CME

Faculty: Richard Lafayette, MD, FACP

Faculty: Hong Zhang

IgA nephropathy (IgAN) remains the most common primary glomerulonephritis worldwide and a leading cause of chronic kidney disease and end-stage kidney disease in adolescents and young adults. The 2025 KDIGO clinical practice guideline updates represent a major paradigm shift, lowering the optimal proteinuria target from <1.0 g/day to <0.3 g/day and emphasizing earlier escalation at persistent proteinuria ≥0.5 g/day, even in the absence of rapid eGFR decline. Notably, these guidelines recommend a simultaneous, dual-pathway approach, combining optimized supportive therapy (RAAS inhibition, SGLT2 inhibitors) with the timely introduction of immunomodulatory or disease-modifying agents in high-risk patients. However, real-world practice across Asia has not yet caught up. Explore this series for practical strategies to support patient selection and the integration of emerging agents into individualized care.

Faculty: Richard Lafayette, MD, FACP

Faculty: Suzuki Yusuke, MD, PhD

IgA nephropathy (IgAN) remains the most common primary glomerulonephritis worldwide and a leading cause of chronic kidney disease and end-stage kidney disease in adolescents and young adults. The 2025 KDIGO clinical practice guideline updates represent a major paradigm shift, lowering the optimal proteinuria target from <1.0 g/day to <0.3 g/day and emphasizing earlier escalation at persistent proteinuria ≥0.5 g/day, even in the absence of rapid eGFR decline. Notably, these guidelines recommend a simultaneous, dual-pathway approach, combining optimized supportive therapy (RAAS inhibition, SGLT2 inhibitors) with the timely introduction of immunomodulatory or disease-modifying agents in high-risk patients. However, real-world practice across Asia has not yet caught up. Explore this series for practical strategies to support patient selection and the integration of emerging agents into individualized care.

Faculty: Richard Lafayette, MD, FACP

Faculty: Suzuki Yusuke, MD, PhD

IgA nephropathy (IgAN) remains the most common primary glomerulonephritis worldwide and a leading cause of chronic kidney disease and end-stage kidney disease in adolescents and young adults. The 2025 KDIGO clinical practice guideline updates represent a major paradigm shift, lowering the optimal proteinuria target from <1.0 g/day to <0.3 g/day and emphasizing earlier escalation at persistent proteinuria ≥0.5 g/day, even in the absence of rapid eGFR decline. Notably, these guidelines recommend a simultaneous, dual-pathway approach, combining optimized supportive therapy (RAAS inhibition, SGLT2 inhibitors) with the timely introduction of immunomodulatory or disease-modifying agents in high-risk patients. However, real-world practice across Asia has not yet caught up. Explore this series for practical strategies to support patient selection and the integration of emerging agents into individualized care.

Faculty: Deepak Bhatt, MD, MPH, MBA, FACC, FAHA

Faculty: Amir H. Hamrahian, MD

2025 delivered an expanded approval for Cushing syndrome for one agent, a complete response letter for another, and deeper insights on the prevalence of Cushing syndrome (or hypercortisolism) in people with difficult-to-control metabolic conditions. 2026 promises to be jam packed with further insights on Cushing syndrome prevalence and data for emerging drugs. Join our faculty as they review advances from 2025 and look ahead to what’s coming in 2026.

Faculty: Jonathan Barratt, MD, PhD

Professor Jonathan Barratt illustrates the integration of shared decision-making in the management of IgA nephropathy while interacting with a real patient with IgAN, highlighting how patient-centered conversations about proteinuria, GFR, and blood pressure can guide individualized treatment strategies. Emphasis is placed on explaining diagnostic findings such as the Oxford MEST-C score, monitoring disease progression, and evaluating emerging therapeutic options, including SGLT2 inhibitors, RAS blockade, budesonide, and sparsentan. Considerations around lifestyle, medication adherence, side effects, and life planning—such as employment and family planning—are explored. This dialogue-driven format demonstrates how collaborative care supports sustainable treatment adherence and improves patient engagement.

Faculty: Steven Fishbane, MD

Faculty: Maurizio Gallieni, MD

Drs. Steven Fishbane and Maurizio Gallieni discuss chronic kidney disease-associated pruritus (CKD-aP), a prevalent and under-recognized complication of CKD. They review the epidemiology, pathophysiology, and treatment strategies supported by pivotal phase 3 trials and new European S2k guidelines, including the use of difelikefalin, a kappa-opioid receptor agonist. Additional insights from biomarker analyses in the KALM studies underscore the link between inflammation and pruritus severity, suggesting a dual mechanism of action for difelikefalin. The program emphasizes the importance of actively screening for CKD-aP and using validated tools to assess symptom burden in clinical practice.

Faculty: Ellie Kelepouris, MD, FACP, FAHA

Faculty: Nihar Desai, MD

Using a real-world patient case, Drs. Ellie Kelepouris and Nihar Desai examine clinical challenges in managing hyperkalemia among patients with chronic kidney disease (CKD) and heart failure (HF). They explore the use of modern potassium binders to sustain guideline-directed medical therapy (GDMT) with renin–angiotensin–aldosterone system (RAAS) inhibitors and break down the differences between patiromer and sodium zirconium cyclosilicate (SZC). Their discussion includes guideline recommendations from KDIGO and European societies, the sodium-related safety signals with SZC, and supporting data from trials such as REALIZE-K and DIAMOND. Findings from the CARE-HK registry are also discussed, highlighting low potassium binder use despite high rates of recurrent hyperkalemia and underutilization of GDMT in advanced CKD.

Faculty: Javed Butler, MD

Patients with heart failure with reduced ejection fraction (HFrEF) who have not experienced a recent worsening event pose a major clinical challenge: persistent and under-recognized cardiovascular (CV) risk. Recent findings show that these patients carry significant annual rates of CV death and heart failure (HF) hospitalization, despite adherence to quadruple guideline-directed medical therapy (GDMT) and device support. For cardiologists, the challenge is twofold: accurately identifying high-risk individuals without overt clinical deterioration and knowing when and how to intensify therapy in patients who appear stable but remain vulnerable. Recent data show that soluble guanylate cyclase (sGC) may provide significant reductions in CV death and all-cause mortality, particularly in individuals with moderately elevated NT-proBNP (≤6,000 pg/mL). These findings are especially important because this population is far more common in routine cardiology practice and has historically been overlooked in discussions of additional therapy. However, cardiologists often underestimate risk in these ambulatory patients and may hesitate to add therapies when GDMT appears to be working well. Tune in to learn best practices for patient selection and the implementation of added sGC therapy.

Faculty: Prof. Dr. Johann Bauersachs

Faculty: Javed Butler, MD

Patients with heart failure with reduced ejection fraction (HFrEF) who have not experienced a recent worsening event pose a major clinical challenge: persistent and under-recognized cardiovascular (CV) risk. Recent findings show that these patients carry significant annual rates of CV death and heart failure (HF) hospitalization, despite adherence to quadruple guideline-directed medical therapy (GDMT) and device support. For cardiologists, the challenge is twofold: accurately identifying high-risk individuals without overt clinical deterioration and knowing when and how to intensify therapy in patients who appear stable but remain vulnerable. Recent data show that soluble guanylate cyclase (sGC) may provide significant reductions in CV death and all-cause mortality, particularly in individuals with moderately elevated NT-proBNP (≤6,000 pg/mL). These findings are especially important because this population is far more common in routine cardiology practice and has historically been overlooked in discussions of additional therapy. However, cardiologists often underestimate risk in these ambulatory patients and may hesitate to add therapies when GDMT appears to be working well. Tune in to learn best practices for patient selection and the implementation of added sGC therapy.

Faculty: Javed Butler, MD

Faculty: Carolyn S. P. Lam, MBBS, PhD

Patients with heart failure with reduced ejection fraction (HFrEF) who have not experienced a recent worsening event pose a major clinical challenge: persistent and under-recognized cardiovascular (CV) risk. Recent findings show that these patients carry significant annual rates of CV death and heart failure (HF) hospitalization, despite adherence to quadruple guideline-directed medical therapy (GDMT) and device support. For cardiologists, the challenge is twofold: accurately identifying high-risk individuals without overt clinical deterioration and knowing when and how to intensify therapy in patients who appear stable but remain vulnerable. Recent data show that soluble guanylate cyclase (sGC) may provide significant reductions in CV death and all-cause mortality, particularly in individuals with moderately elevated NT-proBNP (≤6,000 pg/mL). These findings are especially important because this population is far more common in routine cardiology practice and has historically been overlooked in discussions of additional therapy. However, cardiologists often underestimate risk in these ambulatory patients and may hesitate to add therapies when GDMT appears to be working well. Tune in to learn best practices for patient selection and the implementation of added sGC therapy.