About

Susanne B. Nicholas, MD, MPH, PhD, is a tenured Professor of Medicine and a Clinical Hypertension Specialist in the Division of Nephrology at UCLA. She chairs the Nephrology Racial and Health Equity Committee and holds joint appointments in the Division of Endocrinology, Diabetes and Metabolism, and the Division of General Internal Medicine and Health Policy. Her translational research focuses on understanding and identifying key factors that promote diabetic kidney disease (DKD) pathogenesis, validating novel therapeutic targets and predictive biomarkers of DKD, and performing population studies in chronic kidney disease (CKD) health disparities using a large CKD registry. Over the past 20+ years, her research has led to the identification of a novel biomarker of DKD. She is NIH-funded, has authored over 100 publications, and presented more than 120 scientific abstracts. Dr. Nicholas has received numerous recognitions, including being nominated for the AAMC Mid-Career Women Faculty Professional Development Seminar, receiving the Scientific Co-Chair Appreciation Award from the International Society for Hypertension in Blacks, and the National Kidney Foundation's Medical Advisory Board Distinguished Service Award for over 15 years of service. She has also served as a Mats Wahlstrom Visiting Professor and is actively involved in research and leadership within the nephrology community.

Research topics

• Medicine
• Emergency medicine
• Intensive care medicine
• Environmental health
• Nursing
• Internal medicine

Selected publications

• Therapeutic Considerations in Preventing Chronic Kidney Disease

  Annual Review of Medicine · 2025-11-21 · 1 citations

  article1st authorCorresponding

  Chronic kidney disease (CKD) affects 35.5 million US adults, but most patients are unaware of their diagnosis. Screening for CKD at-risk individuals is required, as symptoms do not appear until advanced stages. The combination of urine albumin-to-creatinine ratio and estimated glomerular filtration rate permits the classification of CKD stages and the determination of risk of CKD progression and cardiovascular disease, which is the most common cause of death in CKD. Cardiovascular-kidney-metabolic syndrome highlights the complex interplay between the heart, kidney, and metabolic disorders, such as diabetes and dysfunctional obesity, which promotes chronic inflammation, leading to injury in these organs and systems. New guideline-directed medical therapies consisting of sodium-glucose cotransporter 2 inhibitors, glucose-like peptide-1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists, in addition to standard-of-care therapies including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, have revolutionized CKD management, which may be best facilitated through a multidisciplinary care approach.

  PublisherDOI

• Population health management of diabetic kidney disease in Los Angeles county municipal health system

  Current Opinion in Nephrology & Hypertension · 2025-11-19

  article

  PURPOSE OF REVIEW: Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, disproportionately affecting underserved and safety-net populations. RECENT FINDINGS: Los Angeles County Department of Health Services (LAC-DHS) Kidney Health Workgroup has developed pragmatic population health frameworks and Expected Practices for DKD co-management with primary-care providers: pragmatic definitions of low kidney function (LKF, <50% of normal) and very low kidney function (VLKF, <25%), and proteinuria severity classification as early (>150 mg/g), heavy (>1 g/g), and massive (>7 g/g) to guide referral urgency; biopsy-agnostic diagnosis of DKD when four out of five criteria are met, including diabetes history or A1c more than 6%, LKF, proteinuria, diabetic microangiopathy, and larger kidney length (>12 cm) or faster CKD progression (>25 ml/min/year); Kidney Disease Integrated Therapy (KDIT) combining four medication categories (RAAS blockade, SGLT2 inhibitors, GLP-1 agonists, nonsteroidal mineralocorticoid antagonist) and renal nutrition and lifestyle medicine (PLADO/PLAFOND diets), adequate hydration, and exercise; and eConsults to support timely detection, dialysis vascular access placement, shared decision-making, and ESRD care coordination. SUMMARY: The DKD management model demonstrates that resource-limited systems can deliver innovative, high-quality kidney care and provide a scalable framework for equity-focused and pragmatic kidney care in municipal health systems.

  PublisherDOI

• 629-P: National CEDER Lessons Learned from Piloting T2D Community Engagement and Research Support Services

  Diabetes · 2025-06-13

  article

  Introduction and Objective: The NIDDK-funded National Center for Engagement in Diabetes Equity Research (CEDER) fosters nationwide community-academic collaborations to increase community engagement and equity in type 2 diabetes (T2D) research and projects. We describe lessons learned from piloting services, including research consultations consisting of expert discussions and community engagement studios with community-partnered structured expert discussions. Methods: The pilot phase (Jul-Dec 2024) included development of a triage process and matching clients with appropriate services and expertise (i.e., community partners, lived experience, T2D intervention expertise). Results: To date, CEDER’s community-academic partners have responded to 29 requests from six states for support with grant applications, study design, community partnerships, health equity, and funding source identification. Process lessons learned include triaging and prioritizing needs for matching community-academic expertise, promoting community-academic discussion, and supporting community-engaged research methods. Project recommendations from community-academic experts included strategies for identifying community-based partnerships, improving accessibility and community-relevant messaging, recruitment and retention, and guidance for NIDDK funding priorities. Conclusion: Community-partnered services supported community and research projects focused on T2D, catalyzing innovative, community-relevant, health-equity-focused research projects, providing early community-engaged feedback for grant applications, and promoting community-academic partnerships and relationship-building. Future goals include geographic expansion, promoting services within public entities and community organizations, and tracking national priorities within T2D projects. Disclosure A. Luitel: None. K.D. Ramirez: None. S.L. Albert: None. S. Albrecht: None. M. AuYoung: None. S.L. Carson: None. Y.M. Castellon-Lopez: None. C. Cooper: None. E.M. Everett: None. M. Hernandez: None. G. Kim: None. T. Moin: None. S. Nicholas: Consultant; Boehringer-Ingelheim, AstraZeneca, Bayer Pharmaceuticals, Inc. Speaker's Bureau; Boehringer-Ingelheim. Consultant; Novo Nordisk, Vertex Pharmaceuticals Incorporated. E. Rodgers: None. C. Trinh-Shevrin: None. J. Zanowiak: None. A. Brown: None. E. Chambers: None. N. Islam: None. Funding U2CDK137135

  PublisherDOI

• Dosing, Treatment Patterns, Urine Albumin-to-Creatinine Ratio (UACR) Changes, and Safety with Finerenone Treatment in Routine Care: FINE-REAL Interim Analysis

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

  article
  PublisherDOI

• 465 Characterization of Latent Safety Threats from a Multidisciplinary In Situ Simulation Program

  Annals of Emergency Medicine · 2025-08-22

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• A Real-World Cohort Study of the Risks of Kidney Failure and Death in Diabetes

  Clinical Journal of the American Society of Nephrology · 2025-09-08 · 5 citations

  articleOpen access

  Key Points Rates and risks of kidney failure versus death in diabetes have not been previously quantified across a full range of kidney function. In a large population with diabetes, risk of death exceeded kidney failure overall, but kidney failure outpaced death at eGFR &lt;30 ml/min per 1.73 m 2 . Current risk estimates are needed to support public health and clinical strategies to monitor and improve kidney health in diabetes. Background Risks of kidney failure versus death in diabetes have not been previously quantified across a full range of kidney function. The aim of the study was to assess competing risks of kidney failure and death in a real-world cohort with diabetes. Methods Cumulative incidence (CMI) functions for kidney failure and death, stratified by baseline eGFR, were estimated for the diabetes population from electronic health record data at Providence and the University of California Los Angeles health systems. Cox proportional hazards models assessed predictors of kidney failure and death. For kidney failure, cause-specific hazards were modeled with competing risk of death. Results Among 618,739 persons with diabetes followed for a median (interquartile range) of 3.79 (1.80–6.00) years during 2013–2022, 4% ( n =24,097) developed kidney failure and 10% ( n =63,128) died. Five-year CMI of kidney failure increased from 2% (95% confidence interval, 1.4% to 1.5%) for eGFR ≥90 ml/min per 1.73 m 2 to 62% (95% confidence interval, 61.0% to 63.5%) for eGFR 15–29 ml/min per 1.73 m 2 . CMI of all-cause death was higher than kidney failure with eGFR ≥45 ml/min per 1.73 m 2 , whereas kidney failure became more common at eGFR &lt;30 ml/min per 1.73 m 2 . Hazards of kidney failure were higher in men (reference: women), 40–59 and 60–79-year groups (reference: 18–39 years), non-White race or Hispanic or Latino/a ethnicity groups (reference: non-Hispanic White), and by noncommercial (reference: commercial) health insurance or hospitalization (yes/no) within 1 year before follow-up. Hazards of death were similar except that age ≥80 years imparted the highest risk, and only the American Indian or Alaska Native and other race groups had higher risk. Conclusions Death was more likely than kidney failure at eGFR ≥45 ml/min per 1.73 m 2 , but this trend reversed at eGFR &lt;30 ml/min per 1.73 m 2 . These contemporary risk estimates are important for public health and clinical strategies for monitoring and interventions to improve kidney health in diabetes.

  PublisherOA PDFDOI

• Improving Kidney Failure Risk Predictions for Clinical Trials Across CKD Stages 1-4

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

  article
  PublisherDOI

• Risks of Kidney Failure and Death in a Real-World Population with Diabetes

  SSRN Electronic Journal · 2025-01-01

  preprintOpen access
  PublisherDOI

• Omission of Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: Comparison of SOUND versus ASCO versus Choosing Wisely Criteria

  European Journal of Surgical Oncology · 2025-12-01

  article
  PublisherDOI

• AKIBoards: A Structure-Following Multiagent System for Predicting Acute Kidney Injury

  ArXiv.org · 2025-04-29

  preprintOpen access

  Diagnostic reasoning entails a physician's local (mental) model based on an assumed or known shared perspective (global model) to explain patient observations with evidence assigned towards a clinical assessment. But in several (complex) medical situations, multiple experts work together as a team to optimize health evaluation and decision-making by leveraging different perspectives. Such consensus-driven reasoning reflects individual knowledge contributing toward a broader perspective on the patient. In this light, we introduce STRUCture-following for Multiagent Systems (STRUC-MAS), a framework automating the learning of these global models and their incorporation as prior beliefs for agents in multiagent systems (MAS) to follow. We demonstrate proof of concept with a prosocial MAS application for predicting acute kidney injuries (AKIs). In this case, we found that incorporating a global structure enabled multiple agents to achieve better performance (average precision, AP) in predicting AKI 48 hours before onset (structure-following-fine-tuned, SF-FT, AP=0.195; SF-FT-retrieval-augmented generation, SF-FT-RAG, AP=0.194) vs. baseline (non-structure-following-FT, NSF-FT, AP=0.141; NSF-FT-RAG, AP=0.180) for balanced precision-weighted-recall-weighted voting. Markedly, SF-FT agents with higher recall scores reported lower confidence levels in the initial round on true positive and false negative cases. But after explicit interactions, their confidence in their decisions increased (suggesting reinforced belief). In contrast, the SF-FT agent with the lowest recall decreased its confidence in true positive and false negative cases (suggesting a new belief). This approach suggests that learning and leveraging global structures in MAS is necessary prior to achieving competitive classification and diagnostic reasoning performance.

  PublisherOA PDFDOI

Recent grants

• NIH Grant U01DK057303

  NIH · $2.5M · 2009

• NIH Grant K08DK059343

  NIH · $487k · 2007

Frequent coauthors

• Keith C. Norris

  University of California, Los Angeles

  76 shared

• Katherine R. Tuttle

  Providence Health & Services

  49 shared

• Anna Skay

  36 shared

• Anna E. Reeves

  Geisinger Medical Center

  36 shared

• Jeffrey F. Harper

  University of Nevada, Reno

  36 shared

• Landon J. Inge

  Ventana Research Corporation (United States)

  36 shared

• James M. Mullin

  Lankenau Institute for Medical Research

  36 shared

• Cromwell E. Espineda

  36 shared

Awards & honors

• Mid-Career Women Faculty Professional Development Seminar (2…
• International Society for Hypertension in Blacks (2013)
• Scientific Co-Chair Appreciation Award (2013)
• Mats Wahlstrom Visiting Professor, Division of Renal Disease…
• Network of Minority Health Research Investigators (NIDDK/NIH…