Early Anemia Management: Incorporating New Evidence Into
Appropriate Treatment Strategies for Chronic Kidney Disease

RPA 2007 Official Symposium
Introduction: Framing the Issues
Jay B. Wish, MD
Anemia in CKD: Impact on Patient Outcomes and Health Care Costs
William M. McClellan, Jr, MD, MPH
Rationale for Early Anemia Treatment
Jay B. Wish, MD
Treatment Options for the CKD Patient With Anemia
Richard A. Lafayette, MD
Panel Discussion
Drs. Wish, McClellan, and Lafayette
Access to these talks is FREE. However, if you are not already, you must first register on HDCN for the Free Zone at this link to obtain a FREE ZONE username and password.

  1. Participants will review and evaluate new clinical trial data as they relate to the 2006 NKF-K/DOQI guidelines in diagnosing and treating anemia with ESAs to the appropriate hemoglobin (Hb) targets
  2. In order to better manage anemia in their patients with CKD, participants will analyze the prevalence, morbidity, and economic impact of untreated anemia
  3. Participants will review therapeutic options and implement the appropriate ESA treatment plans and dosing schedules to improve quality of life for patients with anemia and CKD
  4. Given the utilization costs associated with the care of patients with anemia and CKD, participants will assess the impact of treatment on health care outcomes and explore ways to reduce costs for these patients
This activity has been prepared under the direction of:

Program Chair:
Jay B. Wish, MD

Professor of Medicine
Case Western Reserve University
Cleveland, Ohio

Richard A. Lafayette, MD
Associate Professor of Medicine
Clinical Chief, Division of Nephrology
Senior Associate Chair, Department of Medicine
Stanford University
Stanford, California

William M. McClellan, Jr, MD, MPH
Professor of Medicine
Emory University
Atlanta, Georgia
This Webcast is a recording of a satellite symposium conducted during the 2007 Annual Meeting of the Renal Physicians Association (RPA). This symposium was approved by the RPA. It was not part of the official RPA Annual Meeting as planned by the RPA Program Committee.
Date of Web Release: May 23, 2007
CME Credit Available Through: May 23, 2008
AMA PRA Category 1 Credits™: 1.5
Target Audience: This program has been developed for nephrologists and other health care professionals who are interested in learning about anemia and its impact on patients with CKD. No prerequisites are required

Method of participation: Listen to the talk(s), read the PubMed abstracts of linked slides and references, take the post-test, read the abstracts linked to in the post-test feedback section.
Physicians click on the blue button to obtain CME credit.
Other health care professionals, please click on the gray button to obtain a certificate of completion.
Sponsored by SCEPTER™
Supported by an educational grant from Ortho Biotech Products, L.P.

Please review the statement of needs, the learning objectives, and the faculty disclosure information for this activity. Listen to the symposium lectures and view the accompanying slide show. You may stop and review any slide or advance the slide show by using the control buttons on the top right of your screen. Links to PubMed abstracts are provided for your reference. You may also follow along with the synchronized text at the bottom of the screen. Once you have viewed the Webcast in its entirety, click on the Post-Test link and answer the 10 questions to earn your continuing medical education (CME) credits. A minimum score of 70% is required.* To print out your certificate of credit immediately, click on the Evaluation link and fill out the form completely. A completed Evaluation must accompany your completed Post-Test to obtain your CME credit certificate.

*If you do not achieve a score of 70%, you will be given an opportunity to retake the Post-Test.

You will need Windows® or Macintosh® operating software and a connection to the Internet with a 28.8 kbps modem or better. Your computer should have an audio card and speakers. An audio player, either the Windows Media Player® from Microsoft® or the Real Player® from Real Media® is required and either can be downloaded for free per instructions on the individual lecture pages. Flash® version 8.0 is required for the full-screen version of the slide program. Acrobat® Reader is required to print the certificate of credit, and this can be downloaded free from www.adobe.com.

For any questions concerning this specific CME Webcast, please send an e-mail to info@iche.edu, or call Hypertension, Dialysis and Clinical Nephrology (HDCN) at 1-630-325-3276 Monday through Friday, between 9:00 AM and 5:00 PM CT.

Anemia begins in chronic kidney disease (CKD) as early as Stage 3 and increases in prevalence as CKD progresses. For the millions of Americans with CKD Stages 3-5, anemia is an important clinical consideration because it is associated with serious health consequences, such as impaired cognitive function, reduced aerobic capacity, and compromised well-being. Since anemia is often underrecognized and undertreated in early CKD, screening and diagnosis are critical long before the progression to end-stage renal disease. Treatment with erythropoiesis stimulating agents (ESAs) has been shown to improve quality of life and functional capacity, in addition to reducing the need for transfusion. Data continue to accumulate on the most appropriate management approach to the anemia of CKD in terms of ESA dosing regimens and therapy. Increases in morbidity, transfusion requirements, and hospitalizations associated with untreated anemia result in escalating health care costs. In a study of 2.3 million health plan members in 2000, medical costs for patients with anemia were found to be almost twice as much as that for patients with the same comorbid conditions but without anemia. From a clinical as well as economic standpoint, there is strong evidence to support the screening and treatment of anemia early in CKD. In response to the evolving evidence, the National Kidney Foundation (NKF) issued updated Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines for the screening, diagnosis, and treatment of anemia, providing compelling support for an educational initiative to increase awareness of anemia in the setting of CKD. This satellite symposium will focus on the evidence surrounding the early diagnosis and treatment of anemia to improve quality of life for patients with CKD, as well as examining the impact of early anemia treatment on health care outcomes and costs.

Credit Designation Statement
SCEPTER designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Accreditation Statement
SCEPTER is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians.

Policy on Disclosure
SCEPTER adheres to the ACCME Essential Areas and Policies, including the Standards for Commercial Support, regarding industry support of CME. Disclosure information is provided during the planning process to ensure resolution of any identified conflicts. Disclosure of faculty and commercial relationships, as well as the discussion of unlabeled or unapproved use of any drug, device, or procedure by the faculty, will be disclosed to learners.

Faculty Disclosures
The faculty for this activity reported the following:

Jay B. Wish, MD
has served on the speakersí bureaus for Amgen and Ortho Biotech Products, L.P. He is a consultant for Roche. He has also received honoraria from Amgen, Ortho Biotech Products, L.P., and Roche.

Richard A. Lafayette, MD
has received grant and/or research support from Amgen, Ortho Biotech Products, L.P., and Roche. He is a consultant for Ortho Biotech Products, L.P.

William M. McClellan, Jr, MD, MPH
has received grant and/or research support from Amgen. He is a consultant for Amgen, Ortho Biotech Products, L.P., and Roche.

Educational Partner Disclosure
The content collaborators at the Education Partner Company reported the following:

The internal staff of Quintiles Medical Education reports no conflict or financial interest with any manufacturers of products or providers of services.

The opinions expressed herein are those of the authors and do not necessarily represent the views of the sponsor, the educational partner, or the supporter. Please review complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients.

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