Calcimimetics for Secondary Hyperparathyroidism: Something Old, Something New

Secondary hyperparathyroidism (SHPT) is a frequently encountered complication in patients with chronic kidney disease (CKD). This activity provides the most recent understanding of the pathophysiologic connections between SHPT and CKD-Mineral and Bone Disorder (CKD-MBD). The introduction of the calcimimetic, cinacalcet for the treatment of SHPT in patients on dialysis was based on its ability to reduce elevated levels of parathyroid hormone (PTH). Subsequent clinical studies confirmed the beneficial effects of cinacalcet on biochemical parameters reflecting mineral disturbances and bone disease. This activity discusses the clinical implications of cinacalcet on biochemical endpoints, intermediate endpoints including bone mineral density and arterial calcification, and finally on hard clinical endpoints. Unfortunately, the practical use of cinacalcet in clinical practice due to adverse effects and low patient adherence creates low utilization despite potential benefits. The emergence of a newer intravenous calcimimetric, etelcalcetide, that may offer prospects for improved patient acceptance, is discussed during this educational program.

Supported by an educational grant from Amgen

PLEASE NOTE: YOU MUST LOGIN OR CREATE AN ACCOUNT BEFORE ENROLLING IN THIS EDUCATIONAL ACTIVITY.
Learning Objectives: 

After participation in this activity, learners will be better able to:

  • Review the pathophysiology of SHPT and CKD-MBD, including new developments such as the effects of FGF23
  • Examine the effects of various therapeutic interventions (e.g. calcimimetics, vitamin D, phosphate binders) on SHPT
  • Describe the characteristics and clinical effects of novel therapeutic interventions for SHPT

Target Audience

  • Physicians 
  • Pharmacists
  • Nurses  
  • Dialysis Technicians 
  • Physician Assistants 
  • Nurse Practitioners
  • Dietitians 
  • Social Workers
Accreditation/Designation of Credit Statements:

In support of improving patient care, the National Kidney Foundation 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.

Physician

The National Kidney Foundation designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.  

Nurse and Dialysis Technician

Awarded 1.5 contact hours of continuing nursing education (includes 0.44 contact hours in the area of pharmacology).

Pharmacist

This application-based enduring activity has been assigned ACPE Universal Activity Number 0620-0000-17-033-H01-P, for 1.5 contact hours (0.15 CEUs). The activity is available for credit through June 15, 2018. To receive credit, learners must read the activity overview, learning objectives and faculty disclosures, complete the pre-test, review the content, complete the post-test with a minimum score of 70% (post-test may be taken up to 3 times) and electronic activity evaluation. An NABP eProfile ID and date of birth in MMDD format are prerequisites for receiving continuing pharmacy education credits. All ACPE credit awarded to participants must be uploaded to CPE Monitor™ within 30 days of the activity date, so pharmacists and pharmacy technicians are required to provide their e-Profile ID and date of birth (MMDD) at the time of the activity.  Please contact cmeinfo@kidney.org if you do not see activity information listed in your profile within 30 days.  For more information and to set up your e-Profile visit: www.MyCPEmonitor.net.

Physician Assistant 

AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit(s)™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 1.5 hours of Category I credit for completing this program.

The activity is available for credit through June 15, 2018.

Nurse Practitioner 

This activity is approved for 1.5 contact hours of continuing education (which includes 0.44 hours of pharmacology) by the American Association of Nurse Practitioners. Activity ID 17052693.  

This activity was planned in accordance with AANP CE Standards and Policies. 

Dietitian 

The National Kidney Foundation is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR).  CDR Credentialed Practitioners will receive 1.5 Continuing Professional Education Units (CPEUs) for completion of this activity/material.

The activity is available for credit through June 15, 2018.

Social Worker

The National Kidney Foundation Council of Nephrology Social Workers, Provider #1014, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org, through the Approved Continuing Education (ACE) program.  The National Kidney Foundation Council of Nephrology Social Workers maintains responsibility for the program. Social workers participating in this course will receive 1.5 continuing education clock hours.      

National Kidney Foundation SW CPE is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #0064.

Licensed social workers should contact their individual jurisdiction to review current continuing education requirements for licensure renewal.

Method of Participation:

Learners will review the materials on accreditation information, target audience, learning objectives, and disclosure information; participate in the entire self-study consisting of slides and audio; and complete the post-test (minimum score of 70% required) and evaluation to successfully earn credit.  The estimated time for completion is 1.5 hours. To receive AMA PRA Category 1 Credit(s)™, participants must receive a minimum score of 70% on the post-test.  

If you participated in the live symposium Calcimimetics for Secondary Hyperparathyroidism: Something Old, Something New on April 19, 2017 and claimed credit, you should not claim credit for this endured activity.

Declaration of Disclosure:

It is the policy of the National Kidney Foundation (NKF) to ensure balance, independence, objectivity, and scientific rigor in all CME/CE activities. Any individual who has control over CME/CE content is required to disclose to learners prior to the activity any relevant financial relationship(s) they may have with commercial interests supporting this activity or whose products or devices are discussed in this activity.  

If, on the basis of information disclosed, a perceived conflict exists, resolution will be achieved based on NKF's Disclosure and Conflict of Interest Policy.

Unlabeled/Investigational Use:

During their presentations, faculty may discuss an unlabeled use or an investigational use not approved for a commercial product. Each faculty member is required to disclose this information to the audience when referring to an unlabeled or investigational use.

Disclaimer:

The faculty and National Kidney Foundation (NKF) do not recommend the use of any pharmaceutical, diagnostic test, or device outside of the labeled indications as approved by the FDA. Please refer to the official prescribing information for each product for approved indications, contraindications, and warnings.

Information contained in this NKF educational resource is based upon current data available at the time of publication. Information is intended to help clinicians become aware of new scientific findings and developments.  This NKF educational resource is not intended to set out a preferred standard of care and should not be construed as one. Neither should the information be interpreted as prescribing an exclusive course of management.

Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of information in this NKF educational resource is responsible for interpreting the data as it pertains to clinical decision making in each individual patient.

Course summary
Available credit: 
  • 1.50 AANP Contact Hours
  • 1.50 ACPE Contact Hours
  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 ANCC Dialysis Technician Contact Hours
  • 1.50 ANCC Nurse Contact Hours
  • 1.50 ASWB Continuing Education Clock Hours
  • 0.44 AANP Pharmacology
  • 0.44 ANCC Pharmacology
  • 1.50 Attendance
  • 1.50 Category I Credit for Physician Assistants
  • 1.50 CDR CPEUs
Course opens: 
03/03/2017
Course expires: 
06/15/2018
Cost:
$0.00
Rating: 
0
Faculty Disclosures:

Myles Wolf, MD, MMSc 
Professor of Medicine Chief 
Duke University School of Medicine 
Durham, NC
Disclosure: Consultant: Amgen, Ardelyx, Diasorin, Keryx, Lilly, Pfizer, Ultragenyx CME lecture: Amgen

Csaba P. Kovesdy, MD 
Director, Clinical Outcomes and Clinical Trials Program 
Fred Hatch Professor of Medicine 
Memphis, TN
Disclosure: Consultant: Sanofi-aventis, AstraZeneca, Fresenius Medical Care, Keryx, Relypsa

James B. Wetmore, MD, MS 
Associate Professor of Medicine 
University of Minnesota School of Medicine 
Minneapolis, MN 
Disclosure: Speakers' Bureau: OPKO Renal

Planning Committee Disclosures:

Dena Rifkin, MD, MS, FNKF
Nephrologist
VA San Diego
La Jolla, CA
Disclosure: Has no financial relationships with commercial interest(s).

Lawrence Weisberg, MD, FNKF
Professor of Medicine, Chief of Nephrology, CMSRU
Cooper Health System
Camden, NJ
Disclosure: Member, Independent Data Monitoring Committee: PLC Medical Systems, Inc.

Thomas Nolin, PharmD, PhD
Associate Professor
University of Pittsburgh School of Pharmacy
Pittsburgh, PA
Disclosure: Consultant: AM Pharma, Medibeacon; IDMC member: Thrasos Innovation, Inc

Katherine Houle, APRN FNP-BC, CNN-NP
Nephrology Nurse Practitioner
Marquette General/Duke Lifepoint Hospital
Marquette, MI
Disclosure: Speakers' Bureau: Keryx

Marianne Neumann, RN, CNN
Clinical Manager
Fresenius Medical Care
Albany, NY
Disclosure: Has no financial relationships with commercial interest(s).

Beth Shanaman, RD
Registered Dietitian
Northwest Kidney Centers
Seattle, WA
Disclosure: Has no financial relationships with commercial interest(s).

Jennifer McClain, MSW, LSW, NSW-C
Social Worker
Fresenius Medical Care
Las Vegas, NV
Disclosure: Has no financial relationships with commercial interest(s).

Gail Torres, RN, MS, RD
Director of Clinical Communications
National Kidney Foundation
New York, NY
Disclosure: Has no financial relationships with commercial interest(s).

Danielle Nathan, MA
Professional Education Director
National Kidney Foundation
New York, NY
Disclosure: Has no financial relationships with commercial interest(s).

Kathryn Troy, MPH
Professional Education Coordinator
National Kidney Foundation
New York, NY
Disclosure: Has no financial relationships with commercial interest(s).

Nathalie Harden
Director, CME
National Kidney Foundation
New York, NY
Disclosure: Has no financial relationships with commercial interest(s).

Available Credit

  • 1.50 AANP Contact Hours
  • 1.50 ACPE Contact Hours
  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 ANCC Dialysis Technician Contact Hours
  • 1.50 ANCC Nurse Contact Hours
  • 1.50 ASWB Continuing Education Clock Hours
  • 0.44 AANP Pharmacology
  • 0.44 ANCC Pharmacology
  • 1.50 Attendance
  • 1.50 Category I Credit for Physician Assistants
  • 1.50 CDR CPEUs

Accreditation Period

Course opens: 
03/03/2017
Course expires: 
06/15/2018

Price

Cost:
$0.00

Enrollment Restricted

Required Hardware/software

System requirements can be found here.

Contact Information:

For any questions concerning this activity, please send an email to CMEinfo@kidney.org or call NKF at 1-800-622-9010.

To view NKF privacy and confidentiality policy as it relates to CME/CE activity, please visit http://www.kidney.org/

For additional professional education resources, contact NKF at 1-800-622-9010 or visit https://www.kidney.org/professionals