ReferralNephrology

<ActivityDefinition xmlns="http://hl7.org/fhir">
  <id value="cc-cpg-activity-referral-nephrology"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: cc-cpg-activity-referral-nephrology</p><p><b>url</b>: <a href="http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-referral-nephrology">http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-referral-nephrology</a></p><p><b>version</b>: 0.1.0</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>: Aug 5, 2019 12:02:55 PM</p><p><b>publisher</b>: Elsevier Inc</p><p><b>description</b>: Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]</p><p><b>jurisdiction</b>: World <span style="background: LightGoldenRodYellow">(Details : {http://unstats.un.org/unsd/methods/m49/m49.htm code '001' = 'World', given as 'World'})</span></p><p><b>relatedArtifact</b>: </p><p><b>kind</b>: ServiceRequest</p><p><b>code</b>: Referral to nephrologist <span style="background: LightGoldenRodYellow">(Details : {SNOMED CT code '306286007' = 'Referral to nephrologist', given as 'Referral to nephrologist (procedure)'})</span></p><p><b>timing</b>: </p><p><b style="color: maroon">Exception generating Narrative: null</b></p></div>
  </text>
  <url
       value="http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-referral-nephrology"/>
  <version value="0.1.0"/>
  <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="2019-08-05T12:02:55-04:00"/>
  <publisher value="Elsevier Inc"/>
  <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="&lt;p&gt;Refer to nephrologist for co-management of treatment plan in cases of:&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;Unclear etiology of kidney disease&lt;/li&gt;
&lt;/ul&gt;

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

&lt;ul&gt;
	&lt;li&gt;Acute kidney injury or abrupt sustained fall in GFR&lt;/li&gt;
&lt;/ul&gt;

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

&lt;ul&gt;
	&lt;li&gt;Consistent finding of significant albuminuria (albumin/creatinine ratio of 300 mg/g or more)&lt;/li&gt;
&lt;/ul&gt;

&lt;ul&gt;
	&lt;li&gt;Hypertension resistant to treatment with 4 or more antihypertensive agents&lt;/li&gt;
&lt;/ul&gt;

&lt;ul&gt;
	&lt;li&gt;Difficulty in decreasing the level of albuminuria despite institution of ACE inhibitor or angiotensin II receptor blocker therapy&lt;/li&gt;
&lt;/ul&gt;

&lt;ul&gt;
	&lt;li&gt;Persistent electrolyte abnormalities, including hyperkalemia or high serum phosphate&lt;/li&gt;
&lt;/ul&gt;

&lt;ul&gt;
	&lt;li&gt;Recurrent or extensive nephrolithiasis&lt;/li&gt;
&lt;/ul&gt;

&lt;ul&gt;
	&lt;li&gt;Hereditary kidney disease&lt;/li&gt;
&lt;/ul&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;Nephrologist involvement is recommended when the cause of chronic kidney disease is not clear&lt;/p&gt;

&lt;ul&gt;
	&lt;li&gt;Renal biopsy may be performed to determine the cause as well as to predict disease progression and response to therapy&lt;/li&gt;
&lt;/ul&gt;"/>
    <citation
              value="Chronic Kidney Disease Clinical Overview. ClinicalKey. &lt;a href=&#39;https://www.clinicalkey.com/#!/content/clinical_overview/67-s2.0-26a91efc-ff97-4e11-b49f-c70331e79cee&#39; target=&#39;_blank&#39;&gt;Source&lt;/a&gt;"/>
    <url
         value="http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325"/>
  </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>