Patients with advanced cirrhosis develop hypervolemic or dilutional hyponatremia, which is recognized as a predictive factor of negative outcomes, such as poor quality-of-life, hospitalization, and early mortality. Hyponatremia in cirrhosis almost always occurs in patients with advanced liver failure, making exact identification of the consequences of hyponatremia difficult.
This program is intended to inform physicians about new insights regarding the therapeutic and management options for the treatment of hyponatremia in these patients. It will also provide physicians with the latest informed thinking about how to incorporate new therapeutic insights into clinical practice, in order to better manage patients.
Douglas M. Heuman, MD, FACP, FACG, AGAF (Chair)
Professor of Medicine
Virginia Commonwealth University
Chief of Hepatology
Hunter Holmes McGuire Department of
Veterans Affairs Medical Center
Douglas M. Heuman, MD, FACP, FACG, AGAF (Chair) is Professor of Medicine at Virginia Commonwealth University and serves as Chief of Hepatology and Medical Director of Liver Transplantation at the Hunter Holmes McGuire Veterans Affairs Medical Center in Richmond, VA. He is a graduate of Yale College and the University of Massachusetts Medical School. He completed his residency and GI fellowship at Virginia Commonwealth University and Ohio State University.
His clinical research interests include many aspects of end stage liver disease, including survival modeling in cirrhosis, drug pharmacokinetics in liver disease, treatment of ascites, hyponatremia and hepatic encephalopathy, hepatocellular carcinoma, and liver transplantation.
Mónica Guevara, MD, PhD
Liver Unit, Hospital Clinic
University of Barcelona
Mónica Guevara, MD, PhD was born in Buenos Aires, Argentina. In 1982, she obtained her medical degree at the Shool of Medicine in the Unviversidad of Buenos Aires. She was a resident in the Hospital de Gastroenterología Bonorino Udaondo in Buenos Aires, where she earned a specialty in gastroenterology. In 1995, Dr. Guevara earned a pre-doctoral fellowship at the Liver Unit of the Hospital Clinic in Barcelona. She obtained her PhD in 2001.
Since 2001, she has been working in the Liver Unit of the Hospital Clinic of Barcelona as a clinical researcher. Her field of expertise is the alteration of renal function in patients with cirrhosis. During these years, she has published in leading journals of the specialty. She is a professor in research on liver disease in the Universidad de Barcelona. She is part of the scientific committee of the international ascites club, and has participated in the last consensus of this entity. Finally, she has been invited to numerous national and international liver meetings as a speaker in topics related to cirrhosis and renal complications.
Robert W. Schrier, MD
Professor of Medicine
University of Colorado School of Medicine
Robert W. Schrier, MD was Chairman of the Department of Medicine at the University of Colorado School of Medicine for 26 years, and Head of the Division of Renal Diseases and Hypertension for 20 years. In 1989, he was elected a member of the Institute of Medicine of the National Academy of Sciences. He has been President of the Association of American Physicians, American Society of Nephrology, National Kidney Foundation, and International Society of Nephrology. Dr. Schrier is a Master of the American College of Physicians and Honorary Fellow of the Royal College of Physicians. He has authored more than 1000 scientific papers and edited numerous books including editions in internal medicine, geriatrics, drug usage, and kidney disease. His research contributions center on autosomal dominant polycystic kidney disease, pathogenesis of acute renal cell injury, hypertension and diabetic nephropathy, and renal and hormonal control of body fluid volume in cirrhosis, cardiac failure, nephrotic syndrome, and pregnancy. Dr. Schrier’s research has been funded by the National Institutes of Health for more than 40 years.
For his contributions as Chairman of Medicine at the University of Colorado, Dr. Schrier was honored by Governor Owens with an Honorary Proclamation designating May 4, 2002 Robert W. Schrier Day in Colorado and by Mayor Wellington Webb who proclaimed May 4, 2002 Robert W. Schrier Day in the City and County of Denver. In 2002, Dr. Schrier also received the prestigious Belle Bonfils-Stanton Award for Contributions in Science and Medicine.
Dr. Schrier has received honorary degrees from DePauw University, the University of Colorado, the University of Silesia, and the University of Toledo. He has received the highest awards of the American College of Physicians (John Phillips Award), the National Kidney Foundation (David Hume Award), the American Society of Nephrology (John Peters Award), the International Society of Nephrology (Jean Hamburger Award), the German Society of Nephrology (Franz Vollhard Award), the Western Society of Clinical Investigation (Mayo Soley Award), the Association of Professors of Medicine (Robert H. Williams Award), the American Kidney Fund (National Torchbearer Award), the Association of American Physicians (Francis Blake Award), Acute Renal Failure Commission (Bywaters Award), the New York Academy of Medicine (The Edward N. Gibbs Memorial Award), the University of Strasburg (Louis Pasteur Medal), the American Association of Kidney Patients (Medal of Excellence), the Grand Hamdan International Award for Medical Sciences, and the Alexander von Humboldt Research Award for his contributions in biomedical research, education, and clinical medicine.
This activity is intended for hepatologists and other physicians who treat patients with liver disease.
This program is designed to address the following IOM competencies: provide patient-centered care and employ evidence-based practice.
At the conclusion of this activity, participants should be able to demonstrate improved ability to:
- Discuss the pathogenesis and underlying mechanisms of hyponatremia associated with liver disease
- Identify the clinical manifestations, sequelae, and complications associated with hyponatremia of liver disease
- Determine appropriate treatment strategies and the role of emerging agents to improve patient outcomes
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Potomac Center for Medical Education and Rockpointe Corporation. The Potomac Center for Medical Education is accredited by the ACCME to provide continuing medical education for physicians.
The Potomac Center for Medical Education designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
For questions regarding CME credit, the post-test, or evaluation, please email firstname.lastname@example.org.
The Potomac Center for Medical Education (PCME) adheres to the policies and guidelines, including the Standards for Commercial Support, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous.
All persons in a position to control the content of a continuing medical education program sponsored by the Potomac Center for Medical Education are required to disclose any relevant financial relationships with any commercial interest to PCME as well as to learners. All conflicts are identified and resolved by PCME in accordance with the Standards for Commercial Support in advance of delivery of the activity to learners. Disclosures will be made known to the participants prior to the activity.
The content of this activity was vetted by an external medical reviewer to assure objectivity and that the activity is free of commercial bias.
The faculty reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
Douglas M. Heuman, MD, FACP, FACG, AGAF: Research Support: Bayer, Bristol-Myers Squibb, Celgene, Exelixis, Novartis, Osiris, Otsuka, Scynexis
Mónica Guevara, MD, PhD: Nothing to Disclose
Robert W. Schrier, MD: Nothing to Disclose
Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
Barry Watkins, PhD; Bradley Pine; Blair St. Amand; Jay Katz; Dana Simpler, MD: Nothing to Disclose
The contents of some CME activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.
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Instructions for Participants and Obtaining CME Credit
There is no fee for this activity. To receive credit, participants must take the pre-test, view this CME activity in its entirety, and then complete the post-test and evaluation. To complete the evaluation online, choose the best answer to each question. The estimated time for completion of this activity is 1.0 hour. To receive their certificates, participants must demonstrate mastery of the presented material via the post-test.
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