This syllabus reviews the major clinical studies published between January 2017 and January 2019 in relevant journals with the highest impact factors. The authors have focused on randomized trials, case series, and registry data as feasible. In the interest of brevity, case reports, basic science studies, preclinical studies, and data published only in abstract form were generally excluded.
Describe advances in current transplantation outcomes, including delayed graft function, rejection, graft and patient survival, and living donor outcomes
Discuss access to transplantation, deceased donor allocation, and utilization practices, including kidneys from donors with an increased risk of infection and hepatitis C antibody seropositive (HCV Ab1) donors
Examine the spectrum of complications that occur after transplantation, including infection, malignancy, and cardiovascular disease and accompanying individual diagnostic and therapeutic strategies.
Explain the current status of immunosuppression strategies, incompatible transplantation, and efforts to achieve immunologic tolerance
Provide an update on the status on pancreas transplantation
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:
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
Jay L. Koyner, MD—Current Employer: University of Chicago; Consultancy: Astute Medical, Pﬁzer, Sphingotec, Baxter; Research Funding: AstuteMedical, Bioporto, NxStage Medical, Satellite Dialysis - Coplon Grant, NIH; Honoraria: Society of Critical Care Medicine; Patents/Inventions: Listed on a patent for Pi GST to detect severe AKI following cardiac surgery - Argutus Medical; Scientiﬁc Advisor/Membership: Advances in Chronic Kidney Disease, American Journal of Nephrology, ASN’s Acute Kidney Injury Online Community Advisory Group, Scientiﬁc Advisory Board for the NKF of Illinois, Scientiﬁc Advisory Board for the NKF
Charuhas V. Thakar, MD, FASN—Current Employer: University of Cincinnati/Department of Veterans Affairs; Consultancy: Quark Pharmaceuticals, Best Doctors Inc., NxStage; Honoraria: Springer, LEK, Best Doctors Inc., NxStage, Alphasigths Inc.; Scientiﬁc Advisor/Membership: National Kidney Foundation, NxStage; Other Interests: Editor-in-Chief, Advances in Chronic Kidney Disease NKF journal; Speaker’s Bureau: NxStage
John P. Vella, MD, FASN—Current Employer: Maine Nephrology Associates PA; Research Funding: Bristol-Myers Squibb, Vitaeris; Scientiﬁc Advisor/Membership: UpToDate
Alexander C. Wiseman, MD—Current Employer: University of Colorado at Denver and Health Sciences Center; Consultancy: CTI, Hansa, Mallinckrodt, Sanoﬁ; Research Funding: Novartis, Bristol-Myers Squibb, Oxford Immunotec, Quark, Astellas, Hookipa, Medeor, Talaris; Scientiﬁc Advisor/Membership: American Society of Transplantation, American Journal of Transplantation
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
Millie D. Samaniego, MD, FASN—Current Employer: Henry Ford Health System; Scientiﬁc Advisor/Membership: Education Committee Transplantation Society, Gift of Life of Michigan - Board of Advisors, National Kidney Foundation - Vice-Chair of Public Policy Committee, Transplantation Society - Education Committee Member, Medeor member Data safety monitoring board
Neeraj Singh, MD, MBA, FASN—Current Employer: Louisiana State University Health Sciences Center, Willis Knighton Health System; Honoraria: Mallinckrodt, Veloxis; Speaker’s Bureau: Veloxis, Mallinckrodt
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 Statement The American Society of Nephrology (ASN) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
AMA Credit Designation Statement
The ASN designates this enduring material for a maximum of 10 AMA PRA Category 1 Credits ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Original Release Date: November 2019
CME Credit Termination Date: October 31, 2021
Examination Available Online: On or before Monday, November 18, 2019
Estimated Time for Completion: 10 hours
Answers with Explanations
Provided with a passing score after the ﬁrst and/or after the second attempt
November 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.
Maintenance of Certiﬁcation Statement
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 10 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 ACCME 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 ASN nephSAP website (nephSAP.org) has been formatted for cross-browser functionality, and should display correctly in all currently supported web browsers. Individual nephSAP articles are also available in Portable Document Format (PDF), which requires Adobe Reader or comparable PDF viewing software.
The ASN 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 online content display in HTML 5 and/or static PDF, in addition to online evaluation and examination.
If you have difﬁculty viewing any of the pages, please refer to the nephSAP tutorials page for possible solutions. If you continue having problems, contact ASN at email@example.com.