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Strategies for the Early Diagnosis and Management of ADPKD: Coordinating Care Throughout the Patient Journey

Strategies for the Early Diagnosis and Management of ADPKD: Coordinating Care Throughout the Patient Journey

Med-IQ Select
Online Course | Specialties: Family Medicine, Primary Care
Released: 2/24/2021
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Expires: 2/23/2022
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Max Credits: 0.75
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Faculty
Neera Kanhouwa Dahl, MD, PhD
Associate Professor of Medicine, Nephrology
Yale School of Medicine
Director, Nephrology Clinical Trials Program
Yale Medicine
New Haven, CT

Steven S. Raman, MD, FSAR, FSIR
Professor of Radiology, Urology, and Surgery
Director, Abdominal Imaging Fellowship
David Geffen School of Medicine at UCLA
University of California Los Angeles
Los Angeles, CA

John J. Russell, MD, FAAFP
Clinical Professor of Family and Community Medicine
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, PA
Chair, Department of Family Medicine
Director, Family Medicine Residency Program
Abington Hospital-Jefferson Health
Abington, PA

Activity Planners
Iwona Misiuta, PhD, MHA
Clinical Content Manager
Med-IQ
Baltimore, MD

Rebecca L. Julian, MS, ELS
Senior Manager, Editorial
Med-IQ
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Med-IQ
Baltimore, MD

Amy Sison
Director of CME
Med-IQ
Baltimore, MD

Kathryn Schaefer, MSN, RN, CPHRM
Associate Director, Education Quality and Compliance
Med-IQ
East Lansing, MI

Writer
Katherine Kahn
Holyoke, MA

Learning Objectives
Upon completion, participants should be able to:

  • Identify patient factors that increase the index of suspicion of ADPKD
  • Evaluate patients with ADPKD for rapidly progressing disease
  • Select appropriate management strategies for patients with ADPKD based on risk of rapid disease progression
  • Describe strategies to enhance the coordination of care for patients with ADPKD

Target Audience
This activity is intended for primary care clinicians, including family physicians, internal medicine physicians, physician assistants, nurse practitioners, and nurses.

Statement of Need
An estimated 140,000 people living in the United States have autosomal dominant polycystic kidney disease (ADPKD). It is the most common genetic renal disease and the fourth leading cause of end-stage renal disease (ESRD) worldwide. At least 50% of patients with ADPKD progress to dialysis-dependent kidney failure by the age of 60 years. In addition, these patients have an elevated risk of hypertension and cardiovascular disease independent of their renal function. With the introduction of disease-modifying therapies that have the potential to delay ADPKD progression, primary care physicians (PCPs) now play a greater role in recognizing and referring patients to nephrologists and radiologists, who can fully evaluate their risk of disease progression and implement appropriate renal protective strategies. Therefore, PCPs would benefit from education to ensure that patients with ADPKD are diagnosed sooner, confidently comanage patients with nephrologists and radiologists, and implement recommended management strategies at the appropriate specialty level based on properly assessed disease progression.

Providership Statement
Provided by Med-IQ.

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Med-IQ designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CME MOCSuccessful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.75 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
 
CLAIMING MOC POINTS: If you intend to claim MOC points for your participation, you will need to provide your unique, six-digit ABIM ID Number. Please note, your name, ABIM ID number, birthdate, and completion status will be shared with ABIM through the ACCME PARS system. Your points will be automatically submitted to the ABIM on your behalf; please allow 4 weeks for your points to display on the ABIM website.

Med-IQ is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

This nursing activity has been approved for up to 0.75 contact hour.

Medium/Method of Participation
This is a 0.75-credit CME/CE activity. To receive credit, read the introductory CME/CE material, complete all of the modules, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.

Initial Release Date: February 24, 2020
Expiration Date: February 23, 2021
Estimated Time to Complete This Activity: 45 minutes

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Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 12 months, including those of a spouse/life partner, that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are mentioned within this activity.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.

Neera Kanhouwa Dahl, MD, PhD
Consulting fees/advisory boards: Natera, Otsuka America Pharmaceutical, Inc.
Fees received for promotional/non-CME activities: Otsuka America Pharmaceutical, Inc.

Steven S. Raman, MD, FSAR, FSIR, has indicated no real or apparent conflicts.

John J. Russell, MD, FAAFP
Consulting fees/advisory boards: Bayer HealthCare Pharmaceuticals, GlaxoSmithKline, Sanofi-aventis U.S. Inc.
Fees received for promotional/non-CME activities: Sanofi-aventis U.S. Inc.

The writer, peer reviewers, and activity planners have no financial relationships to disclose.

Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, it is the policy of Med-IQ to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.

Contact Information
For CME/CE questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email info@med-iq.com.

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Disclaimer
The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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This activity is available free of charge to participants.

Acknowledgment of Commercial Support
This activity is supported by an educational grant from Otsuka America Pharmaceutical, Inc.

Copyright
© 2021 Copyrighted

Abstract

Here are some key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available by clicking the "Continue" button below.

  • ADPKD is an inherited disorder characterized by extensive and progressive renal cyst formation
  • Mutations in the PKD1 or PKD2 genes are the cause of ADPKD in the overwhelming majority of cases
  • Ultrasonography easily confirms or excludes a diagnosis of cystic kidney disease and is widely available and inexpensive; genetic testing is recommended only in certain situations
  • Hypertension is the most common clinical manifestation of ADPKD and is the primary risk factor associated with CV complications and progression to ESKD
  • The pivotal CRISP studies revealed a direct correlation between kidney enlargement from renal cyst expansion and decline in renal function
  • Criteria for rapid progression have not been outlined by the FDA or other regulatory agencies, but the most commonly used algorithm is the Mayo imaging classification model of ADPKD
  • The goals of ADPKD treatment are to delay disease progression, preserve kidney function, and prevent complications; to that effect, general principles of ADPKD management include controlling hypertension and other CV risk factors, employing renoprotective strategies, managing symptoms, and improving quality of life
  • Tolvaptan, a highly selective vasopressin V2 receptor antagonist, remains the only FDA-approved agent for the treatment of ADPKD; clinical trials have demonstrated that tolvaptan slows the decline of kidney function and delays disease progression in adults with ADPKD

View reference list.

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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