Question 3
What are the key differences between steroidal MRAs and nonsteroidal MRAs?
Daniel Ngui, BScPT, PT, MD, CCFP, FCFP
Case Studies of Hyperkalemia in Heart failure and Chronic Kidney Disease
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About Presentations
These patient case studies are part of a wider programme entitled ‘Hyperkalaemia in Cardiorenal Disease’. Watch these short videos, where Dr Burton presents a CKD patient at high risk of hyperkalaemia, and Dr Zieroth presents a HF patient with moderate to severe hyperkalaemia. After the videos have played, you can vote using the polls on how you would treat these patients. These cases, and their management strategy, will be discussed during a live roundtable. The panel will discuss emerging data and the changing landscape of medical management of hyperkalaemia. If you’d like to register for this roundtable, please enter your email after completing the polls.
This programme is supported by an unrestricted educational grant from AstraZeneca and brought to you by Radcliffe Medical Education.
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CKD patient at high risk of hyperkalaemia
Dr. James Burton
Professor of Renal Medicine
University of Leicester, UKProf James Burton
Prof James Burton is Honorary Consultant Nephrologist and Professor of Renal Medicine and Associate Dean for Clinical Research at the University of Leicester, Leicester, UK. His principal research interests are the mechanisms underlying uraemic cardiovascular disease modification of cardiovascular risk in patients with end-stage renal disease and the identification and application of novel biomarkers.
In addition, Prof Burton is involved in the development and running of clinical trials; he is Chief Investigator for the NIHR funded NightLife trial investigating the impact of nocturnal dialysis on patient outcomes as well as the Kidney Research UK funded CONFIRM study exploring the utility of a novel cardiac magnetic resonance imaging (MRI) techniques in haemodialysis patients. Prof Burton is the independent Chair of two multi-centre NIHR Trial Steering Committees and sits on a number of others.
He is the current Chair of the UK Kidney Association Clinical Guidelines Committee and has himself chaired a number of UK guideline updates making sure that research translates into clinical practice.
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HF patient with moderate/severe hyperkalaemia
Dr Shelley Zieroth
Professor at the College of Medicine
University of Manitoba, CanadaDr Shelley Zieroth
Dr Shelley Zieroth is Professor at the College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba, as well as Director of the Heart Failure and Heart Transplant Clinics at St. Boniface Hospital in Winnipeg, CA.
She is also Head of the Medical Heart Failure Program for Cardiac Sciences Manitoba. She is involved in several heart failure clinical trials as a PI, National Lead or Executive Committee member. She is the Immediate Past President of the Canadian Heart Failure Society and Co-Chair of the Canadian Cardiovascular Society Heart Failure Guidelines. She serves as Co-Chair of Canada’s largest annual heart failure meeting, HF Update and serves as Scientific Planning Committee Chair for the Canadian Cardiovascular Congress hosted by the Canadian Cardiovascular Society. She is currently President-elect of the Federation of Medical Women of Canada.
Dr Shelley Zieroth is an Editorial Board member of Cardiac Failure Review.
KLINRISK: Clinical Risk Prediction for Kidney Disease
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ABOUT PRESENTATION
The Klinrisk algorithm uses data from blood and urine tests including CBC, metabolic panel, and urine albumin to estimate the probability of kidney function loss of up to 40% or kidney failure in the next 5 years. The risk categories and recommendations are provided to alert providers to the risk of progression of CKD, complications of kidney disease and associated care pathways recommended by clinical practice guidelines.
Klinrisk algorithm is for clinical care and should be considered as an aid to help with clinical decision making and is not meant to replace a physician’s advice or diagnosis.
The laboratory tests required for the algorithm were performed at LifeLabs.
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DOWNLOADS
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ABOUT SPEAKER
Navdeep Tangri, MD, PhD, FRCP (C)
Max Rady College of Medicine
Internal Medicine
Section of Nephrology
University of ManitobaDr. Tangri’s research program is clinical and translational and focused on improving clinical decision making for patients with advanced chronic kidney disease. He developed and validated the Kidney Failure Risk Equation (KFRE) to predict the need for dialysis in patients with CKD and is presently engaged in multiple validation and implementation exercises to increase the uptake of the KFRE.
In addition, Dr. Tangri is conducting a large prospective study on frailty, physical and cognitive function in advanced CKD, as well as leading a multinational randomized trial on the safety and efficacy of a new therapy in this population. He has published over 200 manuscripts and presented at multiple national and international scientific meetings and is a recipient of the CIHR New Investigator Award and a CIHR Foundation grant.
DOACs in Renally Impaired Patients
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ABOUT PRESENTATION
Atrial fibrillation is common in patients with CKD, with rates significantly higher than in the general population. CKD significantly increases thromboembolic risk above baseline and is also associated with increased risk of bleeding. The evidence to support oral anticoagulants (vitamin K antagonist or direct oral anticoagulants [DOACs]) is less robust in individuals with reduced creatinine clearance. The use of direct oral anticoagulants does represent an important opportunity and challenge in patients with impaired kidney function. This presentation by Dr. Jason Andrade reviews the literature on DOAC use with a specific focus on Edoxaban in chronic kidney disease. -
ABOUT SPEAKER
Jason Andrade, M.D., FRCPC, FHRS, is a Cardiac Electrophysiologist at Vancouver General Hospital in Canada, with joint appointment at the Montreal Heart Institute. He is an Associate Professor of Medicine at the University of British Columbia (UBC), and an Assistant Professor at the Université de Montréal.
See Dr. Andrade's full bio here.
Jason Andrade, M.D., FRCPC, FHRS, is a Cardiac Electrophysiologist at Vancouver General Hospital in Canada, with joint appointment at the Montreal Heart Institute. He is an Associate Professor of Medicine at the University of British Columbia (UBC), and an Assistant Professor at the Université de Montréal.
Dr. Andrade is the Director of Electrophysiology and Director of the Atrial Fibrillation Clinic at Vancouver General Hospital (VGH). He is co-chair of the Canadian Cardiovascular Society (CCS) Atrial Fibrillation Guidelines committee, chair of the Canadian Heart Rhythm Society (CHRS) Device Committee, and medical chair for Heart Rhythm Disease for the Cardiovascular Disease Network in the province of British Columbia.
Dr. Andrade has authored over 200 scientific publications, predominantly in the domain of atrial fibrillation. His publications can be found in journals such as the New England Journal of Medicine, Circulation, Journal of the American College of Cardiology (JACC), Journal of the American Medical Association (JAMA), The Lancet, and Heart Rhythm. In addition, he is also the author of several textbooks, book chapters, and medical apps.
EDUCATION
- Undergraduate: McMaster University (Summa Cum Laude)
- Medical Degree: University of Ottawa, Canada (Magna Cum Laude)
- Residency: University of British Columbia
- Fellowship: University of British Columbia – Cardiology
- Fellowship: Montreal Heart Institute – Cardiac Electrophysiology
ACCOMPLISHMENTS
- Grant funding of $6,602,170 as Principal Investigator, and $74,391,112 as co-investigator
- Principal investigator of the CIRCA-DOSE and the EARLY-AF multicenter randomized clinical trials
- In 2021, recognized as World’s Expert in AF research
- In 2021, recipient of the Clinical Faculty Award for Excellence in Research, University of British Columbia
- In 2020, recipient of the Donald M Whitelaw Award, University of British Columbia
- In 2019, recipient of the Alumni Achievement Award, University of Ottawa
- In 2018, recipient of the Robert E. Beamish Award, Canadian Cardiovascular Society
PUBLICATIONS
https://www.ncbi.nlm.nih.gov/myncbi/1fWvtqNE7LdYpI/bibliography/public/
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Disclosure
Dr. Andrade created the slide content appearing in this presentation. He was provided an honorarium by Servier Canada to support the time spent on preparing and delivering this presentation.
