Optimizing Outcomes in Patients with Diabetic Kidney Disease
NephrologyOptimizing Outcomes in Patients with Diabetic Kidney Disease
1.0 AMA PRA Category 1 Credit(s) ™ 1.0 AANP Contact Hours 0.75 Pharmacology
January 15, 2021
The accreditation for this activity has expired.
Primary Audience:
Primary care physicians; nurse practitioners; physician assistants; and other clinicians involved in the care of patients with Diabetic Kidney Disease.
Relevant Terms:
Diabetes; chronic kidney disease; diabetic kidney disease
Robert Toto, MD
Associate Dean, Translational Science
Professor Internal Medicine
UT Southwestern Medical Center
Dallas, TX
Robert Toto, M.D., is the Mary M. Conroy Professor of Kidney Disease in UT Southwestern’s Department of Internal Medicine. He specializes in kidney disease treatment and research. Dr. Toto also is the Associate Dean of Clinical and Translational Research in the Graduate School of Biomedical Sciences; the Director of the Center for Translational Medicine; and the Medical Director of UT Southwestern’s Multi-Specialty Clinic.
Dr. Toto earned his medical degree at the University of Illinois Medical School. He completed a residency in internal medicine at the University of Michigan and Baylor College of Medicine and then received advanced training in nephrology through fellowships at the U.S. Public Health Service Hospital and UT Southwestern Medical Center. He joined the UT Southwestern faculty in 1983.
He is nationally and internationally known for clinical research and teaching. He has been awarded numerous teaching awards from medical students and residents at UT Southwestern and is a regular speaker at national and international nephrology meetings on a variety of topics in renal disease. He has served on program committees for the American Society of Nephrology, the International Congress of Nephrology, and the National Kidney Foundation and is actively involved with training and research policy development at the national level through the American Society of Nephrology and the National Institutes of Health.
Dr. Toto’s research interests include detection, prevention, and treatment of progressive kidney diseases, including diabetes and hypertension. He has an active laboratory and has been intimately involved in the design and conduct of phase I clinical trials as well as several major outcomes trials in patients with chronic kidney disease, including NIH- and nonfederally funded trials (eg, the AASK trial, the HEMO study, and TREAT). He has authored more than 100 original articles and textbook chapters related to diagnosis and management of hypertension and kidney diseases.
Javier Morales, MD, FACP, FACE
Clinical Associate Professor of Medicine
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell University
Vice President
Advanced Internal Medicine Group, P.C.
East Hills, NY
Dr. Morales is in private practice with the Advanced Internal Medicine Group in East Hills, NY. After having graduated from UMDNJ-NJ Medical School, his medical training included residencies at Memorial Sloan-Kettering Cancer Center and North Shore University Hospital where he served as Chief Medical Resident. In addition to numerous publications, he has served as principal investigator for several different studies and clinical trials. He is active in the educational sector and presents at continuing education symposia both nationally and internationally. Dr. Morales serves as clinical instructor for several nurse practitioner programs, physician assistant programs, and the internal medicine residency program at Northwell Health at North Shore University Hospital and Winthrop University Hospital. He is a also Clinical Assistant Professor of Medicine at the Northwell School of Medicine at Hofstra University. | 1. | Utilize recommended screening strategies to ensure early diagnosis of chronic kidney disease (CKD) in patients with diabetes, including the use of urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR). | 2. | Discuss how diabetic kidney disease (DKD) confers a high risk of cardiovascular disease (CVD), renal events, and associated mortality and implications for management. |
| 3. | Discuss the role of inflammation, fibrosis and the mineralocorticoid receptor in the progression of CKD. | 4. | Incorporate current treatment approaches and discuss novel treatment approaches based on current and emerging data, to optimize the care of patients with type 2 diabetes and decrease the risk of progression of DKD. |
| 1. | Utilize recommended screening strategies to ensure early diagnosis of chronic kidney disease (CKD) in patients with diabetes, including the use of urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR). |
| 2. | Discuss how diabetic kidney disease (DKD) confers a high risk of cardiovascular disease (CVD), renal events, and associated mortality and implications for management. |
| 3. | Discuss the role of inflammation, fibrosis and the mineralocorticoid receptor in the progression of CKD. |
| 4. | Incorporate current treatment approaches and discuss novel treatment approaches based on current and emerging data, to optimize the care of patients with type 2 diabetes and decrease the risk of progression of DKD. |
Course Summary
Diabetic kidney disease (DKD), is estimated to affect 20-40% of patients with diabetes mellitus and is the leading cause of end-stage renal disease (ESRD). All-cause mortality in patients with DKD is 30-fold higher than in individuals who have diabetes without chronic kidney disease (CKD), and many of these deaths are due to cardiovascular disease (CVD), rather than to ESRD. Treatment for DKD recently evolved to include sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which have demonstrated cardiorenal benefits. Emerging treatments such as non-steroidal selective mineralocorticoid receptor antagonists (MRAs) have the potential to further reduce CVD risk and DKD progression. As newer agents begin to emerge to further reduce renal risk in patients with diabetes, clinicians need to be aware of them and their MOA so they can rapidly integrate them into practice as they become available. Using video clips taken from a live broadcast presented as part of Emerging Challenges and Clinical Updates in Primary Care 2020, this activity will address strategies to screen for DKD, discuss the impact of inflammation and fibrosis on cardiovascular risk, and identify treatment approaches to optimize care of patients with type 2 diabetes and decrease risk of progression of DKD.
Faculty
Javier Morales, MD, FACP, FACE
Clinical Associate Professor of Medicine
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell University
Vice President
Advanced Internal Medicine Group, P.C.
East Hills, NY
Robert Toto, MD
Associate Dean, Translational Science
Professor Internal Medicine
UT Southwestern Medical Center
Dallas, TX
Planning Committee
Sandy Bihlmeyer, Med
Senior Project Manager
National Association for Continuing Education
Plantation, FL
Michelle Frisch, MPH, CHCP
Vice President, Operations
National Association for Continuing Education
Plantation, FL
Joshua F. Kilbridge
President and Creative Director
Kilbridge Associates
San Francisco, CA
Sheila Lucas, CWEP
Activity Director
National Association for Continuing Education
Plantation, FL
Laurl Ann Matey, MSN, RN, CHPN
Medical Director
National Association for Continuing Education
Plantation, FL
Gregg Sherman, MD
Chief Medical Officer/Course Director
National Association for Continuing Education
Plantation, FL
Angela Golden, DNP, FNP-C, FAANP
Family Nurse Practitioner
NP Obesity Treatment Clinic and NP from Home, LLC
Assistant Professor (Ret), Northern Arizona University
Past President, American Association of Nurse Practitioners
Munds Park, AZ
Accreditation Information
The National Association for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The National Association for Continuing Education designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
National Association for Continuing Education is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 121222. This activity is approved for 1.0 contact hour(s) (which includes .75 hour(s) of pharmacology).
Policy on Faculty and Provider Disclosure
Educational programs sponsored by the National Association for Continuing Education (NACE) must demonstrate balance, independence, objectivity, and scientific rigor. All faculty, authors, editors, staff and planning committee members participating in a NACE-sponsored activity are required to disclose any relevant financial interest or other relationship with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services that are discussed in an educational activity. Any potential conflicts of interest will be resolved prior to the activity.
Per the ACCME, a Commercial Interest is defined as an entity producing, marketing, re-selling or distributing health care goods or services consumed by or used on, patients. Providers of clinical service directly to patients are not considered to be commercial interests - unless the provider of the clinical service is owned, or controlled by, a defined commercial interest.
Resolution of Personal Conflicts of Interest
NACE requires disclosure of relevant financial relationships with the commercial interest from course directors, faculty, members of the activity planning committee, and others in a position to control the content of the educational activity. Any individual who refuses to disclose his or her relationships will be disqualified from any involvement in the planning, development, teaching/presenting, managing, or evaluation of the educational activity.
The faculty reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:
Javier Morales has disclosed the following financial relationships:
- Consultant: Novo Nordisk, Lilly, Mylan, Abbott, Intarcia, AstraZeneca, Boehringer Ingelheim
- Advisory Board: Novo Nordisk, Lilly, Intarcia, Boehringer Ingelheim, AstraZeneca, Janssen, Bayer Pharmaceuticals
- Speaker Bureau: Novo Nordisk, Lilly, AstraZeneca, Boehringer Ingelheim, Mylan, Janssen
Robert Toto has disclosed the following financial relationships:
- Consultant: Akebia Therapeutics AstraZeneca, Bayer Pharmaceuticals, Otsuka Pharmaceutical, Quest Diagnostics, Reata Pharmaceuticals, Relypsa, Inc., Medscape
- Advisory Board Member: Reata Pharmaceuticals, Medscape
- Speaking/Teaching: Medscape, NACE
The planning committee reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:
Sandy Bihlmeyer has no relevant conflicts of interest with any ACCME-defined commercial interest
Michelle Frisch has no relevant conflicts of interest with any ACCME-defined commercial interest.
Joshua F. Kilbridge has no relevant conflicts of interest with any ACCME-defined commercial interest.
Sheila Lucas has no relevant conflicts of interest with any ACCME-defined commercial interest.
Laurl Ann Matey has no relevant conflicts of interest with any ACCME-defined commercial interest.
Angela Golden, DNP, FNP-C, FAANP, Activity Planning Committee, has no relevant conflicts of interest with any ACCME-defined commercial interest.
Gregg Sherman has no relevant conflicts of interest with any ACCME-defined commercial interest.
Statement of Commercial Support:
This educational activity is supported in part by an educational grant from Bayer HealthCare Pharmaceuticals Inc.
This activity is presented by National Association for Continuing Education.
Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Instructions to Receive Credit
In order to receive credit for this activity, the participant must complete the posttest and program evaluation. Your posttest will automatically be graded. If you successfully complete the posttest (score of 75% or higher), your statement of participation will be made available immediately. Click on the View Statement of Participation link and print the statement for your records. If you receive a score lower than 75%, you will receive a message notifying you that you did not pass the posttest. You will have 2 opportunities to pass the posttest.
Fee Information & Refund/Cancellation Policy
There is no fee for this educational activity.
COURSE VIEWING REQUIREMENTS
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