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

: Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam] - JSON Representation

Active as of 2024-03-01

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{
  "resourceType" : "ActivityDefinition",
  "id" : "cc-cpg-activity-ultrasound-renal",
  "meta" : {
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    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ActivityDefinition</b><a name=\"cc-cpg-activity-ultrasound-renal\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource ActivityDefinition &quot;cc-cpg-activity-ultrasound-renal&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/HL7/cqf-recommendations//StructureDefinition-cpg-computableactivity.html\">CPG Computable Activity Definition</a></p></div><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>CQF knowledge representation level</b>: structured</p><p><b>url</b>: <code>http://hl7.org/fhir/uv/cpg/ckd/ActivityDefinition/cc-cpg-activity-ultrasound-renal</code></p><p><b>version</b>: 1.0.0</p><p><b>name</b>: UltrasoundRenalHistory</p><p><b>title</b>: Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]</p><p><b>status</b>: active</p><p><b>experimental</b>: true</p><p><b>date</b>: 2024-03-01 20:11:40+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>: Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]</p><p><b>jurisdiction</b>: World <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (m49.htm#001)</span></p><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: justification</p><p><b>display</b>: Renal ultrasonography\n\n\n\tPerform ultrasonography to detect structural abnormalities when routine evaluation and urinalysis are inconclusive or to distinguish between acute and chronic kidney disease\n\n\n\n\tSmall hyperechoic kidneys, cysts, or lesions are irregularities associated with chronic kidney disease\n\n\n\n\tUltrasonography will also detect presence of stones, cysts, or masses that can affect renal function\n\n\n\n\tDiagnosis of chronic kidney disease requires abnormalities persisting beyond 3 months\n\n\n&amp;nbsp;\n\nDifferential Diagnosis\n\n\n\tRenal artery stenosis\n\t\n\t\tNarrowing of the renal arteries resulting in loss of kidney function and blood pressure alteration\n\t\tBoth renal artery stenosis and chronic kidney disease present with hypertension and reduced GFR\n\t\tAlthough also a cause of chronic kidney disease, renal artery stenosis (usually from atherosclerosis) is present before the development of kidney disease\n\t\tRenal bruit is indicative of renal artery stenosis\n\t\tDuplex ultrasonography can identify blockage in the renal artery and high velocity flow rate, indicative of renal artery stenosis\n\t\n\t\n\n\n\n\tNeoplasm\n\t\n\t\tNeoplasm of the kidney is a tumor growth in the renal cells\n\t\tBoth diseases present with RBCs in urine\n\t\tNeoplasia can be differentiated by detecting tumor mass on kidney\n\t\tContrast-enhanced CT scanning or ultrasonography can identify renal neoplasias, which can then be further evaluated with MRI</p><p><b>citation</b>: Chronic Kidney Disease Clinical Overview. ClinicalKey. Source</p><p><b>url</b>: <a href=\"http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75D50232E05352E3610A5325\">http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75D50232E05352E3610A5325</a></p><blockquote><p><b>document</b></p></blockquote></blockquote><p><b>kind</b>: ServiceRequest</p><p><b>code</b>: Ultrasound of bilateral kidneys <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#13301000087109 &quot;Ultrasonography of bilateral kidneys (procedure)&quot;)</span></p><p><b>timing</b>: Events: Now()</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>"
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      "valueCode" : "computable"
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      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-knowledgeRepresentationLevel",
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  "url" : "http://hl7.org/fhir/uv/cpg/ckd/ActivityDefinition/cc-cpg-activity-ultrasound-renal",
  "version" : "1.0.0",
  "name" : "UltrasoundRenalHistory",
  "title" : "Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]",
  "status" : "active",
  "experimental" : true,
  "date" : "2024-03-01T20:11:40+00:00",
  "publisher" : "HL7 International - Clinical Decision Support WG",
  "contact" : [
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  "description" : "Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001",
          "display" : "World"
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  "relatedArtifact" : [
    {
      "type" : "justification",
      "display" : "Renal ultrasonography\n\n\n\tPerform ultrasonography to detect structural abnormalities when routine evaluation and urinalysis are inconclusive or to distinguish between acute and chronic kidney disease\n\n\n\n\tSmall hyperechoic kidneys, cysts, or lesions are irregularities associated with chronic kidney disease\n\n\n\n\tUltrasonography will also detect presence of stones, cysts, or masses that can affect renal function\n\n\n\n\tDiagnosis of chronic kidney disease requires abnormalities persisting beyond 3 months\n\n\n&nbsp;\n\nDifferential Diagnosis\n\n\n\tRenal artery stenosis\n\t\n\t\tNarrowing of the renal arteries resulting in loss of kidney function and blood pressure alteration\n\t\tBoth renal artery stenosis and chronic kidney disease present with hypertension and reduced GFR\n\t\tAlthough also a cause of chronic kidney disease, renal artery stenosis (usually from atherosclerosis) is present before the development of kidney disease\n\t\tRenal bruit is indicative of renal artery stenosis\n\t\tDuplex ultrasonography can identify blockage in the renal artery and high velocity flow rate, indicative of renal artery stenosis\n\t\n\t\n\n\n\n\tNeoplasm\n\t\n\t\tNeoplasm of the kidney is a tumor growth in the renal cells\n\t\tBoth diseases present with RBCs in urine\n\t\tNeoplasia can be differentiated by detecting tumor mass on kidney\n\t\tContrast-enhanced CT scanning or ultrasonography can identify renal neoplasias, which can then be further evaluated with MRI",
      "citation" : "Chronic Kidney Disease Clinical Overview. ClinicalKey. Source",
      "url" : "http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75D50232E05352E3610A5325",
      "document" : {
        "url" : "http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75D50232E05352E3610A5325"
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    }
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  "kind" : "ServiceRequest",
  "code" : {
    "coding" : [
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        "system" : "http://snomed.info/sct",
        "code" : "13301000087109",
        "display" : "Ultrasonography of bilateral kidneys (procedure)"
      }
    ],
    "text" : "Ultrasound of bilateral kidneys"
  },
  "timingTiming" : {
    "_event" : [
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