Managing Protein-Energy Wasting: The Role of Serum Albumin in Stratifying Risk in Dialysis Patients
Serum albumin is an important way to monitor patients in stages 4 and 5 chronic kidney disease and there is evidence it is being underutilized. At the same time, there is increasing evidence that serum albumin is more accurate than realized in predicting malnutrition and cardiovascular disease. As serum albumin declines, risk of sudden death or other adverse outcomes increases. The role of inflammation in this process is being seen as equally important to nutrition. This program outlines the recommendations of KDOQI guidelines as well as the new science behind using albumin as a way to stratify risk.
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After completing this educational activity, participants should be able to:
- Identify the factors contributing to poor outcomes in dialysis patients.
- Recognize the clinical value of serum albumin in CKD patient assessment.
- Describe patient outcomes associated with protein-energy wasting (PEW) and the rationale for monitoring adequate serum albumin levels based on scientific findings.
- Identify recommended serum albumin targets according to current clinical practice guidelines and their value in predicting outcomes.
- Discuss evolving concepts of PEW, malnutrition-inflammation syndrome and malnutrition-inflammation-atherosclerosis syndrome.
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Target Audience
This activity is designed for physicians, physician assistants, nurses, nurse practitioners, dietitians, dialysis technicians, pharmacists, and other health care professionals who care for people with chronic kidney disease (CKD).
Accreditation
PHYSICIAN
The National Kidney Foundation is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The National Kidney Foundation designates this educational activity for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
This activity is applicable for Category 2-B Credit through the American Osteopathic Association for Doctors of Osteopathy.
PHYSICIAN ASSISTANT
AAPA accepts certificates of participation for educational activities certified for Category I credit from AOACCME, Prescribed credit from AAFP, and AMA PRA Category I CreditTM from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 1.0 hour of Category I credit for completing this program.
NURSE AND TECHNICIAN
The National Kidney Foundation is an approved provider of continuing nursing education by the New York State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
It has been assigned code 6EXQ7J-PRV-O6.
1.0 contact hour will be awarded.
NURSE PRACTITIONER
This program has been approved for 1.0 contact hour of continuing education by the American Academy of Nurse Practitioners. Program ID 0902094.
This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standards.
DIETITIAN
The National Kidney Foundation is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR). Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 1.0 continuing professional education unit (CPEU) for completion of this program/material.
PHARMACIST
The University of Illinois at Chicago, College of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. The ACPE universal activity number assigned to this educational offering is 016-999-09-023-H01-P.
This activity is accredited by the University of Illinois at Chicago, College of Pharmacy for 0.1 CEUs (1.0 contact hour).
This activity is knowledge based.
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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 individuals who have control over CME content are required to disclose to learners 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 Declaration
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, National Kidney Foundation, and Novo Nordisk 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.
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Method of Participation
This activity contains two case studies, each of which has self-evaluation questions.
To complete the activity, you must follow each case study in its entirety and answer the questions. The estimated time for completion is 1.0 hour.
Post-test and Evaluation
Upon conclusion of this activity, you will be asked to complete the post-test and program evaluation. Please be sure to fill these out completely and your certificate will be available for you to print out. A minimum score of 75% is required for certification. If you do not pass the test, you may retake it.
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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 www.kidney.org/about/privacy.cfm
For additional information about KLS and/or to learn about KLS educational opportunities, contact NKF at 800-622-9010 or visit
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