{
  "resourceType" : "PlanDefinition",
  "id" : "va-ckd-recommendations",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition",
    "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-computableplandefinition"]
  },
  "language" : "en",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <table class=\"narrative-table\">\n    <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Metadata</th>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Version</th>\n\n\n\n<td class=\"content-container\">2.0.0</td>\n\n\n</tr>\n\n\n\n\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Identifier</th>\n\n\n\n<td class=\"content-container\">VA_CKD_Recommendations</td>\n\n\n</tr>\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Identifier</th>\n\n\n\n<td class=\"content-container\">urn:oid:2.16.840.1.113883.4.642.40.48.34.38</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Experimental</th>\n\n\n\n<td class=\"content-container\">true</td>\n\n\n</tr>\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Use Context</th>\n\n\n\n<td class=\"content-container\">\n    Clinical Focus\n\n = \n    Chronic kidney disease (disorder)\n\n\n</td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Jurisdiction</th>\n\n\n\n<td class=\"content-container\">\n    World\n\n\n</td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Topic</th>\n\n\n\n<td class=\"content-container\">\n    Treatment\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Steward (Publisher)</th>\n\n\n\n<td class=\"content-container\">HL7 International / Clinical Decision Support</td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Steward Contact</th>\n\n\n\n<td class=\"content-container\">HL7 International / Clinical Decision Support</td>\n\n\n</tr>\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n\n<td class=\"content-container\"><div><p>VA CKD Recommendations</p>\n</div></td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n\n<td class=\"content-container\">\n    ECA Rule\n\n\n</td>\n\n\n</tr>\n\n\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">PlanDefinition Action</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Id</th>\n\n\n\n<td class=\"content-container\">001</td>\n\n\n</tr>\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Strength of Recommendation</th>\n\n\n\n<td class=\"content-container\">\n    Weak\n\n\n</td>\n\n\n</tr>\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Title</th>\n\n\n\n<td class=\"content-container\">CKD Protein Diet</td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n\n<td class=\"content-container\">In patients with stage 3 and 4 CKD, we suggest a protein diet of 0.6 to 0.8 g/kg/day as it may slow the decline in glomerular filtration rate (GFR) and progression to end-stage renal disease (ESRD).</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Condition</th>\n  <td class=\"content-container\">\n  <em>Kind</em>: Applicability\n  \n    <br/>\n    \n      \n      <em>Logic Definition</em>: <a href=\"null\">Has CKD stage 3 or 4</a> \n    \n   \n  </td>\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n  <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.5.4 of the sample-content-ig Liquid templates</th>\n</tr>\n\n    </tbody>\n  </table>\n</div>"
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability",
    "valueCode" : "shareable"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability",
    "valueCode" : "computable"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability",
    "valueCode" : "publishable"
  }],
  "url" : "http://hl7.org/fhir/uv/cpg/PlanDefinition/va-ckd-recommendations",
  "identifier" : [{
    "use" : "official",
    "value" : "VA_CKD_Recommendations"
  },
  {
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.40.48.34.38"
  }],
  "version" : "2.0.0",
  "name" : "VACKDRecommendations",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
      "code" : "eca-rule",
      "display" : "ECA Rule"
    }]
  },
  "status" : "active",
  "experimental" : true,
  "date" : "2026-04-29T15:06:55+00:00",
  "publisher" : "HL7 International / Clinical Decision Support",
  "contact" : [{
    "name" : "HL7 International / Clinical Decision Support",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/dss"
    }]
  }],
  "description" : "VA CKD Recommendations",
  "useContext" : [{
    "code" : {
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "focus",
      "display" : "Clinical Focus"
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "709044004",
        "display" : "Chronic kidney disease (disorder)"
      }]
    }
  }],
  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "001",
      "display" : "World"
    }]
  }],
  "topic" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/definition-topic",
      "code" : "treatment",
      "display" : "Treatment"
    }]
  }],
  "action" : [{
    "id" : "001",
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
          "code" : "weak",
          "display" : "Weak"
        }]
      }
    },
    {
      "url" : "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-directionOfRecommendation",
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-recommendation-direction-cs",
          "code" : "for",
          "display" : "For"
        }]
      }
    }],
    "title" : "CKD Protein Diet",
    "description" : "In patients with stage 3 and 4 CKD, we suggest a protein diet of 0.6 to 0.8 g/kg/day as it may slow the decline in glomerular filtration rate (GFR) and progression to end-stage renal disease (ESRD).",
    "documentation" : [{
      "type" : "documentation",
      "display" : "VA/DoD Clinical Practice Guideline for The management of Chronic Kidney Disease in Primary care",
      "url" : "http://www.healthquality.va.gov",
      "document" : {
        "url" : "http://www.healthquality.va.gov"
      }
    }],
    "condition" : [{
      "kind" : "applicability",
      "expression" : {
        "language" : "text/cql",
        "expression" : "Has CKD stage 3 or 4"
      }
    }]
  }]
}