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Peerview.Com/CWT900 Improving Outcomes and Preventing Chronic CME Improving Outcomes and Preventing Chronic Kidney Disease Progression: Evaluating the Role of Novel Nonsteroidal Mineralocorticoid Receptor Antagonists Chair George L. Bakris, MD American Heart Association University of Chicago Medicine Chicago, Illinois Faculty Rajiv Agarwal, MD, MS Indiana University School of Medicine Indianapolis, Indiana What’s Inside 3 Current Guidance for Screening and Diagnosing Patients With or at Risk of Chronic Kidney Disease 5 Strategies for Managing Patients With Chronic Kidney Disease and the Interplay Among Common Comorbidities 9 Evaluating the Role of Mineralocorticoid Receptor Antagonists in Managing Chronic Kidney Disease: Current and Emerging Agents Participate in interactive questions, download activity slides, and obtain your instant CME credit online. This CME activity is jointly provided by Medical Learning Institute, Inc. and PVI, PeerView Institute for Medical Education. PeerView.com/CWT900 Activity Information Media: Enduring Material Planning Committee Disclosures Accredited Activity Release Date: December 29, 2020 The planners from Medical Learning Institute, Inc., the accredited provider, and PVI, Accredited Activity Expiration Date: December 28, 2021 PeerView Institute for Medical Education, the joint provider, do not have any financial Time to Complete Activity: 30 minutes relationships with an ACCME-defined commercial interest related to the content of this accredited activity during the past 12 months unless listed below. Activity Description In this activity, two experts in nephrology discuss emerging evidence for improving Margery Tamas, MPH, has a financial interest/relationship or affiliation in the form of: outcomes and preventing chronic kidney disease (CKD) progression using Consultant for Fresenius Medical Care North America. nonsteroidal mineralocorticoid receptor antagonists. Content/Peer Reviewer Disclosures Target Audience The following Content/Peer Reviewer has nothing to disclose: This activity has been designed to meet the educational needs of nephrologists, endocrinologists, family practice/general practice physicians, and other clinicians Matthew A. Goodman, MD involved in the care of patients with CKD. Disclosure of Unlabeled Use Educational Objectives This educational activity may contain discussions of published and/or investigational Upon completion of this activity, participants should be better able to: uses of agents that are not indicated by the FDA. The planners of this activity • Apply current guidance consistent with the latest recommendations for screening, do not recommend the use of any agent outside of the labeled indications. The diagnosis, and treatment of patients with or at risk of developing CKD opinions expressed in the educational activity are those of the faculty and do • Describe the interrelationships among CKD and other common cardiometabolic not necessarily represent the views of the planners. Please refer to the official comorbidities prescribing information for each product for discussion of approved indications, • Evaluate the role and clinical potential of novel nonsteroidal mineralocorticoid contraindications, and warnings. receptor antagonists in providing renoprotection and preventing disease progression in patients diagnosed with CKD Disclaimer Participants have an implied responsibility to use the newly acquired information Providership, Credit, and Support to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for This CME activity is jointly provided by Medical Learning Institute, Inc. and PVI, patient management. Any procedures, medications, or other courses of diagnosis PeerView Institute for Medical Education. or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/ This activity is supported by an educational grant from Bayer HealthCare or dangers in use, review of any applicable manufacturer's product information, and Pharmaceuticals Inc. comparison with recommendations of other authorities. Physician Continuing Medical Education Method of Participation This activity has been planned and implemented in accordance with the There are no fees for participating in or receiving credit for this accredited activity. accreditation requirements and policies of the Accreditation Council for For information on applicability and acceptance of continuing education credit for Continuing Medical Education (ACCME) through the joint providership of this activity, please consult your professional licensing board. Medical Learning Institute, Inc. and PVI, PeerView Institute for Medical Education. The Medical Learning Institute, Inc. is accredited by the ACCME to provide continuing A statement of credit will be issued only upon receipt of a completed activity medical education for physicians. evaluation form and will be emailed to you upon completion. You will receive your certificate from [email protected]. If you have questions regarding The Medical Learning Institute, Inc. designates this enduring material for a the receipt of your emailed certificate, please contact via email at info@PeerView. maximum of 0.5 AMA PRA Category 1 CreditTM. Physicians should claim only the credit com. commensurate with the extent of their participation in the activity. About This CME Activity Faculty Disclosures PVI, PeerView Institute for Medical Education, and Medical Learning Institute, Inc. are responsible for the selection of this activity’s topics, the preparation of editorial Chair content, and the distribution of this activity. Our activities may contain references George L. Bakris, MD to unapproved products or uses of these products in certain jurisdictions. The Professor of Medicine preparation of PeerView activities is supported by educational grants subject to Director, American Heart Association written agreements that clearly stipulate and enforce the editorial independence of Comprehensive Hypertension Center PVI and Medical Learning Institute, Inc. University of Chicago Medicine Chicago, Illinois The materials presented here are used with the permission of the authors and/or other sources. These materials do not necessarily reflect the views of PeerView or any George L. Bakris, MD, has a financial interest/relationship or affiliation in the form of: of its partners, providers, and/or supporters. Consultant and/or Advisor for Alnylam Pharmaceuticals, Inc.; AstraZeneca; Bayer Corporation; Ionis Pharmaceuticals, Inc.; Janssen Pharmaceuticals, Inc.; KBP Biosciences Co., Ltd; Merck & Co., Inc.; Novo Nordisk, Inc.; and Vascular Dynamics, Inc. Faculty Rajiv Agarwal, MD, MS Professor of Medicine Indiana University School of Medicine Indianapolis, Indiana Rajiv Agarwal, MD, MS, has a financial interest/relationship or affiliation in the form of: Consultant and/or Advisor for Akebia Therapeutics, Inc; Bayer Corporation; Boehringer Ingelheim GmbH; DiaMedica Therapeutics, Inc.; Eli Lilly and Company; Merck & Co., Inc.; Reata Pharmaceuticals, Inc.; Relypsa Inc.; and sanofi-aventis U.S. LLC. Data Safety Monitoring Board for AstraZeneca. Other Financial or Material Support for Bayer Corporation and Janssen Pharmaceuticals, Inc. as part of the adjudication committee. Steering committee for Akebia Therapeutics, Inc; Bayer Corporation; and Janssen Pharmaceuticals, Inc. Go online to complete the post-test and evaluation for CME credit PeerView.com/CWT900 2 Improving Outcomes and Preventing Chronic Kidney Disease Progression: Evaluating the Role of Novel Nonsteroidal Mineralocorticoid Receptor Antagonists Current Guidance for Screening If you actually look then at kidney disease, cardiovascular (CV) disease, and type 2 diabetes mellitus (T2DM) as interrelated and Diagnosing Patients With or disorders, it’s very clear that there’s a major overlap. Approximately 35% of patients—if you take a middle number—have diabetes at Risk of Chronic Kidney Disease and kidney disease, and then there is an even higher percentage of patients with heart failure (HF), diabetes, and kidney disease. So George L. Bakris, MD there’s no question about it, this is not just a kidney problem; this Rajiv Agarwal, MD, MS is a problem that relates to organs. Dr. Bakris: Hello, I’m Dr. George Bakris from the University of Remember the heart and the kidney are married, they’re a married Chicago Medicine. Welcome to this educational activity on chronic couple, and if one isn’t doing well, the other one isn’t doing well. kidney disease (CKD). Joining me today is Dr. Rajiv Agarwal from Remember that concept. So what’s good for the kidney is good for Indiana University School of Medicine. Together, we plan to discuss the heart, and vice versa. some of the current guidelines pertaining to the screening and treatment of patients with CKD, including current and recent What Should Be Done to Detect and Monitor CKD Progression? advances with mineralocorticoid receptor antagonists. (Adapted From KDIGO Guidelines)1 • Check annually Prevalence of End-Stage Kidney Disease – BP 1 in 2000 and 2015 (People per Million) – Glucose/A1C – Lipid levels 2015 2000 – Albuminuria-spot urine (with blood test) • If kidney disease is present, eGFR is <60 mL/min/1.73 m2 – Check electrolytes and urine albumin every 6-8 months • If eGFR is <30 mL/min/1.73 m2 – Check electrolytes, kidney function, and albuminuria every 3-4 months 1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group.
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