Learning Objectives

• To describe the characteristics of ESKD patients treated with dialysis in the United States and internationally and to review unique transitions in the care of dialysis patients.
• To summarize developments regarding in-center hemodialysis, home-suitable dialysis, and dialysis methods.
• To discuss management challenges, including anemia, nutrition, cardiovascular disease, and infectious complications, in patients undergoing dialysis.

It is the policy of the 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.

View the full ASN Conflict of Interest and Disclosure Policy: https://www.asn-online.org/education/cme/coi-disclosure.pdf.

EDITORS:

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.

EDITORIAL AUTHOR:

Thomas A. Golper, MD, FASN—Employer(s): Vanderbilt University Medical Center; Consultancy: NxStage; Lightline; Research Funding: Renal Research Institute; Honoraria: UpToDate; NxStage; Renal Research Institute, Home Dialysis University; Advisory or Leadership Role: NxStage; LightLine Medical,: Home Dialysis University; Other Interests or Relationships: Section Editor for Dialysis UpToDate; Executive Committee Home Dialysis University

AUTHORS:

Scott D. Bieber, DO—Employer(s): Kootenai Health; No additional relevant financial relationship(s) with ineligible companies to disclose.

Gordon Chun-Kau Chan, MBChB—Employer(s): Prince of Wales Hospital; No additional relevant financial relationship(s) with ineligible companies to disclose.

Agnes Choy, MbChB—Employer(s): Prince of Wales Hospital; No additional relevant financial relationship(s) with ineligible companies to disclose.

Osama El Shamy, MD, FASN—Employer(s): Vanderbilt University Medical Center; Consultancy: Outset Medical; Honoraria: Home Dialysis University; UpToDate; Other Interests or Relationships: Home Dialysis Academy of Excellence

Holly M. Koncicki, MD, MS—Employer(s): Icahn School of Medicine at Mount Sinai; Honoraria: Author for UpToDate

Philip K.T. Li, MD—Employer(s): Prince of Wales Hospital; Consultancy: ; Honoraria: Speaker Honoraria for Baxter on Modern PD Symposium May 2021; Advisory or Leadership Role: KI, PDI; Other Interests or Relationships: President, International Association of Chinese Nephrologists; Vice President, Hong Kong Academy of Medicine

Jolanta Malyszko, MD, PhD, FASN—Employer(s): Warsaw Medical University, Poland; Honoraria: Bayer, Astra Zeneca, Boehringer Ingelheim

Matthew B. Rivara, MD, FASN—Employer(s): University of Washington; Advisory or Leadership Role: Editorial Board - CJASN; North American Chapter Council, International Society of Peritoneal Dialysis; Vice chair, medical executive committee, Northwest Kidney Centers; Other Interests or Relationships: National Kidney Foundation Project ECHO

ASN STAFF:

Suzanne P. Armstrong, MA—Employer(s): American Society of Nephrology; No additional relevant financial relationship(s) with ineligible companies to disclose.

Commercial Support

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 22, Number 2, August 2023

• Manohar Bairy, MBBS, MD, Tan Tock Seng Hospital, SINGAPORE
• Anip Bansal, MD, FASN, University of Colorado Anschutz Medical Campus, UNITED STATES
• Khaled Boubes, MD, FASN, The Ohio State University, 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
• John S. Hammes, MD, Balboa Nephrology Medical Group, 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, FASN, 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
• Amr El-Husseini Mohamed, MD, PhD, University of Kentucky, UNITED STATES
• Chanigan Nilubol, MD, MedStar Georgetown University Hospital, UNITED STATES
• Arvind Ponnusamy, Royal Preston Hospital, UNITED KINGDOM
• Arash Rashidi, MD, FASN, University Hospitals Cleveland Medical Center, UNITED STATES
• Anand M. Ravindran, MD, MBBS, Toledo Clinic Nephrology, UNITED STATES
• Muhammad Abdur Razzak, MD, MBBS, Dhaka Medical College, BANGLADESH
• Bharat Sachdeva, MD, Louisiana State University, 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 Medical City, SAUDI ARABIA
• Amit Sharma, MD, MBBS, FASN, FORTIS HOSPITAL, INDIA
• Michiko Shimada, MD, PhD, FASN, Hirosaki University, JAPAN
• Jun Shoji, MD, University of California, San Francisco, UNITED STATES
• Nicole S. Stankus, MD, MS, FASN, University of Chicago, UNITED STATES
• Anna T. Valson, MD, Christian Medical College, INDIA
• 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
• Anna L. Zisman, MD, FASN, University of Chicago, UNITED STATES

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.

Target Audience

Physicians, scientists, advanced practitioners, nurses, pharmacists, and other health professionals working and training in the field of nephrology.

Accreditation 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.

AMA Credit Designation Statement – Physicians: 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: August 2023

CME/MOC Termination Date: July 31, 2025 at 11:59 pm ET

Examination Available Online: On or before August 31, 2023

Estimated Time for Completion: 10 hours 

Self-Assessment Examination

• Answers with explanations are provided with a passing score after the first and/or second attempt
• This issue will be archived December 1, 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, CE, 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
  • IMPORTANT: select the credit type that corresponds with your designation, and
  • Print a Certificate

Your ASN Transcript is available on the ASN website:

• Go to the ASN website and log in to your ASN Profile page
• Select the CME/CE Transcript tab
• View credits claimed or print a certificate with continuing education information for completed learning activities