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Management of Chronic Kidney Disease Stages 1–3

• CME Information
• Faculty Biographies & Disclosures
• References
• Course Presentations
• CME Posttest

CME Information

Course Overview Educational Objectives Target Audience Method of Participation

Accreditation Statement Term of Approval Peer Review Program Director

Disclaimer Disclosure Acknowledgement of Support

Course Overview

The prevalence of chronic kidney disease in the United States is rising for every stage of chronic kidney disease (CKD). CKD is associated with a number of adverse outcomes, including increased risk for mortality, cardiovascular disease, end stage renal disease, bone loss and fractures, infections, cognitive impairment, and frailty. Treatment of nonprimary CKD is often not directed at the CKD, but rather at underlying conditions or cardiovascular risk factors, such as hypertension or diabetes. Treatments may include blood pressure lowering medications, such as angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB), or other nonspecific therapies and other nonpharmacological interventions targeted, for example, at blood pressure control, glycemic control, cholesterol control, and obesity treatment.

This continuing medical education activity covers data from a systematic review of existing research that was conducted by the Minnesota Evidence-based Practice Center to evaluate the level of evidence currently available regarding screening, monitoring, and treatments for CKD, stages 1–3. It provides an overview of the comparative benefits and adverse effects of interventions for CKD, stages 1–3. This information is intended to inform patient care decisions by primary care practitioners.

Educational Objectives

At the conclusion of this activity, the participant should be able to:

• Identify the benefits of medications and other interventions used as monotherapy or in combination for the treatment of chronic kidney disease, stages 1–3, with respect to the long-term outcomes of mortality and end-stage renal disease, as well as short-term vascular outcomes.
• Identify the risks of adverse events resulting from interventions used as monotherapy or in combination for the treatment of chronic kidney disease, stages 1–3, with respect to the long-term outcomes of mortality and end-stage renal disease, as well as short-term vascular outcomes.

Target Audience

This CME activity is designed to meet the educational needs of primary care physicians and specialists who treat patients with or at risk for chronic kidney disease, stages 1–3.

Method of Participation

This activity is in PowerPoint file format and is accompanied by talking points and references linked to PubMed abstracts.

To receive a maximum of 1.0 AMA PRA Category 1 Credit(s)™ you should:

• View the presentations in this enduring material.
• Complete the posttest (you must answer 7 out of 8 questions correctly).
• Complete and submit the CME registration and evaluation forms.

The estimated time to complete this activity, including review of the materials, is 1.0 hour(s).

Hardware/software requirements: Activities should be run with recent versions of common browsers, including Internet Explorer, Firefox, and Google Chrome.

If you have questions about the participation process, please e-mail the Office of Continuing Medical Education, cme@bcm.edu or phone 713.798.8237.

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.    

Term of Approval

October 2012 through October 2015. Original release date: October 2012

Peer Review

In August 2012, this continuing medical education online enduring material was reviewed by Sushrut S. Waikar, MD, MPH, Assistant Professor of Medicine, Harvard Medical School, and Director of Renal Ambulatory Services, Brigham and Women’s Hospital, Boston, Massachusetts. To ensure the continued scientific relevance of this enduring material, its content will be reviewed again in October 2015.

Disclosures: Nothing to disclose.

Program Director

Michael Fordis, MD
Sr. Associate Dean
Director, Center for Collaborative and Interactive Technologies
Director, John M. Eisenberg Center for Clinical Decisions and Communications Science
Baylor College of Medicine
Houston, Texas

Disclosures: Nothing to disclose.

Disclaimer

This CME activity is designed for use by healthcare professionals for educational purposes only. Information and opinion offered by the contributors represent their viewpoints. Conclusions drawn by the participant should be derived from careful consideration of all available scientific information. Prescription information and use of medical devices should be undertaken only after confirmation of information by consulting the FDA-approved uses and information.

Baylor College of Medicine makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Links are provided to other Internet sites solely for the convenience of users. Once you link to another site, you are subject to the site's terms and conditions of use including copyright and licensing restrictions.

Disclosure

The Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support ^SM, Baylor College of Medicine (BCM) has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: l) at the time of the activity or within 12 months prior; and 2) of their spouses/partners.

Baylor College of Medicine does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.

The following individual(s) has/have reported no financial or other relationships with commercial entities whose products/services may relate to the educational content of this activity:

Kim L. Farina, PhD, Medical Writer: Nothing to disclose.
Howard A. Fink, MD, MPH, Reviewer: Nothing to disclose.
Michael Fordis, MD, Activity Director: Nothing to disclose.
Andrea D. Humphries, PhD, Medical Writer: Nothing to disclose.
Sreedhar Mandayam, MD, MPH, Contributor: Nothing to disclose.
Sushrut S. Waikar, MD, MPH, Peer Reviewer: Nothing to disclose.

Some drugs/devices identified during this activity may have United States Food and Drug Administration (FDA) clearance for specific purposes only or for use in restricted research settings. The FDA has stated that it is the responsibility of the individual physician to determine the FDA status of each drug or device that he/she wishes to use in clinical practice and to use the products in compliance with the applicable law.

Baylor College of Medicine requires that all contributors disclose an unlabeled use or investigational use (not yet approved for any purpose) of pharmaceutical and medical device products, and provide adequate scientific and clinical justification for such use. Physicians are urged to fully review all the available data on products or procedures before using them to treat patients.

Acknowledgement of Support

This CME activity is supported by a contract, HHSA290200810015C, from the Agency for Healthcare Research and Quality.

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