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] - XML Representation

Active as of 2024-08-23

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<ActivityDefinition xmlns="http://hl7.org/fhir">
  <id value="cc-cpg-activity-ultrasound-renal"/>
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    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ActivityDefinition cc-cpg-activity-ultrasound-renal</b></p><a name="cc-cpg-activity-ultrasound-renal"> </a><a name="hccc-cpg-activity-ultrasound-renal"> </a><a name="cc-cpg-activity-ultrasound-renal-en-US"> </a><p><b>url</b>: <a href="ActivityDefinition-cc-cpg-activity-ultrasound-renal.html">ActivityDefinition Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]</a></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>: 2024-08-23 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>Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]</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 13301000087109}">Ultrasound of bilateral kidneys</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>
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  <url
       value="http://hl7.org/fhir/uv/cpg/ckd/ActivityDefinition/cc-cpg-activity-ultrasound-renal"/>
  <version value="1.0.0"/>
  <name value="UltrasoundRenalHistory"/>
  <title
         value="Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2024-08-23T13:40:17+00:00"/>
  <publisher value="HL7 International - Clinical Decision Support WG"/>
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  <description
               value="Ultrasound, Renal; History: [add diagnosis, symptom(s)]; Question: [add reason for exam]"/>
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  <relatedArtifact>
    <type value="justification"/>
    <display
             value="Renal ultrasonography


	Perform ultrasonography to detect structural abnormalities when routine evaluation and urinalysis are inconclusive or to distinguish between acute and chronic kidney disease



	Small hyperechoic kidneys, cysts, or lesions are irregularities associated with chronic kidney disease



	Ultrasonography will also detect presence of stones, cysts, or masses that can affect renal function



	Diagnosis of chronic kidney disease requires abnormalities persisting beyond 3 months


&amp;nbsp;

Differential Diagnosis


	Renal artery stenosis
	
		Narrowing of the renal arteries resulting in loss of kidney function and blood pressure alteration
		Both renal artery stenosis and chronic kidney disease present with hypertension and reduced GFR
		Although also a cause of chronic kidney disease, renal artery stenosis (usually from atherosclerosis) is present before the development of kidney disease
		Renal bruit is indicative of renal artery stenosis
		Duplex ultrasonography can identify blockage in the renal artery and high velocity flow rate, indicative of renal artery stenosis
	
	



	Neoplasm
	
		Neoplasm of the kidney is a tumor growth in the renal cells
		Both diseases present with RBCs in urine
		Neoplasia can be differentiated by detecting tumor mass on kidney
		Contrast-enhanced CT scanning or ultrasonography can identify renal neoplasias, which can then be further evaluated with MRI"/>
    <citation
              value="Chronic Kidney Disease Clinical Overview. ClinicalKey. Source"/>
    <url
         value="http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75D50232E05352E3610A5325"/>
    <document>
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           value="http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75D50232E05352E3610A5325"/>
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    </coding>
    <text value="Ultrasound of bilateral kidneys"/>
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