Clinical Practice Guidelines
2.0.0-draft - draft International flag

Clinical Practice Guidelines, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 2.0.0-draft built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of and changes regularly. See the Directory of published versions

PlanDefinition: CKD Ambulatory Plan Definition (Experimental)

Official URL: Version: 2.0.0-draft
Active as of 2024-06-06 Computable Name: ChronicKidneyDiseaseAmbulatory

Usage:Clinical Focus: Chronic kidney disease (disorder)

Copyright/Legal: Copyright © Elsevier, and others.

Chronic Kidney Disease - Ambulatory

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ResourcePlanDefinition "cc-cpg-plan-ckd"

Profiles: CPG Order Set Definition, CPG Computable Plan Definition

CQF Knowledge capability: shareable

CQF Knowledge capability: computable

CQF Knowledge capability: publishable

CQF knowledge representation level: structured


version: 2.0.0-draft

name: ChronicKidneyDiseaseAmbulatory

type: Order Set (PlanDefinitionType#order-set)

status: active

experimental: true

date: 2024-06-06 21:28:30+0000

publisher: HL7 International / Clinical Decision Support

contact: HL7 International / Clinical Decision Support:

description: Chronic Kidney Disease - Ambulatory


*Clinical Focus (Details: UsageContextType code focus = ' Clinical Focus ', stated as ' Clinical Focus ')Chronic kidney disease (disorder) (SNOMED CT#709044004)

jurisdiction: World (m49.htm#001)

copyright: Copyright © Elsevier, and others.

topic: Treatment (DefinitionTopic#treatment)


type: justification

display: SYNOPSIS - Chronic Kidney Disease KEY POINTS Decline in function of the kidney characterized by at least 3 months of reduced GFR (less than 60 mL/minute/ 1.73 m²) or at least 3 months of structural or functional kidney damage Assessment of both GFR and albuminuria is necessary to diagnose chronic kidney disease and monitor disease progression GFR is most commonly estimated through measuring serum creatinine and the use of GFR estimating equations, either the Modification of Diet in Renal Disease Study equation or the Chronic Kidney Disease Epidemiology Collaboration equation Albuminuria is measured by urine albumin/creatinine ratio; greater than 30 mg/g indicates albuminuria Chronic kidney disease is commonly associated with hypertension, diabetes, and cardiovascular disease First line therapy includes ACE inhibitors and/or angiotensin II receptor blockers to reduce albuminuria and hypertension If left untreated, chronic kidney disease can progress to end-stage renal disease requiring dialysis or renal transplant Symptoms of end-stage renal disease (eg, pruritus, refractory electrolyte imbalances, metabolic acidosis, severe nausea, neurologic impairments) typically occur when GFR is 5 to 10 mL/minute/1.73 m² Carefully monitor electrolyte levels, hemoglobin, parathyroid hormone levels, and sodium bicarbonate levels to detect complications of chronic kidney disease, including cardiovascular disease, anemia, bone mineral disease, and metabolic acidosis URGENT ACTION Hyperkalemia may require urgent treatment in patients being treated for chronic kidney disease Urgent treatment consists of calcium chloride or calcium gluconate and regimens of sodium bicarbonate, glucose and insulin, or nebulized albuterol PITFALLS Early stages are often asymptomatic, causing chronic kidney disease to be untreated, leading to further progression of kidney damage and worse prognosis

citation: Chronic Kidney Disease Clinical Overview. ClinicalKey. Source






title: Referrals

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title: Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]

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title: Referral: Dietitian; History: chronic kidney disease; Question: [add reason for referral]

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