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Empowering the Pharmacist to Improve Clinical and Economic Consequences of Diabetic Kidney Disease

This educational activity is sponsored by Postgraduate Institute for Medicine and Letters & Sciences.

This educational activity is supported by an independent educational grant from Bayer HealthCare.


Wendy L. St. Peter, PharmD, FCCP, FASN, FNKF (Moderator)
Professor, University of Minnesota
College of Pharmacy
Minneapolis, Minnesota

Rajiv Agarwal, MBBS, MD, MS, FASN, BRCU
Professor of Medicine
Indiana University School of Medicine and VA Medical Center
Indianapolis, Indiana

Michelle M. Richardson, PharmD, BCPS
Special and Scientific Staff
William B. Schwartz Division of Nephrology Tufts Medical Center
Assistant Professor of Medicine, Tufts University School of Medicine
Boston, Massachusetts


It is the policy of Letters & Sciences and the Postgraduate Institute of Medicine to ensure balance, independence, and scientific rigor in all educational activities/programs. Those who may have the opportunity to influence content of this CPE program (e.g. planners, faculty, authors, reviewers, and others) must disclose all relevant, significant financial relationships with commercial entities so that the providers may identify and resolve any conflicts of interest prior to the program. Additionally, faculty members have been instructed to disclose any limitations of data and unlabeled or investigational uses of product(s), device(s) or clinical strategies to the participants at the time of the presentations.

Wendy St. Peter, PharmD, FCCP, FASN, FNKF, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Quality Insights QIO; Total Renal Care, Inc

Rajiv Agarwal, MBBS, MD, MS, FASN, BRCU, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Akebia; Bayer; Boehringer Ingelheim; Diamedica; Merck; Reata; and Relypsa

Michelle Richardson, PharmD, BCPS, has disclosed the following relevant financial relationships: Receives funding from Dialysis Clinic, Inc. (DCI) to employer (Tufts Medical Center) to direct DCI Outcomes Monitoring Program
Michelle M. Richardson, PharmD, BCPS, will not be discussing or referring to unlabeled/unapproved uses of drugs, devices, products, protocols, or therapeutic strategies.

Executive Committee, CNE Committee, Planning Committee, Curriculum Committee Members, Content managers/members of the CPE planning, executive and curriculum committees of Letters & Sciences and Postgraduate Institute for Medicine, report no relationships with commercial interests.

Michele Nichols, PharmD (External Content Reviewer) has no commercial/financial relationships to disclose.

Shannon L. DeVita, MSN, RN, CNL, DNP (External Content Reviewer) has no commercial/financial relationships to disclose.


Joint Accreditation StatementIn support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and Integritas Communications.  Postgraduate Institute for Medicine 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.

acpePostgraduate Institute for Medicine designates this continuing education activity for 1.5 contact hour(s) (0.15 CEUs) of the Accreditation Council for Pharmacy Education.
UAN: JA4008162-9999-21-2825-H01-P

Type of Activity: Knowledge
Media: Internet

Fee Information: There is no fee for this educational activity
Estimated time to complete activity: 90 minutes


September 24, 2021


September 24, 2022


Community pharmacists, clinical pharmacists, health system pharmacists, managed care decision makers, and Pharmacy and Therapeutics Committee members.


Participants must 1) read the learning objectives and faculty disclosures; 2) view the educational activity in its entirety; and 3) complete the posttest and evaluation form directly after the activity within a maximum of 60 days of participating in the activity. To answer the questions, click on your selected choice for each answer then proceed to the next question. Once completed, click on the Grade Exam button at the bottom of the page. Your posttest will automatically be graded. If you successfully complete the posttest (score of 70% or higher), your statement of participation will be made available immediately. Click on the View Statement of Participation link and print the statement for your records. If you receive a score lower than 70%, you will receive a message notifying you that you did not pass the posttest. You will have 2 opportunities to pass the posttest. To receive Credit, you must provide your date of birth and NABP number. All Credit information will be uploaded into CPE monitor within 30 days.


The goal of this educational activity is to better equip pharmacists with the data, clinical insights, and resources to achieve the clinical and educational goals in managing chronic kidney disease (CKD) in patients with T2D.

CKD has been recognized as a leading public health problem both in the Unites States and worldwide. In the United States, the estimated prevalence of CKD is 14.9% (of the US population surveyed in 2015-2018), and the number of patients with end-stage renal disease (ESRD) in 2018 was 131,636, an increase of 2.3% since 2017 (US Renal Data Systems, 2020). Because diabetes is the leading cause of ESRD, there is a strong economic and health imperative to improve outcomes for people with diabetes and CKD. CKD is also the most debilitating and expensive complication of diabetes while management of diabetes in CKD is most challenging.

Pharmacists play integral roles and serve as community-based resources by screening, identifying and referring individuals with the goal of preventing cardiorenal complications of diabetes and CKD. According to data published by the Association of American Medical Colleges (AAMC), the US could see an estimated shortage of up to 55,200 PCPs by 2033 [Primary Care Collaborative, 2020]. With this growing shortfall in availability of PCPs, pharmacists along other healthcare professionals, need to fill the gap in primary preventive care services for chronic diseases.

Pharmacists are ideally suited to help manage CKD; individuals with CKD experience multiple comorbidities (ie, diabetes , hypertension, heart failure), are at high risk for medication-related problems, require close monitoring with potential need for preventing drug interactions, as well as renal dose adjustments, and benefit from educational counseling. With 66% of adults taking 5 or more drugs per day and 27% taking 10 or more per day, a pharmacist’s review is critical (Caroll, 2019). Medication therapy management (MTM) as well as treatment recommendations in chronic disease is part of the scope of pharmacy practice and has been associated with improved clinical outcomes. Improving outcomes for individuals with CKD requires comprehensive interdisciplinary care. Pharmacist-initiated CKD risk assessment helps alert PCPs of at-risk patients who need further diagnostic evaluation and referral to nephrology/specialist management.

It is incumbent upon pharmacists, as frontline clinicians, to undertake these challenges in patients with CKD. This continuing educational activity will equip clinicians with the appropriate knowledge and confidence for identifying/screening, diagnosis, and treatment (including information and data/place in therapy of novel options and current guidelines) of patients with CKD and T2D.


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

  • Examine the significant economic consequences of diabetes, CKD, and ESRD and the importance of primary and secondary prevention using community-based pharmacists in collaboration with PCPs to improve clinical and economic outcomes
  • Identify areas with potential for pharmacist-delivered preventive services by earlier screening and identifying at-risk patients for CKD, chronic care management of patients with diabetes and other comorbidities, as well as patient education and lifestyle recommendations
  • Apply recent clinical evidence supporting the role of emerging therapies that target inflammatory and fibrosis pathways in the management of progressive renal decline and/or proteinuria in CKD patients with T2D
  • Review current treatment guidelines and as well as clinical data supporting emerging agents that provide cardiorenal benefits in patients with CKD
  • Maximize the clinical benefits of guideline-directed therapy by patient selection, treatment recommendation, monitoring, and mitigation/management of potential adverse events that may arise to help achieve optimal clinical outcomes


Please ensure the computer system you plan to use meets the following minimum requirements:

  • Operating System: Windows 98 or higher & Macintosh 2.2 or higher
  • Internet Browser (Mac & Windows): Internet Explorer 6.0 or higher, Google Chrome, Safari 5.0.6 or higher, Firefox 3.0.3 or higher, & Opera 5 or higher
  • Broadband Internet connection: Cable, High-speed DSL & any other medium that is internet accessible
  • Peripherals: Computer speakers or headphones
  • Monitor Screen Resolution: 320 x 480 or higher
  • Media Viewing Requirements: Adobe Reader, Microsoft PowerPoint, Flash Player & HTML5


The audience is advised that one or more sections in this continuing education activity may contain references to devices and/or protocols or clinical strategies that are unlabeled, investigational, or unapproved by the FDA. Healthcare professionals should note that the use of information presented that is outside of current approved labeling is considered experimental and are advised to consult current prescribing information. The faculty is required to disclose on-site any unlabeled, investigational, and/or unapproved uses or therapies that are to be discussed.


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