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CME: Management strategies for complications of chronic kidney disease (CKD): anemia and hyperphosphatemia

Activity Description / Statement of Need:

In this online, self-learning activity:

Chronic Kidney Disease (CKD) affects about 15% of the general population in the United States according to data from the CDC’s National Health and Nutrition Examination Survey and causes a number of complications with anemia and hyperphosphatemia common among them. Anemia occurs in about 15% of patients and arises from  a result of decreased production of erythropoietin (EPO) which signals bone marrow to produce red blood cells, whereas hyperphosphatemia occurs in the later stages of CKD because the kidney is the primary method by which the body maintains phosphate. This retention of phosphate leads to the development of CKD-Mineral Bone Disorder (CKD-MBD), with the literature suggesting that hyperphosphatemia occurs in a large portion of patients on dialysis based on usage of phosphate binders (PBs).

Anemia and hyperphosphatemia are associated with higher morbidity and mortality in patients in late CKD, especially those undergoing dialysis.

Target Audience:

The following healthcare professionals (HCPs): nephrologists and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in nephrology; and any other HCPs with an interest in or who clinically encounter patients with CKD.


Commercial Support Disclosure: This activity is supported by an educational grant from Akebia.

Learners may participate in this activity free of charge.


Release Date: March 24, 2020 -- Expiration Date: March 24, 2022

Faculty: Phuong Chi Pham, MD

Agenda

Faculty introduction and disclosures

Epidemiology and overview of anemia and hyperphosphatemia in CKD

  • Epidemiology
  • Definitions
  • Diagnosis & classifications/staging

Treatment of anemia and hyperphosphatemia in CKD

  • Overview of therapeutic options and recent literature review
    • Anemia: iron supplementation and erythropoiesis-stimulating agents
    • Hyperphosphatemia: PBs
    • Role of diet and non-pharmacologic recommendations
    • Impact of dialysis dependence on treatment approach

Patient case(s)

  • Non-dialysis dependent CKD patient with anemia
  • Dialysis dependent CKD patient with anemia
  • Dialysis dependent CKD patient with hyperphosphatemia

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Describe common complications that patients with CKD experience
  • Describe management strategies for anemia and hypherphosphatemia of CKD and their impact
  • Determine appropriateness of therapies for anemia and hypherphosphatemia of CKD, given a patient case
  • Describe effective management strategies for monitoring anemia and hyperphosphatemia in patients with CKD, taking into account dialysis status

Accreditation

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of  1.00 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Physicians: For maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in this section, then it does NOT provide MOC credit. This activity offers MOC credit for ABIM only.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmaceutical education. This activity is approved for 1.00 hours (0.10 CEUs) of continuing education.  Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test.   Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit.  ACPE # 0574-0000-20-007-H01-P.  CPE credit effective 3/24/20 and expires 3/24/22

This is a Knowledge (K)-type activity.

Pharmacists: You must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty Disclosure:  Phuong Chi Pham, M.D., University of California Los Angeles, has no relevant conflicts of interest to disclose.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant conflicts of interest to disclose.

Commercial Support Disclosure: This activity is supported by an educational grant from Akebia.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.