The France Foundation
A Continuing Medical
Education Company

The Dannemiller
Memorial Educational
Foundation
Self Study Program based on a Satellite Symposium of the American Society of Nephrology 33rd Annual Scientific Meeting, October, 2000
Release date: February, 2001

This program is sponsored by the Dannemiller Memorial Educational Foundation and by The France Foundation. This is not part of the official 33rd Annual Meeting as planned by the ASN Program Committee.
Supported by an unrestricted educational grant from AstraZeneca LP.

To access this self study program at no charge please click here to register first with HDCN. This program offers 2.5 hours of Category I CME Credit for Physicians through the Dannemiller Memorial Educational Foundation and The France Foundation. LINKS TO THE POST-TEST AND EVALUATION FORM ARE AT THE BOTTOM OF THIS PAGE.




Upon completion of this activity, the participant should be able to:
  1. Realize the safety and efficacy of supramaximal doses of ARBs in humans with proteinuria and chronic renal failure.
  2. Assess the new data that use supramaximal doses of ARBs for the complete blockade of the RAS for the reduction of proteinuria and renal protection.
  3. Describe the mechanisms responsible for the intrarenal formation of angiotensin II and the intrarenal compartmentalization of angiotensin II.
  4. Describe the changes in intrarenal angiotensin II during the development of angiotensin II-dependent hypertension and how this is altered by treatment with AT1 receptor blockers.
  5. Discuss the circumstances where angiotensin II generation in the kidney is the dominant contributing pathway to the activity of the renin-angiotensin system.
  6. Discuss the renal vascular role of intrarenal angiotensin II in human subjects, both in health and in diabetes.
  7. Understand the renin-angiotensin system abnormalities in early diabetes.
  8. Understand the connection between hyperglycemia and activation of the renin-angiotensin system.
  9. Understand how genetic factors affect angiotensinogenís contribution to essential hypertension.
  10. Describe how the search for a physiological mechanism of angiotensinogen-mediated hypertension has brought attention to a paracrine renin-angiotensin system operating along the entire nephron.



Dr. Weinberg

Dr. Navar

Dr. Miller

Dr. Fisher

Dr. Lalouel
Naomi D. Fisher, M.D., Assistant Professor of Medicine, Harvard medical School / Brigham and Women's Hospital, Endocrine and Hypertension Division, Boston, MA

Jean-Marc Lalouel, M.D., Professor of Human Genetics, University of Utah Health Sciences Center / Howard Hughes Medical Center, Salt Lake City, UT

Judith A. Miller, M.D. FRCP(C), MSc, Associate Professor of Medicine, University of Toronto. Toronto General Hospital, Toronto, Ontario, CANADA

L. Gabriel Navar, Ph.D., Chairman and Professor, Department of Physiology, Tulane University Medical School, New Orleans, LA

Marc S. Weinberg, M.D. Clinical Professor of Medicine, Boston University School of Medicine, Chief of Nephrology, Roger Williams Medical Center, Providence, RI


Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Dannemiller Memorial Educational Foundation and the France Foundation. The Dannemiller Memorial Educational Foundation is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement: The Dannemiller Memorial Educational Foundation designates this educational activity for up to 2.5 hours in category 1 credit towards the AMA Physicianís Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity.

Statement of Need: Blockade of the Renal Angiotensin System (RAS) lowers systemic blood pressure and intraglomerular pressure in hypertension and chronic renal diseases. Studies suggest that use of angiotensin-converting enzyme inhibitors (ACE inhibitors) is associated with a maximal renoprotective effect when compared to conventional agents. Studies have also demonstrated that interruption of the RAS axis using drugs that interfere with the production or action of angiotensin II reduces proteinuria and/or delays the progression of renal disease in patients with diabetic and nondiabetic glomerular diseases. Understanding the effect of the blockade of the RAS on intrarenal hemodynamics and the pathophysiology of hypertension and diabetic nephropathy is a must for every physician.

Goal: To update physicians on the characteristics of the renin-angiotensin system by ACE and non-ACE pathways, and its uptake and transport in the kidney.

Intended Audience: This activity has been developed for physicians treating patients experiencing hypertension secondary to intrarenal hemodynamics.

Faculty Disclosures: The Dannemiller Memorial Educational Foundation requires that the faculty participating in a continuing medical education activity disclose to participants any significant financial interest or other relationship (1) with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation, and (2) with any commercial supporters of the activity. The presenting faculty reported the following:

Marc S. Weinberg, MD, FACP, has received unrestricted educational grants and has served as a consultant and lecturer for AstraZeneca, Merck & Co. Inc., Pfizer Inc., and Bristol-Myers Squibb, whose products may be discussed in this program.

L. Gabriel Navar, PhD, has received research grants from AstraZeneca and is a member of the Speakers Bureau at AstraZeneca, whose products may be discussed in this program.

Naomi D. L. Fisher, MD, receives research support from AstraZeneca, SmithKline Beecham, and Bristol-Myers Squibb, whose products may be discussed in this program.

Judith Miller, MD, FRCP(C), MSc has nothing to disclose.

Jean-Marc Lalouel, MD, DSc, has nothing to disclose.

Method of Participation: This activity should take approximately 2.5 hours to complete. The participant should, in order, read the objectives contained in this activity, read or listen to the activity, answer the five-question, multiple-choice post-test, and complete the registration/evaluation form that appears at the end of this activity. This form provides each participant the opportunity to comment on the extent to which educational objectives were met, the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and their views on future educational needs. To receive credit for this activity, follow the instructions provided at the beginning of the post-test. This credit is valid through December 31, 2001. No credit will be given after this date.

Link to Post-Test/Evaluation Form: Please CLICK HERE.


This program is sponsored by
The Dannemiller Memorial Foundation and The France Foundation.
This was not part of the official 33rd Annual Meeting as planned by the ASN Program Committee.
Supported by an unrestricted educational grant from AstraZeneca LP.
 
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