JAAPA CME Post-Test October 2024

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Updated Guidelines for Chronic Kidney Disease

Chronic kidney disease (CKD) is an increasingly common condition worldwide that leads to substantial mortality. Research in the past decade has informed significant advances in preventing CKD or delaying its progression, mainly through new medications. This progress, however, requires adequate screening and identification of early CKD to truly transform patient outcomes. Revised guidelines from the Kidney Disease: Improving Global Outcomes consortium of experts aim to help clinicians incorporate these advances into practice. This activity summarizes key updates from the guidelines regarding the evaluation and management of CKD that can lead to better patient outcomes.

Learning Objectives

At the conclusion of this activity, participants should be able to:
  • Describe the increasing burden of CKD
  • Describe how to diagnose and stage CKD using standardized definitions
  • List new treatments for CKD and their indications
  • Describe when specialist care by nephrology is appropriate

Managing Neonatal Hyperbilirubinemia: An Updated Guideline

More than 80% of newborn infants experience jaundice as a result of elevated bilirubin during the first few weeks after birth. In most cases, hyperbilirubinemia is physiologic, but persistent and extreme elevations can lead to serious long-term complications, such as kernicterus. To avoid these complications and help clinicians in the successful assessment, evaluation, and treatment of hyperbilirubinemia, the American Academy of Pediatrics updated its clinical practice guideline for neonatal hyperbilirubinemia. This activity reviews the guideline and highlights significant updates, such as an elevation in the threshold for phototherapy and exchange transfusion, inclusion of gestational age, and removal of racially based norms.
 

Learning Objectives

At the conclusion of this activity, participants should be able to:
  • Identify the risks of high serum bilirubin concentrations in a neonate
  • Differentiate physiologic jaundice from pathologic jaundice
  • Apply a management plan based on thresholds of TSB
  • Understand how the updated AAP guideline changes the standard of care in evaluating and treating newborns and infants with jaundice
  • Discuss how genetic ancestry, not race alone, plays a role in identifying risk factors for hyperbilirubinemia neurotoxicity
 

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