Learning Objectives

• Examine recent scientific advances in our understanding of the pathophysiology of disorders of fluid, electrolytes, and acid-base balance.
• Describe how the pathophysiology relates to the care of patients.
• Analyze how recent studies related to fluid, electrolyte, and acid-base disorders can be applied to clinical decision making.

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, FASN—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:

Michael Emmett, MD—Employer(s): Baylor University Medical Center; Other Interests: I receive payment for my work as the editor of the Acid-Base and Electrolyte related chapters in “UpToDate”.

AUTHORS:

Anand Achanti, MD—Employer(s): Medical University of South Carolina; Research Funding: Omeros- PI - IgA trial; Cure GN- PI; Kaneka Medical America LLC - sub-ILDL apheresis for FSGS; Advisory or Membership Role: Travere Therapeutics: Expert Advisory Committee on IgA management; Alexion: Expert Advisory Committee on TMA management.

Waleed A. Elsheikh, MD, MBBS—Employer(s): Medical University of South Carolina. No relevant financial relationships with ineligible companies to disclose.

Andrew Z. Fenves, MD, FASN—Employer(s): Massachusetts General Hospital and Harvard Medical School; Consultancy:Weber Gallagher & Associates Law Firm; Shook, Hardy and Bacon Law Firm for expert testimony; Ownership Interest: Apple, Alphabet; Honoraria: UpToDate - royalties; Advance-Medical, Teladoc - expert opinion.

Alexandra Grand, MD—Employer(s): Baylor College of Medicine; Research Funding: Otsuka Pharmaceutical Co., Ltd.

Gregor Lindner, MD, MBA—Employer(s): Johannes Kepler University; Consultancy: Otsuka; Honoraria: Daiichi-Sankyo; Bayer; Otsuka; Advisory or Membership Role: Otsuka.

Svenja Ravioli, MD—Employer(s): Johannes Kepler University; Honoraria: Otsuka.

Joshua Rein, DO, FASN—Employer(s): Icahn School of Medicine at Mount Sinai Hospital; James J. Peters Veterans Affairs Medical Center; Advisory or Membership Role: Editorial Board - Kidney Medicine, International Journal of Nephrology; Co-Chair, Organizing Committee - Basic Research Forum for Emerging Kidney Scientists.

Christoph Schwarz, MD—Employer(s): Pyhrn-Eisenwurzenklinikum Steyr; Honoraria: Otsuka.

Alice M. Sheridan, MD, FASN—Employer(s): Brigham and Women’s Hospital; Advisory or Membership Role: ASN nephSAP, Editorial Director.

Mengyao Tang, MD, MPH, FASN—Employer(s): Massachusetts General Hospital and Harvard Medical School; Research Funding: American Heart Association (23POST1010825); DexCom (IIS-2023-007).

Bryan M. Tucker, DO, MS, FASN—Employer(s): Baylor College of Medicine. No relevant financial relationships with ineligible companies to disclose.

Madhusudan Vijayan, MBBS—Employer(s): Icahn School of Medicine at Mount Sinai Hospital. No relevant financial relationships 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.

Lisa Netha Xayavong, 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 23, Number 2, June 2024

• Ahmed Akl MD, MBChB, MSc, PhD, FASN Urology & Nephrology center, Mansoura University EGYPT
• Arshad Ali, MD, FASN Munson Healthcare UNITED STATES
• Maroun Azar, MD Brown Medicine UNITED STATES
• Emmy Bell, MD, MPH University of Alabama at Birmingham UNITED STATES
• Karim Bitar, MD Laurel Kidney Specialists UNITED STATES
• Alice Ching, MD, FASN Medical College of Wisconsin UNITED STATES
• Pradeep Dhakarwal, MD, FASN Kidney & Hypertension Associates UNITED STATES
• Saleh Kaysi, MD, FASN CHU Brugmann BELGIUM
• Paul S. Kellerman, MD, FASN Oakland University William Beaumont School of Medicine UNITED STATES
• Minesh Khatri, MD, FASN NYU Langone Health UNITED STATES
• Meyer D. Lifschitz, MD Shaare Zedek Medical Center ISRAEL
• Niti Madan, MD, FASN University of California Davis UNITED STATES
• Veena Manjunath, MD East Bay Nephrology Medical Group UNITED STATES
• Adela D. Mattiazzi, MD, FASN University of Miami UNITED STATES
• Franco Musio, MD, FASN Franco Musio, M.D. Medical Consultation Group, LLC UNITED STATES
• Chanigan Nilubol, MD MedStar Georgetown University Hospital UNITED STATES
• Uday S. Nori, MD, FASN The Ohio State University UNITED STATES
• Attur Ravindra Prabhu, MD, MBBS, FASN Kasturba Medical College Manipal, Manipal Academy of Higher Education INDIA
• Nishigandha Pradhan, MD University Hospitals UNITED STATES
• Donal N. Reddan, MBChB Galway University Hospitals IRELAND
• Jordan L. Rosenstock, MD, FASN Northwell Health UNITED STATES
• Stephen M. Sozio, MD, FASN Johns Hopkins University School of Medicine UNITED STATES
• Parikshit Thakur Hameer, MD, FASN Plains Regional Medical Center UNITED STATES
• Sumeska Thavarajah, MD Johns Hopkins University School of Medicine UNITED STATES
• Robert J. Unwin, MBChB, PhD, ScD University College London Medical School UNITED KINGDOM
• Rabi Yacoub, MD, FASN University at Buffalo 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: June 2024

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

Examination Available Online: On or before June 27, 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 June 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