LEARNING OBJECTIVES:

1. To improve the management of common symptoms related to end-stage renal disease, such as pain, nausea, and pruritus.
2. To discuss the use of opioids in the context of end-stage renal disease.
3. To discuss other useful therapeutic options in this context.
4. To explain the fundamental concepts of deprescribing in palliative care.

LEARNING OBJECTIVES:

1. To present the current state of anticoagulation in patients with chronic kidney disease.
2. To explore the limitations of current knowledge and the complexity of using direct oral anticoagulants (DOACs), particularly in advanced renal disease.
3. To introduce factor XI inhibitors as a promising new therapeutic class in anticoagulation, to highlight their benefits in reducing bleeding risk, and to discuss their relevance and use for patients with chronic kidney failure.

LEARNING OBJECTIVES:

1. To briefly explain the definitions of sarcopenia, frailty, and malnutrition in the context of CKD.
2. To estimate the prevalence of these conditions in patients suffering from CKD stages 3 to 5, and to explain the underlying mechanisms.
3. To demonstrate the harmful impact of these conditions on quality of life, morbidity, and mortality in patients suffering from CKD stages 3 to 5.
4. To propose clinically useful tools to detect the occurrence of sarcopenia and frailty in this clientele, and to evaluate their progression over time.
5. To discuss therapeutic strategies (nutrition, exercise, pharmacotherapy) to prevent the occurrence or progression of sarcopenia, frailty, and malnutrition.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

LEARNING OBJECTIVES:
Using clinical cases for a multidisciplinary audience (nephrologists, pharmacists, nurses, dietitians):

1. To briefly review the prevalence of CKD stage 4 to 5 in Cananda, more specifically for patients over 75 years-old, and to address the most prevalent and debilitating symptoms affecting the clientele; and life expectancy for this cohort of patients.
2. To explore the concept of patient-reported outcome measures (PROMs) and to analyze the potential benefits of their usage to optimize the management of CKD patients stage 3 to 5 and to provide better information for health care professionals to select the best strategies of care.
3. To investigate useful tools in CKD care to optimize the clinical trajectories of CKD patients stage 4-5 and to select the best therapeutic plans for these patients (conservative approach, preservative approach, dialysis, symptom-related).
4. To propose scored communication strategies useful in the context of selecting therapeutic plans for CKD patients in stages 4-5.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

LEARNING OBJECTIVES:
To share with colleagues the vision of one member of each professional group involved, and more specifically:

1. To present relevant concepts (diagnostic, therapeutic, behavioural, organizational approaches or notions acquired in 2025) to the members of multidisciplinary teams in nephrology.
2. To illustrate how the concepts of interest acquired in 2025 can apply in a multidisciplinary practice for the different groups of healthcare professionals.
3. To integrate the concepts conveyed in the presentation to the current practice of the members of the healthcare teams.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

LEARNING OBJECTIVES: Using clinical cases or vignettes in this conference for a multidisciplinary audience (pharmacists, nurses, dietitians, nephrologists)

1. To explain the mechanisms or underlying reasons for ambivalent attitudes in some patients suffering from complex chronic diseases like chronic kidney disease (CKD).
2. To demonstrate the benefits of motivational interviewing in generating a change of attitude.
3. To develop new clinical skills to better detect the underlying causes of ambivalent attitudes or inertia in patients suffering from chronic kidney disease (CKD).
4. To integrate the use of motivational interviewing when working with patients experiencing ambivalent attitudes or clinical inertia.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

PART 1: RENAL HEALTH IN QUEBEC AND CANADA: CURRENT FACTS AND FUTURE GOALS

LEARNING OBJECTIVES:

1. To briefly discuss the current prevalence and incidence of chronic kidney disease (CKD) in Quebec (if statistics available) and/or in Canada, to outline its major etiologies, and to project trends over the next years.
2. To present, based on these statistics, current data on survival for CKD patients at stages 3-5D; to discuss, in relation to the type of dialysis therapy selected, the evolution of these patients (morbidity, mortality).
3. To propose care pathways to enhance the future of CKD patients stages 3-5 in the model of Quebec Healthcare system.
4. To predict, based on these pathways, pharmacoeconomic benefits or enhancement of quality of life for these patients.

PART 2: FUTURE DIRECTIONS FOR ENHANCING RENAL HEALTH CARE

LEARNING OBJECTIVES:

1. To briefly explain the architecture of the Quebec Renal Agency and, more specifically, its relationship with Quebec kidney care centers (dialysis units, kidney protection centers).
2. To present goals to achieve better kidney care over the next years, focusing on the prevention of end-stage kidney disease, selection of dialysis modality, and kidney transplantation.
3. To discuss ways to achieve these goals in the future, utilizing resources available from the agency.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

LEARNING OBJECTIVES, PART 1: Diabetic Nephropathy
Using several clinical vignettes:

1. To summarize and estimate the real clinical benefit, or lack thereof, of nephroprotective therapies often proposed to patients with diabetic nephropathy (renal diet restricted in protein, blood pressure control with target levels to reach, metabolic acidosis control with target levels to reach, according to the most recent literature data).
2. To appropriately integrate the use of therapeutic agents with nephroprotective potential in such a context and within a holistic health approach (agents acting on the RAAS, Finerenone, SGLT2 inhibitors, GLP-1 agonists, or other relevant therapeutic agent classes).
3. To validate, using relevant medical literature, the benefit of combined therapeutic approaches in the clinical context described in the vignettes.
4. To suggest practical solutions to optimize the use of nephroprotective therapies, at appropriate doses and judiciously.

LEARNING OBJECTIVES, PART 2: Chronic Kidney Disease of Non-Diabetic Origin
Using several clinical vignettes:

1. To summarize and estimate the real clinical benefit, or lack thereof, of nephroprotective therapies often proposed to patients with non-diabetic chronic nephropathy (renal diet restricted in protein, blood pressure control with target levels, metabolic acidosis control with target levels, according to the most recent literature data).
2. To appropriately integrate the use of therapeutic agents with nephroprotective potential in such a context and within a holistic health approach (agents acting on the RAAS, SGLT2 inhibitors, GLP-1 agonists (in an appropriate clinical context), or other relevant therapeutic agent classes).
3. To validate, using relevant medical literature, the benefit of combined therapeutic approaches in the clinical context described in the vignettes.
4. To suggest practical solutions to optimize the use of nephroprotective therapies, at appropriate doses and judiciously.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

LEARNING OBJECTIVES:

Using clinical vignettes

1. To discuss the benefits and limitations of using genetic testing in the presence of chronic kidney disease (CKD), to optimize the accuracy of CKD etiologies and improve its management.
2. To define the CKD clientele who would benefit the most from this testing.
3. To correctly select specific genetic tests to order in different clinical scenarios of CKD (phenotypic panel, whole genome sequencing, whole exome sequencing, test for specific variant).
4. To integrate the use of genetic testing in the presence of CKD of unknown origin.
5. To interpret the appropriate course of action in the presence of variants of unknown significance.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

LEARNING OBJECTIVES:
Using clinical cases

1. To briefly define MGUS, MGRS, AMYLOIDOSIS, and to elaborate a classification of MGRS.
2. To discuss the use of clinical tests or other pertinent tests to diagnose diseases causing MGRS (blood and urine tests, imaging, and bone marrow or kidney biopsy).
3. To describe the management (drugs, graft) of these diseases and their prognosis.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

LEARNING OBJECTIVES:

1. To briefly discuss the prevalence and incidence of CKD stages 3 to 5D among the North American population over the age of 75.
2. To describe the outcomes of stage 5D CKD patients aged 75 to 80 years after the initiation of dialysis, in relation to: survival, cognitive function, occurrence of cardiovascular events, and occurrence or progression of sarcopenia.
3. To review the results of recent studies on the benefits of kidney transplantation in the population aged 75 or even 80 years and older, and the impact of using kidneys from donors over 75 years old on graft survival and rejection rates.
4. To suggest helpful clinical prediction scores and screening tests to better select CKD patients over 75 years old for kidney transplantation and to optimize the use of kidneys from elderly donors.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

LEARNING OBJECTIVES:

1. To briefly review key messages from the latest guidelines on induction and maintenance therapies for ANCA-associated vasculitis, including the treatment of relapses.
2. To define the concept of clinical remission and discuss the benefits and limitations of using different markers to predict the efficacy of therapies, such as:
   • monitoring ANCA levels
   • BVAS score
   • imaging
   • laboratory tests (eGFR, urine analysis)
   • other pertinent tools
3. To integrate a management plan for following patients with ANCA-associated vasculitis in different clinical contexts, including:
   • clinical remission with persistence of ANCA in blood test results
   • clinical remission with recurrence of ANCA in blood test results
   • clinical remission with recurrence of haematuria
   • partial regression of head and neck lesions (nasal crusts, tracheal ulcers).
4. To debate the optimal duration of treatment to maintain remission of this disease following induction therapy or clinical relapse, and to discuss the risks associated with continuing or ceasing treatment.
5. To outline a management and therapeutic plan for refractory ANCA-associated vasculitis.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

LEARNING OBJECTIVES:

1. To briefly review the prevalence of resistant hypertension in North America and/or Europe, and to explain its major pathophysiological causes and the possible impact of renal denervation in optimizing hypertension control in this context.
2. To discuss the results of significant clinical studies conducted in recent years, demonstrating the benefits and limitations of renal denervation compared to antihypertensive polypharmacy, in the context of resistant hypertension.
3. To describe devices and techniques for renal denervation presently approved by health regulatory agencies such as the FDA.
4. To outline the advantages and risks of using renal denervation techniques, specifically regarding the preservation of renal function, long-term blood pressure control (over 5 years), and meeting patient expectations for blood pressure management or reduction in antihypertensive medication dosage, for the target population of this technique.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional

LEARNING OBJECTIVES:
with the help of clinical vignettes

1. To briefly review the definition and prevalence of cardiorenal syndrome in North America.
2. To explain the pathophysiology of this syndrome and its impact on kidney and endocrine function, as well as fluid homeostasis.
3. To discuss methods for diagnosing and monitoring this clinical condition.
4. To integrate different therapeutic strategies to overcome the clinical complications related to cardiorenal syndrome, such as:
   • diuretics (in monotherapy or in combination)
   • SGLT2 inhibitors, mineralocorticoid receptor antagonist, hypertonic saline
   • drugs enhancing cardiac output and/or acting on peripheral vascular resistance
5. To propose the appropriate usage of more invasive therapies: cardiac devices and ultrafiltration techniques.

TARGETED CANMEDS SKILLS:
Medical Expert	Communicator	Collaborator
Leader	Health Advocate	Scholar
Professional