Clinical Practice Guidelines Example Implementation Guide - Chronic Kidney Disease
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Clinical Practice Guidelines Example Implementation Guide - Chronic Kidney Disease, published by HL7 International - Clinical Decision Support WG. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cpg-example-ckd/ and changes regularly. See the Directory of published versions

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

Active as of 2024-08-23

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<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>
  <text>
    <status value="generated"/>
    <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>url</b>: <a href="ActivityDefinition-cc-cpg-activity-referral-nephrology.html">ActivityDefinition Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]</a></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: ReferralNephrology</p><p><b>title</b>: Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]</p><p><b>status</b>: Active</p><p><b>experimental</b>: true</p><p><b>date</b>: 2024-08-23 13:40:17+0000</p><p><b>publisher</b>: HL7 International - Clinical Decision Support WG</p><p><b>contact</b>: HL7 International - Clinical Decision Support WG: <a href="http://www.hl7.org/Special/committees/dss/index.cfm">http://www.hl7.org/Special/committees/dss/index.cfm</a></p><p><b>description</b>: </p><div><p>Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]</p>
</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></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>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>
  </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>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeRepresentationLevel">
    <valueCode value="structured"/>
  </extension>
  <url
       value="http://hl7.org/fhir/uv/cpg/ckd/ActivityDefinition/cc-cpg-activity-referral-nephrology"/>
  <version value="1.0.0"/>
  <name value="ReferralNephrology"/>
  <title
         value="Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2024-08-23T13:40:17+00:00"/>
  <publisher value="HL7 International - Clinical Decision Support WG"/>
  <contact>
    <name value="HL7 International - Clinical Decision Support WG"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/dss/index.cfm"/>
    </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:


	Unclear etiology of kidney disease



	Rapid progression of disease (GFR decline greater than 5 mL/minute/1.73 m&amp;sup2;/year)



	Acute kidney injury or abrupt sustained fall in GFR



	GFR less than 30 mL/minute/1.73 m&amp;sup2; (GFR categories G4-G5) to prepare for renal replacement therapy



	Consistent finding of significant albuminuria (albumin/creatinine ratio of 300 mg/g or more)



	Hypertension resistant to treatment with 4 or more antihypertensive agents



	Difficulty in decreasing the level of albuminuria despite institution of ACE inhibitor or angiotensin II receptor blocker therapy



	Persistent electrolyte abnormalities, including hyperkalemia or high serum phosphate



	Recurrent or extensive nephrolithiasis



	Hereditary kidney disease


&amp;nbsp;

Nephrologist involvement is recommended when the cause of chronic kidney disease is not clear


	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>
  <timingTiming>
    <event>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
        <valueExpression>
          <language value="text/cql"/>
          <expression value="Now()"/>
        </valueExpression>
      </extension>
    </event>
  </timingTiming>
  <participant>
    <type value="practitioner"/>
  </participant>
</ActivityDefinition>