Update on the Management of Ascites and Hepatorenal Syndrome CME Enduring Material

Hepatorenal syndrome (HRS) is one of many potential causes of acute kidney injury in patients with acute or chronic liver disease. Accurate diagnosis and effective therapies are the best tools to stem the flow of advancing injury to both the liver and the kidneys. This highly focused CME Enduring Material activity will provide that information. It will be delivered at level that is appropriate for these generalists and their nurse practitioners, physician assistants, and other members of their care team.

Welcome to On-line version of the "Update on the Management of Ascites and Hepatorenal Syndrome." The content represents the most up-to-date information on the diagnostic approaches and effective treatment therapies HRS.

This course consists of one module offering 1.0 credit hour. During the course you will watch and listen to a video presentation.
 When you have viewed the presentation, you will be directed to take the required CME quiz, evaluate the seminar, and claim your Continuing Education credits.

Target Audience

Gastroenterologists, Internists, Hepatologists, as well as related advanced-practice clinicians and nurse specialists.

Joint Provider Statement
 This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Louisville and SC Liver Research Consortiun. The University of Louisville is accredited by the ACCME to provide continuing education for physicians.

Designation Statement
 The University of Louisville Office of Continuing Medical Education & Professional Development designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses - This program has been approved by the Kentucky Board of Nursing for 1.2 continuing education credits through University of Louisville Hospital, provider number 4-0068-12-22-1268. The Kentucky Board of Nursing approval of an individual nursing education provider does not constitute endorsement of program content. Completion criteria to obtain CE's: Attend entire session and complete the evaluation.

Course Instructions 
This online CME activity has been developed by the University of Louisville School of Medicine Continuing Medical Office. This course consists of one module offering 1.0 credit hour. During the course you will watch and listen to a video presentation.

  • You will have to register and create a user profile before you are able to view the material.
  • Once you have finished viewing the material you can either close the presentation window or select the CME Publisher Portal window at the top of the screen to continue with your post-test, evaluation, and generation of your CME certificate.
  • If you are not able to complete a module in one sitting you will be able to re-access the material once you have registered for the course. CLICK HERE on the module registration link and sign in, then Click Registration History from the menu at the left of the page to continue the activity.

As a provider accredited by the ACCME, the Office of CME&PD, School of Medicine, University of Louisville, must ensure balance, independence, objectivity, and scientific rigor in all its accredited educational activities. All Planners, faculty, reviewers, and other persons that affected the content of this CME activity were required to submit a financial disclosure form from which relevant conflicts of interest were determined. If any relevant financial relationship(s) with ineligible companies were disclosed, the materials each of them prepared for this program (or influenced) were peer-reviewed and determined to be without ineligible company bias, were considered fair and balanced in terms of therapeutic options, and presented evidence-based content. All relevant financial relationships with ineligible organizations have been mitigated prior to this activity.

Paul J. Pockros, MD - Course Director, Planner; Consulting: AbbVie, lntercept, Antios, Gilead, Durect; Non-CME Services: Intercept; Contracted Research: lntercept, Gilead; Stocks/Stock Options: Novo
Howard J. Horwitz, MPH
- Course Coordinator, Planner; has no relevant financial relationships to disclose.
Cathleen Frenette, MD
- Planner; Speaking: Bristol Meyers Squibb, Abbvie, Gilead, Eisai, Intercept, Salix, Exelixis, Genentech; Consulting: Bayer, Eisai, Merck, Genentech, Astra Zeneca, Exelixis; Contracted Research: Bayer  
Andrew Muir, MD
- Planner, Faculty; Consulting: Abbvie, Gilead; Contracted Research: Gilead
Florence Wong, MD
- Faculty; has no relevant financial relationships to disclose.
Lisa Pfitzer, MD
- Content Reviewer; has no relevant financial relationships to disclose.
Tracy Ander, DO
- Content Reviewer; has no relevant financial relationships to disclose.
The University of Louisville CME & PD Advisory Board and Office Staff
have nothing to disclose with the following Board Member exceptions: Sathya Krishnasamy, MD -  Novo Nordisk, Kowa (Grant Funding);  Ashlee Bergin, MD – Oraganon (Speaking);  Michael Sowell, MD – Amgen, Abbvie, Biohaven, Teva, Lundbeck (Speaking); Rainer Lenhardt, MD - CSL, Behring (Speaking).

Hardware & Software Requirements
High speed internet connection
Browser: Google Chrome is recommended

Original Release & Termination Dates
Course Originally Released On: 2/01/2022
Date of Most Recent Review: 1/27/2022
Course Termination Date: 2/29/2024

Special Services
If you need special accommodations due to a disability, or for an alternative form of course materials, please contact Howard Horwitz. Continuing Medical Education & Professional Development fully complies with the legal requirements of the ADA and the rules and regulations thereof.

Provider Contact Information
If you need technical support or have questions about the course, please e-mail us at cmepd@louisville.edu

Privacy Policy
The University of Louisville's Continuing Medical Education and Professional Development office respects your privacy. Personal information collected from participants of our medical educational activities will not, unless required by law, be shared with any third party. Names or contact information of learners will not be shared with any ineligible company or its agents without the explicit consent of the individual learner. The primary reason we collect your personal information is for accountability and documentation of your continuing education activities in compliance with Accreditation Council for Continuing Medical Education (ACCME) regulations. We do not distribute unsolicited e-mails, nor, unless required by law, do we share the names of our subscribers with any third party.

The University of Louisville has obtained permission to use the content in this educational activity.

Disclosure of Support from Ineligible Companies
This Internet Activity Enduring Material is Supported by educational grants from Mallinckrodt and Grifols, USA.

Course Learning Objectives
As a result of participating in this activity, participants should be able to:
1. Describe the causes, symptoms, and treatment for ascites.
2. Advice patients of the dangers of cirrhosis and the importance of fluid management.
3. Develop realistic sodium reduction approaches for patients with mild ascites.
4. Evaluate the benefits vs risks of a TIPS procedure.
5. Know how liver disease impacts kidney health and the warning signs of HRS.
6. Differentiate between Type 1 and Type 2 HRS.
7. Explain how Hepatorenal Syndrome advances and can lead to renal failure.
8. Investigate the benefits and risks of various HRS treatment approaches.
9. Advise patients and their families on the most efficacious therapies for Hepatorenal.
10. Syndrome to minimize further damage to the liver and kidneys.


There is no fee to participate in this CME course.
If you exit the activity before completion please select CLICK HERE in the registration option above then login and Click Registration History from the menu at the left of the page to continue the activity.

Content Questions and Comments
All participants are invited to submit their questions or comments about the content or cases in the presentations to
Questions will be routed to the faculty expert for reply and each will be answered within 48 hours of receipt.

This Course is Jointly Provided By