Chronic Kidney Disease and Progression Examination Questions
CKD remains the ninth leading cause of death in the United States. Over 30 million people or approximately 15% of US adults are estimated to have stages 1–5 CKD (1). Data on cause of death are obtained from resident death certificates filed in the United States and are classified in accordance with the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD). Because kidney disease often coincides with multiple other chronic conditions, the contribution of kidney disease to mortality is likely underestimated.
1. Centers for Disease Control and Prevention: Chronic Kidney Disease Surveillance System website. https://nccd.cdc.gov/ckd/. Accessed January 2, 2019
Appraise clinical trial data examining the renal effects of various oral hypoglycemic agents
Evaluate new developments related to clinical risk factors and emerging biomarkers for identification and treatment of cardiovascular disease in CKD.
Discuss new data about weight loss interventions in CKD
Analyze novel methods and tools that improve care delivery models for CKD
The ASN is responsible for identifying and resolving all conﬂicts of interest prior to presenting any educational activity to learners to ensure that ASN CME activities promote quality and safety, are effective in improving medical practice, are based on valid content, and are independent of the control from commercial interests and free of bias. All faculty are instructed to provide balanced, scientiﬁcally rigorous and evidence-based presentations. In accordance with the disclosure policies of the Accreditation Council for Continuing Medical Education (ACCME), individuals who are in a position to control the content of an educational activity are required to disclose relationships with a commercial interest if (a) the relation is ﬁnancial and occurred within the past 12 months; and (b) the individual had the opportunity to affect the content of continuing medical education with regard to that commercial interest. For this purpose, ASN consider the relationships of the person involved in the CME activity to include ﬁnancial relationships of a spouse or partner. Peer reviewers are asked to abstain from reviewing topics if they have a conﬂict of interest. Disclosure information is made available to learners prior to the start of any ASN educational activity.
EDITORIAL BOARD for this Issue:
Richard J. Glassock, MD—Current Employer: Professor Emeritus, The David Geffen School of Medicine at the University of California at Los Angeles; Consultancy: Bristol-Myers Squibb, Genentech, ChemoCentryx, Apellis, Achillion, Omeros, Ionis, Mallinckrodt, NIH, UpToDate (Wolters-Kluwer), American Journal of Nephrology, Karger Publications; Ownership Interests: Reata; Honoraria: Genentech, Karger Publications, Wolters-Kluwer (UpToDate), EcoR1; Scientific Advisor/Membership: University Kidney Research Organization, Journal of the American Society of Nephrology, American Journal of Nephrology, UpToDate, Mallinckrodt, Genentech, Apellis; Other Interests: ASN Communities; Speaker’s Bureau: Genentech
Gerald A. Hladik, MD, FASN—Current Employer: University of North Carolina at Chapel Hill; Honoraria: Renal Research Institute; Scientiﬁc Advisor/Membership: ASN Co-Director, NephSAP, Board Member, Renal Research Institute
Holly J. Kramer, MD, MPH——Current Employer: Loyola University Medical Center; Scientiﬁc Advisor/Membership: Editorial board member: American Journal of Kidney Disease, Advances in Chronic Kidney Disease, Clinical Journal of the American Society of Nephrology, Journal of Renal Nutrition
John Paul Middleton, MD——Current Employer: Duke University Medical Center; Consultancy: Relypsa, AstraZeneca, ZS Pharma, Novo Nordisk; Research Funding: Janssen, NIDDK, Relypsa; Honoraria: Relypsa, Astra Zeneca, ZS Pharma; Scientific Advisor/Membership: Editorial Board, Advances in Chronic Kidney Disease; Steering Committee NIDDK CKD Consortium; Other Interests: Raleigh Radiology (spouse)
Sankar D. Navaneethan, MD, FASN—Current Employer: Baylor College of Medicine; Consultancy: Independent end-point adjudication committee member for clinical trials sponsored by Bayer (ongoing) and Boehringer Ingelheim (completed); Tricida; Research Funding: Keryx; Honoraria: Bayer, Boehringer Ingelheim, Tricida; Scientific Advisor/Membership: Associate Editor, American Journal of Kidney Disease, CardioRenal Medicine; Section Editor, Current Opinion in Nephrology and Hypertension; Editorial board, Clinical Journal of the American Society of Nephrology, American Journal of Nephrology; KDIGO, Guideline writing committee member
Jerry Yee, MD, FASN—Current Employer: Henry Ford Hospital; Consultancy: La Jolla Pharmaceuticals, Elsevier Inc., Vasc-Alert LLC, EBSCO, Merck, Reata; Ownership Interests: Vasc-Alert; Honoraria: National Kidney Foundation, Drexel University, UNC Chapel Hill, Ascension Health; Patents/Inventions: Vasc-Alert; Scientiﬁc Advisor/Membership: NKF: Editor-in-Chief, Advances in Chronic Kidney Disease journal; Editorial Board: American Journal of Nephrology, American Journal of Kidney Diseases, Heart Failure Journal, Clinical Journal of Nephrology, American Journal of Hypertension; ASN Co-Director NephSAP, EBSCO DynaMed: Section Editor; Section Editor Elsevier Ferri’s Clinical Advisor 2018 Textbook
Rohan Paul, MBBS—Current Employer: The George Washington University School of Medicine
Dominic S. Raj, MD, MBBS, FASN—Current Employer: The George Washington University School of Medicine; Consultancy: Carvedia,Medimmune, Kaleido, Relypsa; Research Funding: NIH, Kaleido Pharmaceuticals, Carvedia, Medimmune, Relypsa; Honoraria: Relypsa, Carvedia; Scientiﬁc Advisor/Membership: NIDDK, NHLBI, Washington Academy of Medicine, Relypsa
Gisela A. Deuter, BSN, MSA—Nothing to disclose
There is no commercial support for this issue.
The Editorial Board of NephSAP and KSAP extends its sincere appreciation to the following reviewers. Their efforts and insights help improve the quality of these postgraduate education offerings.
NephSAP/KSAP Review Panel
Mustafa Ahmad, MD, FASN, King Fahad Medical City, Riyadh, Saudi Arabia
Nasimul Ahsan, MD, FASN, University of Florida and Oscar G. Johnson Veteran Affairs Medical Center, Iron Mountain, MI
Dario Roccatello, MD, San Giovanni Hospital and University of Torino, Torino, Italy
Helbert Rondon-Berrios, MD, FASN, University of Pittsburgh School of Medicine, Pittsburgh, PA
Ehab R. Saad, MD, FASN, Medical College of Wisconsin, Milwaukee, WI
Mark C. Saddler, MBChB, Mercy Regional Medical Center, Durango, CO
Neil Sanghani, MD, Vanderbilt University, Nashville, TN
Mohammad N. Saqib, MD, Lehigh Valley Hospital, Allentown, PA
Hitesh H. Shah, MD, Hofstra Northwell School of Medicine, Great Neck, NY
Michiko Shimada, MD, PhD, Hirosaki University, Hirosaki, Japan
Shayan Shirazian, MD, Winthrop-University Hospital State University of New York at Stony Brook, Mineola, NY
Arif Showkat, MD, FASN, University of Tennessee, Memphis, TN
Stephen M. Sozio, MD, Johns Hopkins University School of Medicine, Baltimore, MD
Ignatius Yun-Sang Tang, MD, FASN, University of Illinois at Chicago, Chicago, IL
Ahmad R. Tarakji, MD, King Saud University, King Khalid University Hospital, Riyadh, Saudi Arabia
Hung-Bin Tsai, MD, National Taiwan University, Taipei, Taiwan
Katherine Twombley, MD, Medical University of South Carolina, Charleston, SC
Kausik Umanath, MD, Henry Ford Hospital, Detroit, MI
Puchimada M. Uthappa, MBBS, FASN, Columbia Asia Hospital, Mysore, Karnataka, India
Anthony M. Valeri, MD, Columbia University Medical Center, New York, NY
Allen W. Vander, MD, FASN, Kidney Center of South Louisiana, Thibodaux, LA
Jon R. Von Visger, MD, PhD, The Ohio State University, Columbus, OH
Nand K. Wadhwa, MD, Stony Brook University, Stony Brook, NY
Connie Wang, MD, Hennepin County Medical Center, Minneapolis, MN
Maura A. Watson, DO, Walter Reed National Military Medical Center, Bethesda, MD
Dawn Wolfgram, MD, Medical College of Wisconsin, Milwaukee, WI
Sri Yarlagadda, MBBS, University of Kansas Medical Center, Kansas City, KS
Brian Young, MD, Santa Clara Valley Medical Center, San Jose, CA
Mario Javier Zarama, MD, Kidney Specialists of Minnesota, Saint Paul, MN
Program Mission and Objectives
The Nephrology Self-Assessment Program (NephSAP) provides a learning vehicle for clinical nephrologists to renew and refresh their clinical knowledge, diagnostic, and therapeutic skills. This enduring material provides nephrologists challenging, clinically oriented questions based on case vignettes, a detailed syllabus that reviews recent publications, and an editorial on an important and evolving topic. This combination of materials enables clinicians to rigorously assess their strengths and weaknesses in the broad domain 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.
Original Release Date: September 2019
CME Credit Termination Date: August 31, 2021
Examination Available Online: On or before Monday, September 16, 2019
Estimated Time for Completion: 10 hours
Answers with Explanations
Provided with a passing score after the ﬁrst and/or after the second attempt
September 2021: posted on the ASN website when the issue is archived.
Nephrology certiﬁcation and recertiﬁcation candidates
Method of Participation
Read the syllabus 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 credit.
Upon completion, review your score and incorrect answers and print your certiﬁcate.
Answers and explanations are provided with a passing score or after the second attempt.
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 email@example.com.