Learning Objectives

• To review the physiologic changes of the kidney in pregnancy.
• To describe the clinical presentation and management of specific kidney diseases in pregnancy.
• To discuss management of fertility and pregnancy issues on dialysis as well as in the posttransplant period.
• To review the complications of AKI during pregnancy and the many aspects of pre-eclampsia.

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:

Michelle A. Hladunewich, MD, MS, FASN—Employer(s): University of Toronto; Research Funding: Ionis; Calliditas Therapeutics, Pfizer, Roche, Chinook Pharmaceuticals; Honoraria: UpToDate; Other Interests or Relationships: Medical Lead for Glomerular Disease Ontario Renal Network.

AUTHORS:

Kate Bramham, MBBS, PhD—Employer(s): King’s College Hospital NHS Trust; Consultancy: Alexion, Perkin Elmer, AstraZeneca; Research Funding: Alexion, AstraZeneca; Honoraria: Alexion, Otsuka, AstraZeneca; Advisory or Leadership Role: Alexion, AstraZeneca.

Joyce L Browne, PhD, MD—Employer(s): University Medical Center Utrecht, The Netherlands; Advisory or Leadership Role: Chair board Knowledge Center GlobaL Health; Vice-chair board Simavi.

Salisu Mohammed Ishaku, MBBS, PhD, MPH—Employer(s): Julius Global Health, Julius Center for Health Science and Primary Care, UMC Utrecht, the Netherlands/Equity in Health and Research Initiative Nigeria.

Belinda Jim, MD—Employer(s): Jacobi Medical Center at Albert Einstein College of Medicine; Honoraria: ASN-BRCU; Speakers Bureau: ASN-BRCU.

Priscilla Smith, MBBS, MS, MSc—Employer(s): King’s College Hospital NHS Trust; Research Funding: Bayer AG; Honoraria: AstraZeneca.

Madhusudan Vijayan, MBBS—Employer(s): Mount Sinai Hospital (Myself); Hennes & Mauritz (Spouse); No relevant financial relationship(s) with ineligible companies to disclose.

ASN STAFF:

Suzanne P. Armstrong, MA—Employer(s): American Society of Nephrology; No 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 4, February 2024

• Sandeep Aggarwal, MBBS, MD, FASN, Perelman School ofMedicine/University of Pennsylvania, UNITED STATES
• Andrea Angioi, MD, FASN, AziendaOspedaliera G.Brotzu, ITALY
• Puneet Arora, MD, MBBS, FASN, Max Superspeciality Hospital, INDIA
• Tibor Fulop, MD, PhD, FASN, Medical University of South Carolina, UNITED STATES
• Arvind K. Garg, MD, FASN, Mayo Clinic Health System, La Crosse, WI, UNITED STATES
• Samir Chandra Gautam, MBBS, MD, FASN, Johns Hopkins University Hospital, UNITED STATES
• Vishal Jaikaransingh, MBBS, University of Florida, College of Medicine - Jacksonville, UNITED STATES
• Quresh T. Khairullah, MD, FASN, St. Clair Nephrology, UNITED STATES
• Andrew John Mallett, MBBS, PhD, FASN, Townsville University Hospital & James Cool University, AUSTRALIA
• Frank J. OBrien, MD, FASN Washington University in St. Louis, UNITED STATES
• Macaulay A. Onuigbo, MD, MS, MBA, FASN, University of Vermont, UNITED STATES
• Dwarakanathan Ranganathan, MD, FASN, Metro North Hospitals – Brisbane, AUSTRALIA
• Marion Lee Sanders, PhD, MD, University of Iowa Hospitals and Clinics, UNITED STATES
• Alan Segal, MD, MS, Maine Health, UNITED STATES
• Tripti Singh, MBBS, MD, FASN, University of Wisconsin, UNITED STATES
• Priyesh T. Thakkar, DO, MBA, FASN, Regional Nephrology Associates, 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: February 2024

CME/MOC Termination Date: January 31, 2026 at 11:59 pm ET

Examination Available Online: On or before February 28, 2024

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 February 1, 2026, 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