Specialty
Critical Care, Gastroenterology, Hepatology, Hospitalist, Primary Care

Topic(s)
Hepatorenal syndrome (HRS), Acute Kidney Injury (AKI)

This activity is supported by an educational grant from Mallinckrodt Pharmaceuticals.

Credit Available

• 1.0 AMA PRA Category 1 Credit(s)™
• 1.0 ANCC Contact Hours
• 1.0 AAPA Category 1 CME Credits
• 1.0 ACPE Contact Hours
• 1.0 CA-BRN Contact Hours for California nurses

All other healthcare professionals completing this course will be issued a statement of participation.

Target Audience

This activity was developed for hospitalists, critical care physicians, nephrologists, hepatologists, gastroenterologists, interventionalists, nurse practitioners, physician associates, pharmacists, and other clinicians who provide care for patients with HRS-AKI.

Program Overview

Advancements in understanding the pathogenesis of hepatorenal syndrome (HRS), a form of acute kidney injury (AKI), coupled with clearer diagnostic criteria and availability of more targeted therapy provide new opportunities for improving the health outcomes of patients with HRS-AKI. Intensivist Rahul Nanchal, MD, and hepatologist Ram Subramanian, MD, share their perspectives about the contemporary, pathophysiologically-based management of patients with this devastating disease, with reference to the 2024 Acute Disease Quality Initiative/International Club of Ascites consensus recommendations.

Learning Objectives

Upon completion of this activity, participants should be better able to:

• Contrast the diagnostic criteria of HRS-AKI to other common forms of AKI.
• Describe the role of treatment to reverse pathophysiologic changes associated with HRS-AKI
• Review recent guideline recommendations on the management of HRS-AKI
• Identify strategies that the multidisciplinary care team can implement to foster successful application of guideline-recommended care for patients with HRS-AKI

Faculty

Mitra K. Nadim, MD

Director of Critical Care Nephrology
Keck School of Medicine of USC
Los Angeles, California

Rahul Nanchal, MD

Division of Pulmonary and Critical Care Medicine
Medical College of Wisconsin
Milwaukee, Wisconsin

Ram Subramanian, MD

Medical Director of Liver Transplant & Liver Critical Care Services
Emory University School of Medicine
Atlanta, Georgia

Accreditation Statement

In support of improving patient care, Annenberg Center for Health Sciences at Eisenhower (Annenberg Center) 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.

Credit Designation

In support of improving patient care, Annenberg Center for Health Sciences at Eisenhower (Annenberg Center) 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 Credit

The Annenberg Center designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician Associate Credit

The Annenberg Center has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until May 15, 2026. PAs should only claim credit commensurate with the extent of their participation.

Pharmacist Credit

The Annenberg Center designates this knowledge-based activity for a maximum of 1.0 hour. Credit will be provided to NABP CPE Monitor within 45 days after the activity completion.

Nurse Credit

The Annenberg Center designates this education for a maximum of 1.0 American Nurses Credentialing Center (ANCC) contact hour, including 0.75 pharmacology hour.

Provider is approved by the California Board of Registered Nursing, Provider #13664, for 1.0 contact hour. To receive credit for education contact hours outside of the state of California, please check with your state board of registered nursing for reciprocity.

Disclosures of Conflicts of Interest

Mitra K. Nadim, MD
Advisory Board: Baxter, Idorsia, Mallinckrodt, Ocelot

Ram Subramanian, MD
Consultant: Baxter, eGenesis, OrganOx

Rahul Nanchal, MD
No relevant financial relationships to disclose.

Additional content planners

The following have no relevant financial relationships to disclose:

Eugene Cullen, MD (Peer Reviewer)

Lauren Mangan, PharmD (Medical Writer)

Amber Lea Lambert, MSN, FNP-C, DNP (Nurse Reviewer)

Annenberg Center for Health Sciences
All staff at the Annenberg Center have no relevant financial relationships to disclose.

All the relevant financial relationships listed for these individuals have been mitigated.

Instructions for Participation and Credit

There are no fees for participating and receiving CME credit for this enduring activity. To receive CME credit participants must:

1. Read the CME/CE information and faculty disclosures.
2. Participate in the online activity.
3. Submit the evaluation form.

Certificates will be emailed to the participant.

Course Viewing Requirements

Supported Browsers:
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

The faculty for this activity has disclosed that there will be discussion about the use of products for non-FDA approved indications.

Disclaimer

This activity is designed for educational purposes. Participants have a responsibility to utilize this information to enhance their professional development to improve patient outcomes. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.