Clinical Practice Guidelines
2.0.0 - trial-use 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 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

: CKD Referral Nephrology - TTL Representation

Active as of 2024-11-21

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ActivityDefinition ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "cc-cpg-activity-referral-nephrology"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-computableactivity"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-computableactivity>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ActivityDefinition cc-cpg-activity-referral-nephrology</b></p><a name=\"cc-cpg-activity-referral-nephrology\"> </a><a name=\"hccc-cpg-activity-referral-nephrology\"> </a><a name=\"cc-cpg-activity-referral-nephrology-en-US\"> </a><p><b>CQF Knowledge capability</b>: shareable</p><p><b>CQF Knowledge capability</b>: computable</p><p><b>CQF Knowledge capability</b>: publishable</p><p><b>url</b>: <a href=\"ActivityDefinition-cc-cpg-activity-referral-nephrology.html\">ActivityDefinition ReferralNephrology</a></p><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/6.1.0/NamingSystem-uri.html\" title=\"As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt \r\n\r\nThis oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: \r\n\r\nNote that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.\r\n\r\nThis OID may also be used in CD.codeSystem.\">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.48.11.21</p><p><b>version</b>: 2.0.0</p><p><b>name</b>: ReferralNephrology</p><p><b>status</b>: Active</p><p><b>experimental</b>: true</p><p><b>date</b>: 2024-11-21 04:10:48+0000</p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: HL7 International / Clinical Decision Support: <a href=\"http://www.hl7.org/Special/committees/dss\">http://www.hl7.org/Special/committees/dss</a></p><p><b>description</b>: </p><div><p>Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]</p>\n</div><p><b>jurisdiction</b>: <span title=\"Codes:{http://unstats.un.org/unsd/methods/m49/m49.htm 001}\">World</span></p><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: Justification</p><p><b>display</b>: Refer to nephrologist for co-management of treatment plan in cases of:\n\n\n	Unclear etiology of kidney disease\n\n\n\n	Rapid progression of disease (GFR decline greater than 5 mL/minute/1.73 m&amp;sup2;/year)\n\n\n\n	Acute kidney injury or abrupt sustained fall in GFR\n\n\n\n	GFR less than 30 mL/minute/1.73 m&amp;sup2; (GFR categories G4-G5) to prepare for renal replacement therapy\n\n\n\n	Consistent finding of significant albuminuria (albumin/creatinine ratio of 300 mg/g or more)\n\n\n\n	Hypertension resistant to treatment with 4 or more antihypertensive agents\n\n\n\n	Difficulty in decreasing the level of albuminuria despite institution of ACE inhibitor or angiotensin II receptor blocker therapy\n\n\n\n	Persistent electrolyte abnormalities, including hyperkalemia or high serum phosphate\n\n\n\n	Recurrent or extensive nephrolithiasis\n\n\n\n	Hereditary kidney disease\n\n\n&amp;nbsp;\n\nNephrologist involvement is recommended when the cause of chronic kidney disease is not clear\n\n\n	Renal biopsy may be performed to determine the cause as well as to predict disease progression and response to therapy</p><p><b>citation</b>: </p><div><p>Chronic Kidney Disease Clinical Overview. ClinicalKey. Source</p>\n</div><p><b>url</b>: <a href=\"http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325\">http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325</a></p><h3>Documents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325\">http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325</a></td></tr></table></blockquote><p><b>kind</b>: ServiceRequest</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 306286007}\">Referral to nephrologist</span></p><p><b>intent</b>: Proposal</p><p><b>timing</b>: Events: ?? </p><h3>Participants</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Practitioner</td></tr></table></div>"
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability"^^xsd:anyURI ] ;
fhir:value [ fhir:v "shareable" ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability"^^xsd:anyURI ] ;
fhir:value [ fhir:v "computable" ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability"^^xsd:anyURI ] ;
fhir:value [ fhir:v "publishable" ]
  ] ) ; # 
  fhir:url [ fhir:v "http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-referral-nephrology"^^xsd:anyURI] ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.4.642.40.48.11.21" ]
  ] ) ; # 
  fhir:version [ fhir:v "2.0.0"] ; # 
  fhir:name [ fhir:v "ReferralNephrology"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v "true"^^xsd:boolean] ; # 
  fhir:date [ fhir:v "2024-11-21T04:10:48+00:00"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "HL7 International / Clinical Decision Support"] ; # 
  fhir:contact ( [
fhir:name [ fhir:v "HL7 International / Clinical Decision Support" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/dss" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]"] ; # 
  fhir:jurisdiction ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ] ;
fhir:code [ fhir:v "001" ] ;
fhir:display [ fhir:v "World" ]     ] )
  ] ) ; # 
  fhir:relatedArtifact ( [
fhir:type [ fhir:v "justification" ] ;
fhir:display [ fhir:v "Refer to nephrologist for co-management of treatment plan in cases of:\n\n\n	Unclear etiology of kidney disease\n\n\n\n	Rapid progression of disease (GFR decline greater than 5 mL/minute/1.73 m&sup2;/year)\n\n\n\n	Acute kidney injury or abrupt sustained fall in GFR\n\n\n\n	GFR less than 30 mL/minute/1.73 m&sup2; (GFR categories G4-G5) to prepare for renal replacement therapy\n\n\n\n	Consistent finding of significant albuminuria (albumin/creatinine ratio of 300 mg/g or more)\n\n\n\n	Hypertension resistant to treatment with 4 or more antihypertensive agents\n\n\n\n	Difficulty in decreasing the level of albuminuria despite institution of ACE inhibitor or angiotensin II receptor blocker therapy\n\n\n\n	Persistent electrolyte abnormalities, including hyperkalemia or high serum phosphate\n\n\n\n	Recurrent or extensive nephrolithiasis\n\n\n\n	Hereditary kidney disease\n\n\n&nbsp;\n\nNephrologist involvement is recommended when the cause of chronic kidney disease is not clear\n\n\n	Renal biopsy may be performed to determine the cause as well as to predict disease progression and response to therapy" ] ;
fhir:citation [ fhir:v "Chronic Kidney Disease Clinical Overview. ClinicalKey. Source" ] ;
fhir:url [ fhir:v "http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325"^^xsd:anyURI ] ;
fhir:document [
fhir:url [ fhir:v "http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325"^^xsd:anyURI ]     ]
  ] ) ; # 
  fhir:kind [ fhir:v "ServiceRequest"] ; # 
  fhir:code [
    ( fhir:coding [
a sct:306286007 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "306286007" ] ;
fhir:display [ fhir:v "Referral to nephrologist (procedure)" ]     ] ) ;
fhir:text [ fhir:v "Referral to nephrologist" ]
  ] ; # 
  fhir:intent [ fhir:v "proposal"] ; # 
  fhir:timing [
a fhir:Timing ;
    ( fhir:event [
      ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-expression"^^xsd:anyURI ] ;
fhir:value [
a fhir:Expression ;
fhir:language [ fhir:v "text/cql" ] ;
fhir:expression [ fhir:v "Now()" ]         ]       ] )     ] )
  ] ; # 
  fhir:participant ( [
fhir:type [ fhir:v "practitioner" ]
  ] ) . #