Volume 93, Number 2
Rapidly progressive kidney failure in an 82-year-old man with respiratory symptoms

How to Obtain AMA PRA Category 1 Credit™ and ABIM MOC points
- Review information on this page.
- Read the journal article.
- Return to this page and select the "Complete the CME/MOC Process" link.
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Release Date: February 1, 2026
Expiration Date: January 31, 2027
Estimated Time of Completion: 1 hour
Description
A review of the workup of a patient who presented with worsening dry cough, lower-extremity edema, and fatigue and underwent systematic evaluation to determine the etiology of acute kidney injury on chronic kidney disease.
Learning Objective
To acknowledge that a high index of suspicion for an acute kidney pathology is necessary in chronic kidney disease when serum creatinine values continue to rise.
Target Audience
Directed to practitioners in emergency medicine, hematology, nephrology, oncology, pathology, and rheumatology.
ACCREDITATION STATEMENT
In support of improving patient care, Cleveland Clinic Center for Continuing Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
CREDIT DESIGNATION
American Medical Association (AMA)
Cleveland Clinic Foundation Center for Continuing Education designates this journal-based activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Participants claiming CME credit from this activity may submit the credit hours to the American Osteopathic Association for Category 2 credit.
Certificate of Participation
A certificate of participation will be provided to other health care professionals for requesting credits in accordance with their professional boards and/or associations.
American Board of Internal Medicine (ABIM)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
**Please Note** To receive MOC you must select the MOC option during the online credit claiming process and complete the required steps. ABIM MOC points will be reported within 30 days of claiming credit.
Activity Directors, Authors, and Other Contributors
Activity Director
Brian F. Mandell, MD, PhD
Chairman, Department of Academic Medicine, Education Institute,
Professor of Medicine, Cleveland Clinic Lerner College of Medicine
of Case Western Reserve University,
Editor in Chief, Cleveland Clinic Journal of Medicine,
Cleveland Clinic,
Cleveland, OH
Co-Activity Directors
Craig D. Nielsen, MD, FACP
Vice Chairman, Department of Internal Medicine;
Associate Professor, Cleveland Clinic Lerner College of Medicine
of Case Western Reserve University, Cleveland, OH;
Governor, Ohio Chapter, American College of Physicians;
Deputy Editor, Cleveland Clinic Journal of Medicine,
Cleveland Clinic,
Cleveland, OH
James C. Pile, MD
Department of Hospital Medicine;
Associate Professor, Cleveland Clinic Lerner College of Medicine
of Case Western Reserve University, Cleveland, OH;
Deputy Editor, Cleveland Clinic Journal of Medicine,
Cleveland Clinic, Cleveland, OH
George Thomas, MD, MPH
Director, Center for Blood Pressure Disorders, Department of Kidney Medicine;
Associate Professor, Cleveland Clinic Lerner College of Medicine
of Case Western Reserve University, Cleveland, OH;
Deputy Editor, Cleveland Clinic Journal of Medicine,
Cleveland Clinic,
Cleveland, OH
Mary T. Cusick, MS
Executive Editor, Cleveland Clinic Journal of Medicine,
Cleveland Clinic,
Cleveland, OH
Authors
Bernardo Henrique Mendes Correa, MD
Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte,
Minas Gerais, Brazil
Ali Mushtaq, MD
Department of Internal Medicine, Cleveland Clinic, Cleveland, OH
Ali Awada
Medical Student, American University of Beirut Medical Center, Beirut, Lebanon
Faiz Anwer, MD
Department of Hematology and Medical Oncology, Cleveland Clinic,
Cleveland, OH; Professor, Cleveland Clinic Lerner College of Medicine of
Case Western Reserve University, Cleveland, OH
Anam Ashfaque, MD
Department of Internal Medicine, Rochester General Hospital, Rochester, NY
Other Contributors
CME Disclaimer
The information in this educational activity is provided for general medical 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. The viewpoints expressed in this CME activity are those of the authors/faculty. They do not represent an endorsement by The Cleveland Clinic Foundation. In no event will The Cleveland Clinic Foundation be liable for any decision made or action taken in reliance upon the information provided through this CME activity.
Disclosures
In accordance with the Standards for Integrity and Independence issued by the Accreditation Council for Continuing Medical Education (ACCME), The Cleveland Clinic Foundation Center for Continuing Education mitigates all relevant conflicts of interest to ensure CME activities are free of commercial bias.
The following faculty have indicated that they have a relationship which, in the context of their contributions, could be perceived as a potential conflict of interest:
| Brian F. Mandell, MD, PhD (Activity Director) | ||
| Consulting | Amgen, Horizon Pharma | |
| Research: PI local site | Amgen, Arthrosi Pharma | |
| Teaching and Speaking | Arthrosi Pharma | |
| Advisor or review panel participant | Arthrosi Pharma | |
| Data Monitoring Safety Board | Wave Therapeutics | |
| Adam J. Brown, MD | ||
| Consulting | Amgen, Sanofi | |
| Teaching and speaking | Amgen, Sanofi | |
| Abhijit Duggal, MD | ||
| Advisor or review panel participant | Alung Technologies | |
| Yuebing Li, MD | ||
| Research: Principal investigator | Alexion, Argenx, Immunovant, Johnson & Johnson, Vertex Pharmaceuticals | |
| Member of Clinical Practice Scientific Advisory Board | Alexion | |
| Consulting | Argenx, Immunovant, Johnson & Johnson, Vertex Pharmaceuticals | |
| Christian Nasr, MD | ||
| Advisor or review panel participant | Horizon Therapeutics, Viridian Therapeutics | |
| Faiz Anwer, MD | ||
| Teaching and speaking | Bristol-Meyers Squibb Co. | |
| Consulting | Bristol-Meyers Squibb Co., Caribou Bio | |
| Research Principle Investigator and Co-PI | Bristol-Meyers Squibb Co. | |
All other authors, co-activity directors, reviewers and CCJM staff report no relevant financial relationships which, in the context of their contributions, could be perceived as a potential conflict of interest.
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This CME activity was produced by the Cleveland Clinic Journal of Medicine and the Cleveland Clinic Center for Continuing Education.
Center for Continuing Education | 9500 Euclid Avenue, JJ42 Cleveland, OH 44195
Center for Continuing Education | 9500 Euclid Avenue, JJ42 Cleveland, OH 44195

