Raising the Index of Suspicion in Primary Care: The Role of the Nurse Practitioner in Recognizing and Managing Diabetic Kidney Disease




This CME activity for ACCME credit is provided by Integrity Continuing Education, Inc.

This CE activity for ANCC and AANP credit is jointly provided by Global Education Group and Integrity Continuing Education, Inc.


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


Treatment for diabetic kidney disease has undergone a recent evolution with the approval and guideline recommendations of newer therapies for treatment, including sodium-glucose cotransporter-2 (SGLT-2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and recently, non-steroidal selective mineralocorticoid receptor antagonists (MRAs). These therapies have the potential to reduce cardiovascular disease (CVD) risk and DKD progression. As newer agents begin to take their place in practice and to further reduce renal risk in patients with diabetes, clinicians need to become aware of these therapies, their mechanism of action, and best practices for their use so they can integrate them into care of patients with DKD. This educational activity will also address recommended strategies to screen for and ensure an early diagnosis of DKD and discuss the impact of inflammation and fibrosis on CV risk. The goal of the activity is optimization of care of patients with or at risk for development of DKD.


Kathleen Byrne, MSN, CRNP, FPCNA, CLS, FNLA
Cardiovascular Nurse Practitioner
Adult and Pediatric Cardiology
Heart & Vascular Institute
Johns Hopkins University
Baltimore, Maryland


Release date: June 29, 2022
Expiration date: June 29, 2023
Estimated time to complete activity: 60 minutes



This educational activity has been designed to meet the needs of nurse practitioners, nurses, physicians, and physician assistants who manage patients with or at risk for diabetic kidney disease.


Upon completion of this educational activity, participants should be able to:

  • List recommended screening strategies to ensure early diagnosis of chronic kidney disease (CKD) in patients with diabetes, including the use of urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR)
  • Discuss how DKD confers a high risk of CVD, renal events, and associated mortality, and DKD’s implications for patient management
  • Describe the role of inflammation, fibrosis, and the mineralocorticoid receptor in the progression of DKD
  • Describe how to incorporate current treatment approaches and discuss novel treatment approaches based on current and emerging data, to optimize the care of patients with type 2 diabetes and decrease the risk of progression of DKD

There are no fees for participating and receiving CME credit for this activity. During the period of June 29, 2022 through June 29, 2023, participants must:

  • Read the learning objectives
  • Complete the pretest
  • Study the educational activity
  • Complete the posttest and the evaluation form

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.




Nurse Practitioner Continuing Education

This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of Global Education Group and Integrity Continuing Education. Global Education Group is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 110121. This activity is approved for 1.0 contact hour (which includes 0.2 hour(s) of pharmacology).

Nursing Continuing Education
Global Education Group is accredited with distinction as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 1.0 contact hour is provided by Global Education Group. Nurses should claim only the credit commensurate with the extent of their participation in the activity.

Physician Continuing Education

Integrity Continuing Education, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


Integrity Continuing Education, Inc. designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


For information about ACCME accreditation of this activity, please contact Integrity Continuing Education, Inc. at (855) 835-4004 or cme@integrityce.com.

For information about AANP or ANCC accreditation of this activity, please contact Global Education Group at (303) 395-1782 or cme@globaleducationgroup.com.


Integrity Continuing Education, Inc. and Global Education Group, require instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Integrity Continuing Education, Inc. for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations. All relevant financial relationships have been mitigated.

The following faculty/planners reported the financial relationships or relationships to products or devices they have with ineligible companies related to the content of these CME activities:

Kathleen Byrne, MSN, CRNP, FPCNA, CLS, FNLA has nothing to disclose.

The following project managers/planners: Lindsay Borvansky, Ashley Cann, Stefani Chiarolanza, Donna Fausak, Andrea Funk, Liddy Knight, Rhys Williams, RN, MSN, FNP, Kristin Delisi, NP, Michelle Rizzo, ELS, and Patima Tanapat, PhD, reported that they have no financial relationships or relationships to products or devices with ineligible companies related to the content of this CE activity.


This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Integrity Continuing Education, Inc. and Global Education Group does not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


When you participate in an online educational activity sponsored by Integrity Continuing Education, Inc., you will be asked for your name, degree(s), affiliation(s), street address, telephone number and…(continued)


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The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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