Hemodialysis University™ 2012-2014

International Society for Hemodialysis
Chicago, IL. September 14/15, 2012

3.0 hrs/$30
Part 1. Vascular Access
Jeffrey J. Sands, MD; Gerald Beathard, MD; Deborah Brouwer, RN, Priti Patel, MD, Surendra Shenoy, MD

3.0 hrs/$30
Part 2. Mineral Bone Disorder
Kevin Martin, MB, BCh, FACP; David Spiegel, MD; Peter Kotanko, MD; Lisa Gutekunst, MSEd, RN, CSR, CDN.

3.0 hrs/$30
Part 3. Water for Dialysis and Home Hemodialysis
Peter deOreo, MD; Rich Benner CWS III; Tom Golper, MD; Dennis Ross, MD

3.0 hrs/$30
Part 4. Sodium and Volume Control
John T. Daugirdas, MD; Madhukar Misra, MD, Peter Kotanko, MD

Access to these talks is free of charge, but registration for the free zone of HDCN is required to track the credit certificates. Please register under the correct name, and if you have an MD or equivalent degree, please specify this while registering to enable proper certificate printing.

CME/CEU is provided at the costs listed above ($30 per 3 hours of credit). There is a $10 discount for each 3 hours of credit for ISHD members. Please become a member of ISHD. Get your ISHD membership here.

Part 1. Vascular Access:
  • Describe the barriers to use of AV fistulas
  • Describe patient selection, work-up, and early follow-up care of AV fistulas
  • Discuss methods of surevillance of AV fistula and graft dysfunction
  • Review how hemodialysis catheter-care practice patterns affect infection risk.
Part 2. Mineral Bone Disorder
  • Describe how dialysate calcium affects mineral balance
  • Describe indications for active vitamin D and cinacalcet
  • Discuss relative potencies of phosphorus binders
  • Discuss which foods are high in absorbable phosphorus
Part 3. Water for Dialysis and Home Hemodialysis.
  • Describe common problems with water systems and how to deal with them
  • Review the barriers to setting up a home hemodialysis program
  • Describe optimal patient selection strategies for home hemodialysis
  • Describe the economics of home hemodialysis under current payment systems
Part 4. Blood Pressure and Volume Control in Hemodialysis
  • Describe how dialysate sodium affects patient weight gain and outcome
  • Describe causes and treatment of interdialytic hypertension
  • Describe risk factors and treaetment of dialysis hypotension
  • Review the role of residual kidney function on patient outcome

Gerald Beathard, MD
Capital Nephrology Associates
Austin, Texas

Richard Benner, CWSIII
Corporate Account Manager
Skippack, PA

Deborah Brouwer RN CNN
Vascular Access Specialist
Fresenius Vascular Care
Berwyn, Pennsylvania

John T. Daugirdas, MD (Course Director)
Clinical Professor of Medicine
University of Illinois

Peter DeOreo, MD
Associate Clinical Professor of Medicine
Case Western Reserve University,
Cleveland, OH.

Thomas Golper, MD
Vanderbilt University Medical Center
Director, Home Dialysis Program
Nashville, TN USA

Lisa Gutekunst, MS.Ed, RD, CSR, CDN
Specialist in Renal Nutrition
Cleve-Hill Dialysis
Buffalo, NY

Peter Kotanko, MD
Research Director
Renal Research Institute
New York

Kevin Martin, MB
Division of Nephrology
St. Louis University, Missouri

Madhukar Misra MD (Course Director)
Professor of Medicine
University of Missouri Columbia
School of Medicine. Columbia, MO

Dennis L Ross MD
Kanas Nephrology Physicians
Wichita, KS

Jeffrey J. Sands, MD
Research Director
Renal Research Institute
New York

David M. Spiegel, MD, FACP
Internal Medicine, Nephrology
University of Colorado
Aurora, Colorado

Priti Patel, MD
Medical officer
Division of Healthcare Quality Promotion (DHQP)
Centers for Disease Control and Prevention (CDC)
Atlanta, GA

Surendra Shenoy, MD
General Surgery
Washington University School of Medicine
St. Louis, Missouri

This educational activity is a video and audio recording with accompanying slides of a live presentation held September 14,15, 2012, in Chicago, IL. Continuing medical education credit will be awarded to physicians who successfully complete this activity with a score of 75% or better on the post-test and return an evaluation. Participation should take approximately 3.0 hours. The same number of continuing education contact hours will be awarded to nurses and dialysis technicians who fulfill these guidelines.

To complete this activity and receive credit, the participant should listen to the talks, scroll down to review the accompanying slides, review the PubMed abstracts of the linked slides and references, complete the post-test and evaluation, and read the abstracts linked to the post-test feedback section.

Release Date: June/July, 2013
Review/Approval Date: June/July, 2013
Expiration Date: December 31, 2014
AMA PRA Category 1 Credits™: 12.0 (3.0 for each part)
CEU Contact hours: 12.0 (3.0 for each part)

To complete this educational activity, the user will need Windows (XP or higher) or Macintosh (version 9.0 or higher) operating software, a connection to the internet with a 28.8 kbps MODEM or better. The computer should have an audio card with speakers. An audio player is required and either can be downloaded for free per instructions on the individual lecture pages. Flash 8.0 (from www.adobe.com) is useful but not necessary to see the full-screen slide/audio presentations and the video presentations. Acrobat Reader is required to print the CME certificate, and this can be download free from www.adobe.com.

For questions regarding CME credit or CEU contact hours, the post-test, or evaluation, please call Medical Education Resources at (303)798-9682 or e-mail info@mer.org.
The live program on which this Web-based educational activity is based was supported by educational grants from Fresenius Medical Care, Dialysis Centers Inc, Baxter Healthcare, and Amgen. No industry funding was provided for support of the Web-based program.

Program Overview
The program is divided into 4 components, focusing on vascular access, mineral bone disorder, water treatment and home hemodialysis, and blood pressure and volume control. The educational objectives of each of the 4 components of this program are listed in the left column of this page.

Target Audience
This program is intended for endocrinologists, nephrologists, general internal medicine, and other physicians and health care providers who treat patients with diabetes and kidney disease, including nephrology nurses and dialysis technicians.

Physician Credit
Medical Education Resources is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation
Medical Education Resources designates each enduring material for a maximum of 3.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Credit
Medical Education Resources is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
Each CE activity provides 3 contact hours of continuing nursing education.
Medical Education Resources is approved by the California Board of Registered Nursing, Provider #CEP 12299. This CE activity provides 3 contact hours of continuing nursing education.

Disclosure Policy
It is the policy of Medical Education Resources that participants in CME or CEU activities should be made aware of any affiliation of financial interest that may affect the speaker's presentation(s). Each speaker has completed and signed a conflict of interest statement. The faculty members' relationship will be disclosed in the course materials.

John Daugirdas, MD discloses no conflicts of interest.

Jeffrey Sands, MD discloses that he is an employee of Fresenius Medical Care NA.

Gerald Beathard, MD discloses that he is an employee of Lifeline Vascular Access.

Richard Benner, CWSIII discloses that he is an employee of Mar Cor Purification.

Deborah Brouwer, RN, CNN discloses that she is an employee of Fresenius Vascular Care NA.

Peter DeOreo, MD discloses that he is on the Board of Directors of Arbor Research, and is Chief of Medical Affairs and Quality Assurance for the Centers for Dialysis Care.

Thomas Golper, MD discloses that he has no financial conflicts.

Lisa Gutekunst, MsED, RD, CSR, CDN discloses that she is a consultant for Sanofi; Speaker's bureau for Sanofi, Stockholder of DaVita, and Employee of Davita.

Peter Kotanko, MD discloses that he is an employee of Renal Research Institute and stockholder in Fresenius Medical Care.

Kevin Martin, MD discloses that he is a consultant for Abbott and KAI, Speaker's Bureau for Abbott and Sanofi; and has received honoraria from Abbott, Sanofi, and KAI.

Madhukar Misra, MD discloses no conflicts of interest.

Priti Patel, MD discloses that he has no conflicts of interest.

Dennis Ross, MD discloses that he is a consultant for Fresenius Medical Care; Speaker's Bureau for Amgen, Lilly, and Novartis; Stockholder in Fresenius and Amgen, and an employee of Kansas Nephrology Physicians.

Surendra Shenoy, MD discloses that he has no conflicts of interest.

David Spiegel, MD discloses that he is a consultant for Amgen, has grant and research support from Keryx, and has received honoraria from Sanofi.

Medical Education Resources staff involved in the development of this activity have no financial relationships relevant to the content of this activity.

Off-label/lnvestigational Use
Because this course is meant to educate physicians with what is currently in use and what may be available in the future, there may be "off-label" use discussed in the presentations. Speakers have been requested to inform the audience when off-label use is being discussed.

Dr. Sands discusses off-label and/or investigations use of the following drugs: Zuragen, gentamicin, sodium citrate catheter locks, tPA for use as a catheter lock.

Ms. Brouwer discusses off-label use of stents with AV grafts and fistulae and the Venous Window Needle Guide (VWNG).

Dr. Daugirdas discusses off-label use of midodrine and sertraline for dialysis hypotension treatment.

Dr. Ross discusses nocturnal hemodialysis.

Dr. Spiegel discusses off-label use of phosphorus binders in predialysis CKD.

Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program. The information presented at this CME / CEU program represents the views and opinions of the individual presenters, and does not constitute the opinion or endorsement of, or promotion by, Medical Education Resources. Each participant must use his/her personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses. Before prescribing any medicine, primary references and full prescribing information should be consulted.

Medical Education Resources Policy
Medical Education Resources is committed to on-line privacy and confidentiality. This website is managed by HDCN, and their printed privacy policy applies to this site. CME credit for "ISHD Hemodialysis University 2012-2013: Section 1. Vascular Access" is provided by Medical Education Resources. If you register for CME credit or CE contact hours for this educational activity, HDCN will forward relevant personally identifiable information to Medical Education Resources so that we can maintain records concerning credits we issue to you. We may share aggregated data concerning registrations, post-tests, and evaluations on request of our commercial supporter. We will not share any personally identifiable information.

To obtain information on other Medical Education Resource programs, you can access their home page at www.mer.org.

The CME policy statements of HDCN are listed on this page.