviors that can expedite CKD progression and dialysis initiation. Patients will be provided with guidance about controlling underlying medical diseases and introduced to ESRD treatment modalities. We also facilitate their access to obtain permanent access in a timely manner. We are educating the patients about KT and facilitate the appointments & encourage follow up. Results: 209 patients that are CKD IV and V at our outpatient facility & 25 dialysis. Of those, who chose HoD after CKDEC are 14.3%. This is higher than the national rate of 13%. CKDEC improved referral rate to KT and vascular access (Table 1). Many of our patients who started dialysis in 2021-2022 used CVC (71%) after CKDEC, this is lower than the national CVC rate (83%) image 1 Table 1 - CKDEC transplant referral CKDEC access referral NE transplant referral NE access referral CKD IV 42.8% 23.8% 2.8% 2.2% CKD V 71.4% 92.8% 61.3% 67.7% CKDEC: chronic kidney disease education clinic. NE: did not attend CKDEC Conclusions: CKD education improves HoD rate, referrals to KT and dialysis access among CKD but not ESRD group. we need to continue earlier access to CKD education clinic to continue to improve our outcome measures.

  PublisherDOI

• Atypical Presentation of Renal Amyloidosis in a Patient with Plasma Cell Dyscrasia (PCD)

  Journal of the American Society of Nephrology · 2023-11-01

  articleSenior author

  Journal of the American Society of Nephrology 34(11S):p 474-475, November 2023. | DOI: 10.1681/ASN.20233411S1474d

  PublisherDOI

• A Case of Renal Amyloidosis (AD) Presented as Orthostatic Hypotension

  Journal of the American Society of Nephrology · 2022-11-01

  article1st authorCorresponding

  Introduction: Neurogenic hypotension can happen in the context of immunoglobulin light chain AD. The most serious feature is autonomic nervous system impairment, mainly characterized by severe refractory orthostatic hypotension. Amyloid deposition may be found in many organs and the patient can presents with cardiac, gastrointestinal, renal, and neurological symptoms, but rarely hypotension only. Here we describing a patient who presented with sever orthostatic hypotension, found to have renal AD. Case Description: 67 year old male with past medical history of type 2 diabetes, chronic kidney disease, coronary artery disease, colon cancer, and history of COVID-19 infection who presents to nephrology clinic after being referred by primary care provider for elevated Creatinine to 2.5 mg/dl (baseline around 1.2 mg/dl). on clinic visit found to have severe orthostatic hypotension. blood pressure (BP) supine 121/80 mmHg, heart rate (HR) 87 beat per minute (BPM) ; sitting 106/70 mmHg, HR-92 BPM; standing: 92/59 mmHg, HR-100 BPM, no other abnormalities on physical examination. and was admitted to the hospital for evaluation. upon admission to the hospital, pateint received IV fluid, found to have 11 gram protein on 24 hour urine collection laboratory work up showed positive ANA, immunofixation was positive for lambda chain. Fat pad biopsy without signs of AD. Bone marrow biopsy results were inconclusive. Renal biopsy was performed, findings consistent with AL AD. pateint to start treatment with hematology Discussion: The amyloidoses are a group of disorders in which soluble proteins deposit extracellularly in tissues as insoluble fibrils, causing organ dysfunction that is usually progressive. Renal amyloid is a major source of morbidity in affected individuals. When the kidney is involved, renal insufficiency is common, accounting for 47% of cases in a study. Proteinuria has been reported with full nephrotic syndrome in 25-68%. it usually progress to end stage renal disease if left untreated. in our case we are describing an unusual presentation of renal AD, in which the symptoms were orthostatic hypotension. renal function was below baseline but was improving with volume replacement, pateint was felt to have prerenal acute kidney injury. the significant amount of proteinuria prompted further testing. We feel that nephrotic syndrome from amyloid should be considered when patient presented with orthostatic hypotension.

  PublisherDOI

• Unusual Pathogen Causing Peritonitis in a Peritoneal Dialysis (PD) Patient

  Journal of the American Society of Nephrology · 2021-10-01

  article1st authorCorresponding

  Introduction: Pantoea species causes infection in humans and are pathogenic to plants. Pantoea agglomerans are mostly isolated from human and was reported to cause peritonitis. We are describing a case of peritonitis in a PD patient, caused by Pantoea Calida (PC) and Pantoea Gaviniae (PG). There are few case reports about it causing bacteremia, meningitis infection in human but not peritonitis. Case Description: 44 years old man on continuous cycling PD, has history of cardiomyopathy, was found to have cloudy effluent and was complaining of abdominal pain, nausea and diarrhea. Vitals signs: temperature 38 C, BP 126/80, PR 91. on exam: generalized abdominal tenderness. Effluent fluid analysis cell counts of 3408/μl. With 80% polymorph neutrophils. patient was prescribed intravenous antibiotics vancomycin and cefepime, then started on continuous cefepime intraperitoneal the next day, while effuent culture was pending. On day 5 patient was feeling better and the cell count dropped to 1996/μl, so was discharged home, Cefipime was continued intraperitoneally. 2 days after discharge, effluent was noted to be cloudy again and the cell count was 2948/μl. At this time decision was made to remove PD catheter for persistent peritonitis. Efflent Culture was consistent with PC & PG, susceptible to cefepime. Fungal culture remain negative. PD catheter was removed & Patient was started on hemodialysis. patient was treated with ceftazidime for 2 weeks. infection was treated. patinet chose to remain on hemodialysis. Discussion: Peritonitis is a common and serious complication of PD. It is the major cause of death in around 16% of PD patients.it is reported that Pantoea agglomerans can cause peritonitis. Our patient had peritonitis caused by PC, PG which is a very rare finding. Despite treatment with appropriate antibiotic the symptoms persist and eventually PD catheter was removed, the patient was started on hemodialysis. Pantoea species have been isolated from soil, water, plant, seeds, fruits, and human body fluids. PG, and PC were isolated from infant formula. PC was isolated from dialysate of PD patients and from urine, although pathogenicity remain unknown. In our case the patient had sever peritonitis caused by Pantoea species, the way of transmission is unclear. We recommend further research and examining the dialysate fluid in certain population, aiming that such an infection can be prevented in future.

  PublisherDOI

Frequent coauthors

• Claire Kim

  Vertex Pharmaceuticals (United States)

  3 shared

• Rafia Chaudhry

  University of California, San Francisco

  2 shared

• Sandeep K. Mallipattu

  2 shared

• Anubhav Kumar

  2 shared

• Sidney Kobrin

  University of Pennsylvania

  2 shared

• Amir Kazory

  University of Florida

  2 shared

• Matthew D. Palmer

  Met Office

  2 shared

• Mansoor Ahmed

  Liaquat University of Medical & Health Sciences

  2 shared