The Power of SGLT2 Inhibitors to Improve Renal Outcomes in CKD
March 31, 2021
March 31, 2022
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This activity is jointly provided by AKH and peerXchange.
This activity is supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc. and Eli Lilly and Company.
- Physicians — maximum of 1.0 AMA PRA Category 1 Credit(s)™ and ABIM MOC
- Nurse Practitioners — 1.0 Nursing Contact Hours
All other health care professionals completing this course will be issued a statement of participation.
This activity is designed to meet the educational needs of nephrology and primary care providers (physicians, physician assistants, nurse practitioners, nurses, diabetes educators, and pharmacists) and other specialists (cardiology, endocrinology, internal medicine physicians) involved in the care and treatment of patients with chronic kidney disease.
Chronic kidney disease (CKD) may result from multiple etiologies, including diabetes, hypertension, and various other conditions. Patients with CKD have a significant disease burden, including an increased risk of cardiovascular disease and stroke, anemia, metabolic issues (calcium, phosphorus, potassium abnormalities), kidney failure, and early death.
Clinical trials with SGLT2 inhibitors have shown a decrease in the progression of CKD. SGLT2 inhibitors represent a new category of oral antidiabetic agents that can also reduce systolic and diastolic blood pressure, as well as serum uric acid, and improve the glomerular filtration rate. Apart from affecting renal hemodynamics and glycotoxicity, evidence suggests that SGLT2 inhibitors may be renoprotective due to their effects on inflammation in renal tissues.
With the expanding use of SGLT2 inhibitors beyond glucose control, this AI-driven activity will inform clinicians about the available evidence assessing their efficacy and safety in CKD, renoprotective benefits in patients with CKD with and without T2DM, evolving practice standards, and their relevance to patient care.
Upon completion of this activity, participants should be better able to:
- Describe the unmet medical needs associated with cardiovascular, renal and mortality risks in patients with chronic kidney disease (CKD)
- Explain the effects of SGLT2 inhibition on CKD progression and the potential mechanisms and benefits in the management of patients with and without diabetes mellitus
- Evaluate the role of SGLT2 inhibitors in practice to manage the progression of CKD, when to initiate SGLT2 inhibition therapy, and the recommended dosage and administration based on the estimated glomerular filtration rate (eGFR)
- Examine the safety profile of SGLT2 inhibitors in patients with and without type 2 diabetes mellitus and/or impaired renal function
David Cherney, MD, PhD
Professor of Medicine, University of Toronto
Clinician Scientist, Division of Nephrology, University Health Network
Senior Scientist, Toronto General Hospital Research Institute
Director, Renal Physiology Laboratory, University Health Network
Following his clinical training in Nephrology, Dr. Cherney completed his PhD in human renal physiology at the Institute of Medical Science, University of Toronto in 2008. He is currently Professor in the Department of Medicine, University of Toronto and a Clinician Scientist at the University Health Network and Mount Sinai Hospitals, where he is director of the Renal Physiology Laboratory. He is supported by the Canadian Institutes of Health Research, the JDRF, the Heart and Stroke Richard Lewar Centre of Excellence, the Heart and Stroke Foundation of Canada and the Banting and Best Diabetes Centre. He is also supported by a Department of Medicine, University of Toronto Merit Award.
Dr. Cherney’s research program focuses on physiological factors that initiate renal disease in patients with diabetes, such as renal hyperfiltration and inflammation, and the role of the cardiorenal axis in diabetes. His research group is also involved in early and late phase clinical trials in the cardiorenal-metabolic field, including several primary renal outcome trials in patients with and without diabetes. Dr. Cherney’s research program is closely aligned with his integrated and multidisciplinary cardiac-renal-endocrine clinic at the University Health Network, which maintains a strong emphasis on the prevention of diabetic nephropathy and cardiovascular disease. In 2019, he received the American Society of Nephrology (ASN) Distinguished Researcher Award for outstanding contributions to nephrology. In 2019 he also received the Diabetes Canada/CIHR - Institute of Nutrition Diabetes and Metabolism (INMD) Young Scientist Award.
Jennifer Green, MD
Duke University Medical Center
Professor of Medicine
Division of Endocrinology, Metabolism and Nutrition
Durham, North Carolina
Dr. Jennifer Green is a professor of medicine in the division of endocrinology, metabolism, and nutrition at Duke University and a faculty member of the Duke Clinical Research Institute. Her research has focused upon strategies to treat diabetes mellitus and reduce the risk of cardiovascular, renal and other diabetes-related complications. Her work with the DCRI has included protocol development, oversight of adjudication committees, and clinical and operational leadership for several large, international trials designed to determine the cardiovascular effects of glucose-lowering medications (TECOS, EXSCEL, and Harmony Outcomes). She currently serves as US coordinating center PI and US national representativefor the EMPA-Kidney trial of empagliflozin therapy in patients with chronic kidney disease. Dr. Green is also a member of the American Diabetes Association’s Professional Practice Committee, which publishes the organization’s annual Standards of Care in Diabetes.for the EMPA-Kidney trial of empagliflozin therapy in patients with chronic kidney disease. Dr. Green is also a member of the American Diabetes Association’s Professional Practice Committee, which publishes the organization’s annual Standards of Care in Diabetes.
Credit provided by AKH Inc., Advancing Knowledge in Healthcare.
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and peerXchange. AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
AKH Inc., Advancing Knowledge in Healthcare designates this enduring activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1 medical knowledge MOC points and 0 patient safety MOC credit in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and peerXchange, Inc. AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 030803. This activity is approved for 1 contact hour(s) (which includes 0 hour(s) of pharmacology).
Disclosures of Conflicts of Interest
It is the policy of AKH Inc. and peerXchange Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The faculty must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are resolved by AKH prior to accreditation of the activity and may include any of or combination of the following: attestation to non-commercial content; notification of independent and certified CME expectations; referral to National Faculty Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other faculty for discussion of recommendations; independent review against criteria ensuring evidence support recommendation; moderator review; and peer review.
David Cherney, MD, PhD
- Contracted Research: Astra-Zeneca, Boehringer Ingelheim/Lilly, Janssen, Merck, Novo-Nordisk and Sanofi
- Honoraria: Abbvie, Astra-Zeneca, Bayer, BMS, Boehringer Ingelheim/Lilly, Janssen, Maze, Merck, Mitsubishi-Tanabe, Novo-Nordisk, Prometic and Sanofi
Jennifer Green, MD
- Consultant: AstraZeneca, Boehringer Ingelheim/Eli Lilly, Hawthorne Effect, NovoNordisk, Omada, and Pfizer
- Contracted Research (funds paid to institution): Boehringer Ingelheim/Eli Lilly, Lexicon, Merck and Sanofi
Staff and Reviewers Disclosures
Dorothy Caputo, MA, BSN, RN, AKH Lead Nurse Planner/Reviewer, has no financial relationships to disclose.
Bernadette Marie Makar, MSN, NP-C, APRN-C, AKH Nurse Planner/Reviewer: has no financial relationships to disclose.
Patricia Brignoni, AKH Director of Operations/Reviewer, has no financial relationships to disclose.
Wendy Gloffke, PhD, Medical Writer, has no financial relationships to disclose.
Deborah Dean, President, peerXchange Inc., has no financial relationships to disclose.
AKH Inc. and peerXchange Inc., planners and reviewers has no financial relationships to disclose.
All of the relevant financial relationships listed for these individuals have been mitigated.
Instructions for Participation and Credit
Criteria for Success
Statements of credit will be awarded based on the participant reviewing the activity, scoring a 70% on the post test, and completing and submitting an activity evaluation. A statement of credit will be available upon completion of an online evaluation/claimed credit form. You must participate in the entire activity to receive credit.
Course Viewing Requirements
Internet Explorer 8.0+ for Windows 2003, Vista, XP, Windows 7, Windows 8.1 and above
Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6.0+ for Mac OSX 10.7 and above
Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above
Disclosure of Unlabeled Use
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. and peerXchange Inc., Inc. specifically disclaims responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participant's misunderstanding of the content.
There is no fee to participant in this activity. If you have questions about this activity, please contact AKH Inc. at firstname.lastname@example.org.
Copyright 2021 peerXchange Inc. No part of this publication may be produced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical photocopying, recording, or otherwise, without the prior permission of the publisher.