To examine recent scientific advances in our understanding of the pathophysiology of disorders of fluid, electrolytes, and acid-base balance.
To review how the understanding of pathophysiology can be applied to the care of patients.
To analyze how recent studies related to fluid, electrolyte, and acid-base disorders can be applied to clinical decision making.
It is the policy of American Society of Nephrology (ASN) that all individuals in a position to control the content of ASN's educational activities are expected to disclose all their and their life spouse/partner's financial relationships with “ineligible companies” within the prior 24 months as well as other non-financial interests. (“Ineligible companies” are those whose primary business is producing, marketing, selling, re-selling, or distributing health care products used by or on patients.) Participants should note that the use of products outside U.S. Food and Drug Administration (FDA) approved labeling should be considered experimental and are advised to consult current prescribing information for approval indications.
The intent of this policy is not to prevent expert faculty with relevant relationship(s) with commercial interest(s) from involvement in educational activities, but rather to ensure that these activities promote quality and safety, are effective in improving medical practice, are based on valid content, and are independent of control from commercial interests and free of commercial bias. In addition, all faculty were instructed to provide balanced, scientifically rigorous, and evidence-based presentations.
ASN requires all individuals in a position to control content for this activity to complete disclosure forms on the ASN website. Responses are listed below.
Disclosures have been reviewed and assessed by ASN. All relationships with ineligible companies have been identified and all relevant financial relationships have been mitigated.
Alice M. Sheridan, MD—Employer(s): Brigham and Women’s Hospital; No additional relevant financial relationship(s) with ineligible companies to disclose.
Martina M. McGrath, MBChB, FASN—Employer(s): Brigham and Women’s Hospital; VA Boston Medical Center; No additional relevant financial relationship(s) with ineligible companies to disclose.
Paul M. Palevsky, MD, FASN—Employer(s): United States Department of Veterans Affairs, VA Pittsburgh Healthcare System, and University of Pittsburgh; Consultancy: Janssen Research & Development, LLC; Advisory or Leadership Role: National Kidney Foundation: President, Member, Scientific Advisory Board; Renal Physicians Association: Member, Quality, Safety and Accountability Committee; Quality Insights Renal Network 4: Chair, Medical Review Board; UpToDate: Section Editor, Renal Failure; Journal of Intensive Care Medicine: Member, Editorial Board.
Andrew Davenport, MD—Employer(s): Royal Free Hospital; Advisory or Leadership Role: Advisory board-Yaqrit; Advisory board-Nipro Corporation; Advisory board-WAK Scientific advisory board; CJASN; leadership positions; European Dialysis & Transplant Association ERN committee; President-International Society for Hemodialysis.
Sergio Dellepiane, MD, PhD—Employer(s): Icahn School of Medicine at Mount Sinai; No additional relevant financial relationship(s) with ineligible companies to disclose.
Ilya G. Glezerman, MD—Employer(s): Pfizer Inc. (spouse); Ownership Interest: Pfizer Inc. (spouse); No additional relevant financial relationship(s) with ineligible companies to disclose.
Victoria Gutgarts, MD—Employer(s): Memorial Sloan Kettering Cancer Center; No additional relevant financial relationship(s) with ineligible companies to disclose.
Leal C. Herlitz, MD—Employer(s): Cleveland Clinic; Consultancy: ChemoCentryx; Advisory or Leadership Role: ASN Kidney 360 editorial board.
Daphne H. Knicely, MD, FASN—Employer(s): : University of Virginia; No additional relevant financial relationship(s) with ineligible companies to disclose.
Dennis G. Moledina, MBBS, PhD, FASN—Employer(s): Yale University School of Medicine; Research Funding: NIDDK K23DK117065, R01DK12681, UH3DK114866, P30DK079310; Honoraria: National Kidney Foundation, Remedy Health Media, British Medical Journal; Patents or Royalties: DGM is a coinventor of the pending patent application "Methods and Systems for Diagnosis of Acute Interstitial Nephritis" that is subject to an option for a license agreement with Renalytix AI Inc.; Advisory or Leadership Role: Kidney360, editorial board member.
Girish N. Nadkarni, MD, MPH—Employer(s): : Icahn School of Medicine at Mount Sinai; Ownership Interest: Renalytix, Verici, Doximity, Pensive Health; Consultancy: Renalytix, Siemens Healthineers, Qiming Capital, GLG consulting, Daiichi Sankyo, Reata, Variant Bio; Honoraria: Daiichi Sankyo; Patents or Royalties: Renalytix; Advisory or Leadership Role: Renalytix.
Mark D. Okusa, MD, FASN—Employer(s): University of Virginia Health System; Ownership Interest: AAPL, Allstate (ALL), Citigroup (C), Nextera Energy (NEE), Pepsico (PEP), Walmart (WAL); BABA, AIG, BK, BCS, BP, CAH, CRRFY, CI, C, CMCSA, CRH, CVS, ERJ, EMR, ENIC, ENGIY, E, EBKDY, FNMA, FDX, FISV, FLEX, FMX, F, FCX, GE, GD, GEBHY, GSK, GRFS, HAL; Consultancy: HemoShear, Janssen, Research Funding: NIH-research grant, AM-Pharma/Pfizer; Honoraria: UpToDate, University of Tokyo, Cleveland Clinic Foundation, Korean Society of Nephrology; Patents or Royalties: University of Virginia Patent Office; Advisory or Leadership Role: NIDDH/NIDDK DSMB; Other Interests or Relationships: John Bower Foundation; Travel.
Mark A. Perazella, MD, FASN—Employer(s): Yale University School of Medicine; Honoraria: UpToDate; Advisory or Leadership Role: Kidney360 (Deputy Editor), AJKD, Journal of Ono-Nephrology (Co-Editor-in-Chief), Frontiers in Nephrology: Onco-Nephrology (Associate Editor), Clinical Nephrology (AKI Series Editor), CJASN, KI, and KI Reports (Editorial Board).
Thiago A. Reis, MD—Employer(s): CDRB-Clinica de Doencas Renais de Brasilia; Consultancy: Baxter, B.Braun, Life Pharma, Contatti Medical (CytoSorbents), Eurofarma; Honoraria: AstraZeneca, Baxter, B.Braun, bioMérieux, Life Pharma, Contatti Medical (CytoSorbents), Eurofarma, Jafron, Nova Biomedical; Advisory or Leadership Role: Baxter, bioMérieux, Life Pharma, Contatti Medical (CytoSorbents), Eurofarma; Speakers Bureau: AstraZeneca, Baxter, B.Braun, bioMérieux, Life Pharma, Contatti Medical (CytoSorbents), Eurofarma, Jafron, Nova Biomedical.
Claudio Ronco, MD—Employer(s): University of Padova; Consultancy: Asahi, Jafron, Toray, Astute, GE, Baxter, Medtronic, Cytosorbents, OCD, Biomerieux; Honoraria: Baxter, Fresenius, Astute, GE, Toray, Estor, Medtronic, Jafron, B.Braun; Advisory or Leadership Role: Editor-in-Chief of Blood Purification and Contributions to Nephrology and Cardiorenal Medicine, Associate Editor of Nephrology Dialysis and Transplantation.
Alice M. Sheridan, MD—Employer(s): Brigham and Women’s Hospital; Other Interests or Relationships: nephSAP Editorial Director; No additional relevant financial relationship(s) with ineligible companies to disclose.
Angela Yee Moon Wang, MD, PhD—Employer(s): Queen Mary Hospital, The University of Hong Kong, Hong Kong; Advisory or Leadership Role: Ed Board: JASN, Kidney Int, Clin JASN, Nephrol Dial Transplant, Nephron Clin Practice (Associate Editor), Am J Nephrol, J Nephrol, J Diabetes, J Renal Nutrition, J Geriat Cardiology, Blood Purification, Biomedicine Hub, EMJ, President of International Soc; Other Interests or Relationships: President of International Society of Renal Nutrition and Metabolism, Committee member of ISN-ACT, Member of SONG-HD CVD Outcome Measures Working Group, Member of SONG-PD Working Group, Executive committee member of SONG Initiatives, Council member of ISPD, Deputy Chair of ISN Regional Board, Deputy Chair of ISN Education working group.
Henry H.L. Wu, MBChB—Employer(s): National Health Service, United Kingdom; Other Interests or Relationships: Early Career Researcher Member for the International Society of Nephrology Cardio-Renal Toolkit Workgroup.
Suzanne P. Armstrong, MA—Employer(s): American Society of Nephrology; No additional relevant financial relationship(s) with ineligible companies to disclose.
There is no commercial support for this issue.
The nephSAP editorial team and the KSAP editorial board extend their sincere appreciation to the following reviewers. Their efforts and insights help improve the quality of these postgraduate education offerings.
nephSAP Review Panel, Volume 21, Number 1, April 2022
Manohar Bairy, MBBS, MD, Tan Tock Seng Hospital, Singapore
Anip Bansal, MD, FASN, University of Colorado Anschutz Medical Campus, United States
Eric M. Gibney, MD, Piedmont Healthcare, United States
Kiran M. Goli, MD, FASN, Kidney Care Specialists, LLC, United States
Elvira O. Gosmanova, MD, FASN, Albany Medical College, United States
Sandra Iragorri, MD, Oregon Health and Science University, United States
Insara Jaffer Sathick, MBBS, Memorial Sloan Kettering Cancer Center, United States
George Jarad, MD, Washington University School of Medicine, United States
Poonum Khalid, II,, MBBS, Nishtar medical university Multan, Pakistan
Sana F. Khan, MD, University of Virginia, United States
Charbel C. Khoury, MD, Washington University in St Louis, United States
Norbert H. Lameire, MD, PhD, Ghent University, Belgium
Nicolae Leca, MD, FASN, University of Washington, United States
Adi Leiba, MD, Assuta Ashdod University Hospital, Israel
Roy O. Mathew, MD, FASN, Loma Linda VA Health Care System, United States
Chanigan Nilubol, MD, MedStar Georgetown University Hospital, United States
Arash Rashidi, MD, FASN, University Hospitals Cleveland Medical Center, United States
Anand M. Ravindran, MD, MBBS, Toledo Clinic Nephrology, United States
Subodh J. Saggi, MD, MPH, SUNY Downstate Medical Center, United States
Mohamed A. Sekkarie, MD, MPH, Nephrology and Hypertension Associates, United States
Iqbal Hamid Shah, MD, MBBS, King saud University, Saudi Arabia
Amit Sharma, MD, MBBS, FASN, FORTIS HOSPITAL, India
Michiko Shimada, MD, PhD, FASN, Hirosaki University, Japan
Nicole S. Stankus, MD, MS, FASN, University of Chicago, United States
Anna T. Valson, MD, Christian Medical College, India
Suthaharan Vimalendran, MD, Orillia Soldiers Memorial Hospital, Canada
Eranga Wijewickrama, MD, PhD, FASN, University of Colombo, Sri Lanka
Program Mission and Objectives
nephSAP® provides a learning vehicle for physicians, scientists, advanced practitioners, nurses, pharmacists, and other health professionals working and training in the field of nephrology to renew and refresh their clinical knowledge, diagnostic, and therapeutic skills. This enduring material provides learners challenging, clinically-oriented questions based on case vignettes, detailed learning objectives, a series of articles that review recent publications, and an editorial on an important and evolving topic. This combination of materials enables learners to rigorously assess their strengths and weaknesses in the broad domain of nephrology.
Physicians, scientists, advanced practitioners, nurses, pharmacists, and other health professionals working and training in the field of nephrology.
Accreditation and AMA Credit Designation Statements
In support of improving patient care, the American Society of Nephrology is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
The American Society of Nephrology designates this internet activity (enduring material) for a maximum of 10.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABIM MOC Statement
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 10.0 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 Joint Accreditation for the purpose of granting ABIM MOC credit. MOC points will be applied to only those ABIM candidates who have enrolled in the MOC program. It is your responsibility to complete the ABIM MOC enrollment process.
Original Release Date: April 2022
CME/MOC Termination Date: March 31, 2024
Examination Available Online: On or before April 22, 2022
Estimated Time for Completion: 10 hours
Answers with explanations are provided with a passing score after the first and/or second attempt
This issue will be archived in April 2024, and answers with explanations will be posted on the ASN website
Method of Participation
Read the entire issue that is supplemented by original articles in the reference lists.
Complete the online self-assessment examination.
Each participant is allowed two attempts to pass the examination (75% correct) for CME and MOC.
Upon completion, review your score and incorrect answers and print your certificate.
Activity Evaluation, CME and MOC
Go to ASN eLEARNING CENTER (education.asn-online.org)
Select MY ACTIVITIES from the left-hand navigation.
Select the corresponding issue.
Read all information on the Overview screen.
Follow the onscreen instructions to:
Complete the Exam (i.e., post test),
Complete the Evaluation,
Claim credit/MOC, and
Print a Certificate
Your complete ASN Transcript is available on the ASN eLEARNING CENTER:
Select TRANSCRIPT on the left-hand navigation.
View course status, credits claimed, or print a certificate for completed learning activities.
Instructions to obtain American Board of Internal Medicine (ABIM) Maintenance of Certiﬁcation (MOC) Points
Each issue of nephSAP provides 10 MOC points. Respondents must meet the following criteria:
Be certiﬁed by ABIM in internal medicine and/or nephrology and enrolled in the ABIM–MOC program...
Enter your (ABIM) Candidate Number and Date of Birth prior to completing the examination.
Take the self-assessment examination within the timeframe speciﬁed in this issue of nephSAP.
Upon completion, click Claim Your MOC points, the MOC points submitted will match your CME credits claimed, check the Attestation Statement box and submit.
ABIM will notify you when MOC points have been added to your record.
ABIM MOC Statement
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 10.0 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 Joint Accreditation for the purpose of granting ABIM MOC credit.
MOC points will be applied to only those ABIM candidates who have enrolled in the MOC program. It is your responsibility to complete the ABIM MOC enrollment process.
System Requirements Compatible Browser and Software
The nephSAP website (nephsap.org) is formatted for cross-browser functionality, and should display correctly in all currently supported web browsers. Individual nephSAP articles are available as dynamic HTML or in Portable Document Format (PDF), which requires Adobe Reader or comparable PDF viewing software.
The nephSAP website is designed for responsive display. This means the content display will respond to the device you use and to your devices screen resolution.
Medium or Combination of Media Used
The media used include content provided online as dynamic HTML or downloadable PDF, in addition to an online evaluation and self-assessment examination.
If you have difficulty viewing any of the pages, please refer to the nephSAP technical support page for possible solutions. If you continue having problems, contact ASN at firstname.lastname@example.org.