Real-world patient - estimated gfr (id = "f205")

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

<Observation xmlns="http://hl7.org/fhir">
  <id value="f205"/> 
  <identifier> 
    <system value="https://intranet.aumc.nl/labvalues"/> 
    <!--    Does not exist    -->
    <value value="1304-03720-eGFR"/> 
  </identifier> 
  <!--    eGFR was measured on April fourth    -->
  <status value="final"/> 
  <code> 
    <!--    Kind of observation = eGFR    -->
    <coding> 
      <system value="http://loinc.org"/> 
      <code value="33914-3"/> 
      <display value="Glomerular filtration rate/1.73 sq M.predicted [Volume Rate/Area] in Serum or Plasma
       by Creatinine-based formula (MDRD)"/> 
    </coding> 
  </code> 
  <subject> 
    <reference value="Patient/f201"/> 
    <display value="Roel"/> 
  </subject> 
  <issued value="2013-04-04T14:34:00+01:00"/> 
  <performer> 
    <reference value="Practitioner/f202"/> 
    <display value="Luigi Maas"/> 
  </performer> 
  <!--   no value element since have only component values and unable to interpret results
   needs clinical interpretation   -->
  <interpretation> 
    <text value="interpretation of results should be assigned based upon the level of kindey function"/> 
  </interpretation> 
  <note> 
    <text value="GFR estimating equations developed by the Modification of Diet in Renal Disease
     (MDRD) Study Group and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)...."/> 
  </note> 
  <!--    The observation is complete    -->
  <!--    No reliability concerns    -->
  <method> 
    <!--    Method was MDRD    -->
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="702668005"/> 
      <display value="MDRD"/> 
    </coding> 
  </method> 
  <!--    The MDRD equation does require race (African American or non-African American),
   which also might not be readily available. For this reason, eGFR values for both
   African Americans and non-African Americans are reported. so use component elements
   here   -->
  <component> 
    <code> 
      <!--    Kind of observation = eGFR for AA    -->
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="48643-1"/> 
        <display value="Glomerular filtration rate/1.73 sq M.predicted among blacks [Volume Rate/Area]
         in Serum, Plasma or Blood by Creatinine-based formula (MDRD)"/> 
      </coding> 
    </code> 
    <valueQuantity> 
      <!--    eGFR=54mL/min/1.73m2    -->
      <value value="60"/> 
      <comparator value="&gt;"/> 
      <unit value="mL/min/1.73m2"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="mL/min/{1.73_m2}"/> 
    </valueQuantity> 
    <referenceRange> 
      <low> 
        <value value="60"/> 
        <unit value="mL/min/1.73m2"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="mL/min/{1.73_m2}"/> 
      </low> 
      <appliesTo> 
        <text value="non-black/african-american"/> 
      </appliesTo> 
      <age> 
        <low> 
          <value value="18"/> 
          <unit value="yrs"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="a"/> 
        </low> 
      </age> 
    </referenceRange> 
  </component> 
  <component> 
    <code> 
      <!--    Kind of observation = eGFR for non AA    -->
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="48642-3"/> 
        <display value="GFR/BSA pr.non blk SerPlBld MDRD-ArV"/> 
      </coding> 
    </code> 
    <valueQuantity> 
      <!--    eGFR=54mL/min/1.73m2    -->
      <value value="60"/> 
      <unit value="mL/min/1.73m2"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="mL/min/{1.73_m2}"/> 
    </valueQuantity> 
    <referenceRange> 
      <low> 
        <value value="60"/> 
        <unit value="mL/min/1.73m2"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="mL/min/{1.73_m2}"/> 
      </low> 
      <age> 
        <low> 
          <value value="18"/> 
          <unit value="yrs"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="a"/> 
        </low> 
      </age> 
    </referenceRange> 
  </component> 
</Observation>