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Navigating the CKM axis module 2

CE / CME

Navigating the CKM Axis: Improving CKD and HF Outcomes With Novel and Emerging GMDT

European Learners: 0.50 EBAC® CE Credit

Physician Assistants/Physician Associates: 0.50 AAPA Category 1 CME credit

Physicians: maximum of 0.50 AMA PRA Category 1 Credit

Nurse Practitioners/Nurses: 0.50 Nursing contact hour

Released: December 19, 2025

Expiration: December 18, 2026

Activity

Progress
1 2 3
Course Completed

References

  1. Maddox TM, Januzzi JL Jr, Allen LA, et al. 2024 ACC expert consensus decision pathway for treatment of heart failure with reduced ejection fraction: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2024;83:1444-1488.
  2. Patolia H, Khan MS, Fonarow GC, et al. Implementing guideline-directed medical therapy for heart failure: JACC focus seminar 1/3. J Am Coll Cardiol. 2023;82:529-543.
  3. van Essen BJ, Ceelen DCH, Ouwerkerk W, et al. Pharmacologic treatment of heart failure with reduced ejection fraction: an updated systematic review and network meta-analysis. J Am Coll Cardiol. 2025;86:2513-2526.
  4. Kittleson MM, Panjrath GS, Amancherla K, et al. 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2023;81:1835-1878.
  5. Heidenreich PA, Bozkurt B, Aguilar D, et al; ACC/AHA Joint Committee Members. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145:e895-e1032.
  6. Finerenone [prescribing information]. Whippany, NJ: Bayer HealthCare Pharmaceuticals Inc.; 2025.
  7. Waqas SA, Sohail MU, Saad M, et al. Efficacy of GLP-1 receptor agonists in patients with heart failure and mildly reduced or preserved ejection fraction: a systematic review and meta-analysis. J Card Fail. 2025;31:1076-1080.
  8. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2024;105:S117-S314.
  9. Agarwal R, Filippatos G, Pitt B, et al; FIDELIO-DKD and FIGARO-DKD Investigators. Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. Eur Heart J. 2022;43:474-484.
  10. Perkovic V, Tuttle KR, Rossing P, et al; FLOW Trial Committees and Investigators. Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes. N Engl J Med. 2024;391:109-121.
  11. Bhatt DL, Szarek M, Steg PG, et al; SOLOIST-WHF Trial Investigators. Sotagliflozin in patients with diabetes and recent worsening heart failure. N Engl J Med. 2021;384:117-128.
  12. Voors AA, Angermann CE, Teerlink JR, et al. The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure: a multinational randomized trial. Nat Med. 2022;28:568-574.
  13. Greene SJ, Butler J, Fonarow GC. Rapid and intensive guideline-directed medical therapy for heart failure: 5 core principles. Circulation. 2024;150:422-424.
  14. Greene SJ, Ayodele I, Pierce JB, et al. Eligibility and projected benefits of rapid initiation of quadruple therapy for newly diagnosed heart failure. JACC Heart Fail. 2024;12:1365-1377.
  15. Beavers CJ, Greene SJ. Hyperkalemia in heart failure with reduced ejection fraction: implications and management. Heart Fail Rev. 2025;30:1291-1305.
  16. Mayne KJ, Sardell RJ, Staplin N, et al; EMPA-KIDNEY Collaborative Group. Frailty, multimorbidity, and polypharmacy: exploratory analyses of the effects of empagliflozin from the EMPA-KIDNEY trial. Clin J Am Soc Nephrol. 2024;19:1119-1129.
  17. Vardeny O, Vaduganathan M, Claggett BL, et al. Finerenone, serum potassium, and clinical outcomes in heart failure with mildly reduced or preserved ejection fraction. JAMA Cardiol. 2025;10:42-48.
  18. Lozano-Maneiro L, Puente-García A. Renin-angiotensin-aldosterone system blockade in diabetic nephropathy. Present Evidences. J Clin Med. 2015;4:1908-37.
  19. Pitt B, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999 Sep 2;341(10):709-717.
  20. Zannad F, McMurray JJ, Krum H, et al; EMPHASIS-HF Study Group. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med. 2011;364:11-21.
  21. Baran W, Krzemińska J, Szlagor M, et al. Mineralocorticoid receptor antagonists-use in chronic kidney disease. Int J Mol Sci. 2021;22:9995.
  22. Bakris GL, Agarwal R, Anker SD, et al; FIDELIO-DKD Investigators. Effect of finerenone on chronic kidney disease outcomes in type 2 diabetes. N Engl J Med. 2020;383:2219-2229.
  23. Renal Interventions. Finerenone meets endpoints in phase III trial among adults with type 1 diabetes and CKD. renalinterventions.net/finerenone-meets-endpoints-in-phase-iii-trial-among-adults-with-type-1-diabetes-and-ckd/. Accerssed December 12, 2025.
  24. Patel SK, Teoh H, Saunthar A, et al. The emerging role of aldosterone synthase inhibitors in overcoming renin-angiotensin-aldosterone system therapy limitations: a narrative review. Card Fail Rev. 2025;11:e20.
  25. Persuad N. Phase 2 data show lorundrostat lowers SBP, albuminuria in hypertensive CKD. renalandurologynews.com/reports/lorundrostat-lowers-sbp-albuminuria-chronic-kidney-disease-hypertension. Accessed December 12, 2025.
  26. Tang H, Lu Y, Zhang B, et al. Cardiovascular and kidney outcomes of GLP-1 receptor agonists in adults with obesity: a target trial emulation study. Diabetes Obes Metab. 2025;27:6527-6536.
  27. Badve SV, Bilal A, Lee MMY, et al. Effects of GLP-1 receptor agonists on kidney and cardiovascular disease outcomes: a meta-analysis of randomised controlled trials. Lancet Diabetes Endocrinol. 2025;13:15-28.
  28. O’Riordan M. Tirzepatide matches dulaglutide in large CV outcomes trial: SURPASS-CVOT. tctmd.com/news/tirzepatide-matches-dulaglutide-large-cv-outcomes-trial-surpass-cvot. Accessed December 12, 2025.
  29. Zoungas S, Nicholls S, Miller, D, et al. Tirzepatide vs. dulaglutide is associated with reduced major kidney events in patients with type 2 diabetes, CVD, and very high-risk kidney diseases. J Am Soc Nephrol. 2025;36(10S):10.1681/ASN.2025dh60xrrs.
  30. Ridker PM. From RESCUE to ZEUS: will interleukin-6 inhibition with ziltivekimab prove effective for cardiovascular event reduction? Cardiovasc Res. 2021;117:e138-e140.
  31. Wing S, Ray JG, Yau K, et al. SGLT2 inhibitors and risk for hyperkalemia among individuals receiving RAAS inhibitors. JAMA Intern Med. 2025;185:827-836.