Self Study Program based on a Satellite Symposium of the American Society of Nephrology 33rd Annual Scientific Meeting, October, 2000

This program is sponsored by Tufts University School of Medicine. This is not part of the official 33rd Annual Meeting as planned by the ASN Program Committee. Supported by an unrestricted educational grant from Amgen Inc.

To access this self study program at no charge please click here to register first with HDCN. This program offers 2.0 hours of Category One CME Credit for Physicians by Tufts University School of Medicine.

Overall Program Goal and Educational Objectives

For reasons that are not clearly understood, the number of people with end-stage renal disease (ESRD) is growing. This has led to an increased recognition of the need for early identification of patients with chronic kidney disease. The magnitude of the population with chronic renal insufficiency (CRI) or who are at risk for CRI is just beginning to be appreciated. According to data from the Third National Health and Nutrition Examination Survey (NHANES III), 10.9 million Americans have serum creatinine values of 1.5 mg/dL or greater.

Many CRI patients develop anemia, which is underrecognized and undertreated. In one study, 68% of patients at the initiation of dialysis were severely anemic. With early identification of CRI, the clinician can develop strategies to prevent or delay adverse sequelae. Late referral and poor preparation for renal replacement therapy are associated with poorer long-term outcomes. Data suggest that anemia left untreated can result in poor patient outcomes and debilitating complications.

The risk of left ventricular hypertrophy increases as hemoglobin (Hb) levels fall. For every 0.5 g/dL decrease in Hb, relative left ventricular growth increases by 32%. Thirty-five percent of ESRD patients are diabetics, and 25% to 30% have hypertension, constituting two groups that are identifiable early in the disease process. Furthermore, hematocrit levels correlate with health-related quality-of-life assessments.

Overall, evidence suggests that a focus on prevention and early intervention is likely to be fruitful, reducing the number of patients whose disease proceeds to end stages. Further research, however, is needed.

An Overview of CRI and Anemia in the United States - Underrecognized and Undertreated
Brian Pereira, M.D..
Panel Discussion (video and FAQ mode)
Allen Nissenson, M.D., Roger London, M.D., Steven Fishbane, M.D.
Emerging Data on LVH, Cardiovascular Disease, and Anemia
Adeera Levin, M.D.
Adverse Sequelae of Anemia: More than just Cardiovascular
David Churchill, M.D.
Entire Group Panel Discussion (video and FAQ mode)
Drs. Pereira, Nissenson, London, Fishbane, Levin, and Churchill

Brian Pereira, M.D., Symposium Chairman. Professor of Medicine, Tufts University School of Medicine; Vice Chairman for Strategic Development in the Department of Medicine at New England Medical Center, Boston, MA

David Churchill, M.D., Professor of Medicine in the Faculty of Health Sciences at McMaster University in Hamilton, Ontario, Canada.

Steven Fishbane, M.D., Associate Professor of Medicine, State University of New York at Stony Brook School of Medicine; Director of the Dialysis Network, Associate Chairman of Medicine, and Associate Director of Nephrology at Winthrop University Hospital, Mineola, NY.

Adeera Levin, M.D., Clinical Associate Professor of Medicine, University of British Columbia, Vancouver, Canada.

Roger London, M.D., Assistant Clinical Professor of Medicine, Mount Sinai School of Medicine, New York City; Senior Regional Medical Director for New York, Oxford Health Plans, Norwalk, CT

Allen Nissenson, M.D., Professor of Medicine, University of California at Los Angeles School of Medicine; Director of the Dialysis Program at the UCLA Center for the Health Sciences, Los Angeles, CA .

In accord with the policies of Tufts University School of Medicine (TUSM) Office of Continuing Education and the Essential Areas and Policies and Standards of the Accreditation Council for Continuing Medical Education (ACCME), the ethical opinions of the American Medical Association (AMA), the Guidelines of the Pharmaceutical Research Manufacturers Association (PhRMA), the American Nurses Credentialing Center's Commission on Accreditation (ANCC), the American Council on Pharmaceutical Education (ACPE), and all other professional organizations as applicable, all programs offered by TUSM shall exhibit fair content balance, providing the audience with information of different perspectives from which to develop an informed opinion.

All faculty participating in any TUSM sponsored/cosponsored program are expected to disclose to the audience any real or apparent conflict(s) of interest during the past two years that may have a direct bearing on the subject matter of the continuing education program. This pertains to relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the therapeutic areas to be discussed.

Tufts University School of Medicine (TUSM) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. TUSM takes responsibility for the content, quality, and scientific integrity of this Continuing Education activity.

TUSM designates this educational activity for a maximum of two (2) hours in Category I credit towards the AMA Physician's Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity.

In order to successfully complete this activity, you are required to read or listen to the entire web-based presentation, legibly complete the Post-Test/Evaluation Form, and achieve a minimum passing grade of at least 70% on the Post-Test. The Post-Test and Evaluation Form must be sumitted by December 31, 2002.

Fax the completed Post-Test/Evaluation Form to 617-636-0472 or mail to Tufts University School of Medicine, Office of Continuing Education, 136 Harrison Ave., Boston, MA 02111. Certificates will be mailed within 4-6 weeks after receipt to those who successfully complete the Post-Test/Evaluation form. There is no registration fee to participate in this activity.

TUSM Conflict of Interest Policy
It is intended that any potential conflict should be identified openly so that the listeners may form their own judgements about the presentation(s) with full disclosure of the facts. It remains for the audience to determine whether the outside interests of the faculty reflect a possible bias in either the materials or the conclusions presented. The opinions and recommendations presented do not necessarily reflect the views of the sponsor, grantor, or producer.

Indications and methods of use for pharmaceutical agents and other products in this program may not be necessarily the same as those indicated in the package insert for the product and may reflect the clinical experience, the professional literature or other clinical sources.

The faculty listed below provided the following information:

Brian Pereira Grant/Research Support Amgen
  Consultant Amgen, Baxter
  Speakers' Bureau Amgen
David Churchill Consultant Amgen
Steven Fishbane Grant/Research Support Amgen
  Consultant Amgen
  Speakers' Bureau Amgen
Adeera Levin Grant/Research Support Janssen, Ortho, Baxter
  Consultant Janssen, Ortho, Genzyme, Amgen
  Speakers' Bureau Amgen
Roger London Consultant Amgen
Allen Nissenson Grant/Research Support Amgen, Schein
  Consultant Amgen, Schein
  Speakers' Bureau Amgen, Schein

This is not part of the official 33rd Annual Meeting as planned by the ASN Program Committee.
Supported by an unrestricted educational grant from Amgen, Inc.