Management of Hyperphosphatemia in Patients with ESRD:
A New Direction for Treatment in 2008

CME Satellite Symposium)
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Progression of Coronary Artery Calcification and Patient Outcomes: Results of the CARE-2 Study
Wajeh Qunibi, MD
Critical Examination of Recent Phosphate Binder Clinical Trials: Implications for Future CKD Mineral and Bone Disorder Guidelines
Charles R. Nolan, MD

Audience Questions
Drs. Nolan, Qunibi

Charles R. Nolan, MD
Professor of Medicine & Surgery
Medical Director, Renal Transplant
University of Texas Health Science Center at San Antonio
San Antonio, TX

Wajeh Qunibi, MD
Professor of Medicine
Medical Director of Dialysis Services
University of Texas Health Science Center at San Antonio
San Antonio, TX

This talk or group of talks has a single post-test, which must be completed along with an evaluation form to obtain credit.
Date of Web Release: April 28, 2008
Credit Eligible Through: April 30, 2009
AMA PRA Category 1 Credits™: 1.0
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.
This official symposium was supported by a restricted educational grant from Fresenius Medical Care.

Program Overview
This symposium will provide participants with a comprehensive review of the role of abnormalities of mineral metabolism, particularly hyperphosphatemia, in patient outcomes. Dr. Wajeh Qunibi will address the issues at the center of the current debate. In particular, he will review the results of key clinical trials that evaluated the effect of various phosphate binders on the rate of progression of cardiovascular calcification among patients with stage 5 CKD as well as trials that examined the impact of various binders on patient mortality rates. Following Dr. Qunibi's presentation, Dr. Charles Nolan will review recently published clinical trials that have provided vital new information regarding the potential role of phosphate binder therapy for the prevention of cardiovascular calcification and mortality. Lessons from the past and implications for future CKD Mineral and Bone Disorder Guidelines will be analyzed.

Learning Objectives
At the conclusion of this program, participants will be able to:
  • Identify some of the traditional and uremic risk factors that have been implicated in the development and progression of cardiovascular calcification in patients with stage 5 CKD. In particular, attendees will be able to discuss the role of high serum cholesterol in progression of coronary artery calcification.
  • Summarize the salient findings from recent clinical trials that investigated cardiovascular calcification progression and the mortality rates among patients with stage 5 CKD who were treated with various phosphate binders.
  • Discuss the current process for the development of clinical practice guidelines aimed at improving the quality of care for dialysis patients, and the recommendations for improving the process for future development of clinical practice guidelines.
Target Audience
This program has been designed to meet the learning objectives of the nephrology community including physicians, researchers, fellows and residents, and may be beneficial to nurses and dietitians.

Accreditation Statement
Physician Accreditation
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medical Education Resources and The MedEd Group. Medical Education Resources is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation
Medical Education Resources designates this educational activity for a maximum of 1.0 AMA PHA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosure Policy
It is the policy of Medical Education Resources (MER) to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty/ authors participating in our programs are expected to disclose any relationships they may have with commercial companies whose products or services may be mentioned so that participants may evaluate the objectivity of the presentations.

Dr. Wajeh Qunibi reported that he is on the Speakers Bureau for Fresenius Medical Care. He has also received grants from the following companies: Fresenius Medical Care, American Regent, Amgen, Roche, and serves as a consultant for: Fresenius Medical Care.

Dr. Charles Nolan reported that he is on the Speakers Bureau for Fresenius Medical Care.

The content and views presented in this educational program are those of the faculty and do not necessarily reflect those of Medical Education Resources or Fresenius Medical Care. Dr. Qunibi and Dr. Nolan will disclose if any unlabeled use of products is mentioned in their presentations. Before prescribing any medicine, primary references and full prescribing information should be consulted.

Off-label/lnvestigational Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Before prescribing any medication, physicians should consult primary references and full prescribing information. The faculty presenters will disclose if any unlabeled use of products is mentioned in their presentations. 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 CME policy statements of HDCN are listed on this page.