<?xml version="1.0" encoding="UTF-8"?>

<ActivityDefinition xmlns="http://hl7.org/fhir">
  <id value="cc-cpg-activity-referral-nephrology"/>
  <meta>
    <profile value="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-computableactivity"/>
  </meta>
  <language value="en"/>
  <text>
    <status value="extensions"/><div xmlns="http://www.w3.org/1999/xhtml">
  <table class="narrative-table">
    <tbody>
<tr>


<th colspan="2" scope="row" class="row-header">Metadata</th>


</tr>



<tr>


<th scope="row" class="row-header">Version</th>



<td class="content-container">2.0.0</td>


</tr>







  
<tr>


<th scope="row" class="row-header">Identifier</th>



<td class="content-container">urn:oid:2.16.840.1.113883.4.642.40.48.11.21</td>


</tr>








<tr>


<th scope="row" class="row-header">Experimental</th>



<td class="content-container">true</td>


</tr>





<tr>


<th scope="row" class="row-header">Jurisdiction</th>



<td class="content-container">
    World


</td>


</tr>








<tr>


<th scope="row" class="row-header">Steward (Publisher)</th>



<td class="content-container">HL7 International / Clinical Decision Support</td>


</tr>



<tr>


<th scope="row" class="row-header">Steward Contact</th>



<td class="content-container">HL7 International / Clinical Decision Support</td>


</tr>







<tr>


<th scope="row" class="row-header">Description</th>



<td class="content-container"><div><p>Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]</p>
</div></td>


</tr>









<tr>


<th scope="row" class="row-header">Resource Kind</th>



<td class="content-container">ServiceRequest</td>


</tr>



<tr>


<th scope="row" class="row-header">Code</th>



<td class="content-container">Referral to nephrologist
</td>


</tr>


<tr>


<th scope="row" class="row-header">Intent</th>



<td class="content-container">Proposal</td>


</tr>



<tr>


<th scope="row" class="row-header">Timing</th>



<td class="content-container">Events: ?? </td>


</tr>










<tr>
  <th colspan="2" scope="row" class="row-header">Generated using version 0.5.4 of the sample-content-ig Liquid templates</th>
</tr>

    </tbody>
  </table>
</div>
  </text>
  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
    <valueCode value="shareable"/>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
    <valueCode value="computable"/>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
    <valueCode value="publishable"/>
  </extension>
  <url value="http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-referral-nephrology"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.40.48.11.21"/>
  </identifier>
  <version value="2.0.0"/>
  <name value="ReferralNephrology"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2026-04-29T15:06:55+00:00"/>
  <publisher value="HL7 International / Clinical Decision Support"/>
  <contact>
    <name value="HL7 International / Clinical Decision Support"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/dss"/>
    </telecom>
  </contact>
  <description value="Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
      <display value="World"/>
    </coding>
  </jurisdiction>
  <relatedArtifact>
    <type value="justification"/>
    <display value="Refer to nephrologist for co-management of treatment plan in cases of:&#xA;&#xA;&#xA;&#x9;Unclear etiology of kidney disease&#xA;&#xA;&#xA;&#xA;&#x9;Rapid progression of disease (GFR decline greater than 5 mL/minute/1.73 m&amp;sup2;/year)&#xA;&#xA;&#xA;&#xA;&#x9;Acute kidney injury or abrupt sustained fall in GFR&#xA;&#xA;&#xA;&#xA;&#x9;GFR less than 30 mL/minute/1.73 m&amp;sup2; (GFR categories G4-G5) to prepare for renal replacement therapy&#xA;&#xA;&#xA;&#xA;&#x9;Consistent finding of significant albuminuria (albumin/creatinine ratio of 300 mg/g or more)&#xA;&#xA;&#xA;&#xA;&#x9;Hypertension resistant to treatment with 4 or more antihypertensive agents&#xA;&#xA;&#xA;&#xA;&#x9;Difficulty in decreasing the level of albuminuria despite institution of ACE inhibitor or angiotensin II receptor blocker therapy&#xA;&#xA;&#xA;&#xA;&#x9;Persistent electrolyte abnormalities, including hyperkalemia or high serum phosphate&#xA;&#xA;&#xA;&#xA;&#x9;Recurrent or extensive nephrolithiasis&#xA;&#xA;&#xA;&#xA;&#x9;Hereditary kidney disease&#xA;&#xA;&#xA;&amp;nbsp;&#xA;&#xA;Nephrologist involvement is recommended when the cause of chronic kidney disease is not clear&#xA;&#xA;&#xA;&#x9;Renal biopsy may be performed to determine the cause as well as to predict disease progression and response to therapy"/>
    <citation value="Chronic Kidney Disease Clinical Overview. ClinicalKey. Source"/>
    <url value="http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325"/>
    <document>
      <url value="http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325"/>
    </document>
  </relatedArtifact>
  <kind value="ServiceRequest"/>
  <code>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="306286007"/>
      <display value="Referral to nephrologist (procedure)"/>
    </coding>
    <text value="Referral to nephrologist"/>
  </code>
  <intent value="proposal"/>
  <timingTiming>
    <event>
      <extension url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
        <valueExpression>
          <language value="text/cql"/>
          <expression value="Now()"/>
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    </event>
  </timingTiming>
  <participant>
    <type value="practitioner"/>
  </participant>
</ActivityDefinition>