This page is part of the Clinical Guidelines (v2.0.0-ballot: STU2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions
: Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral] - XML Representation
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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="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: ActivityDefinition</b><a name="cc-cpg-activity-referral-nephrology"> </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 "cc-cpg-activity-referral-nephrology" </p><p style="margin-bottom: 0px">Profile: <a href="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>StructureDefinition Work Group</b>: cds</p><p><b>url</b>: <code>http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-referral-nephrology</code></p><p><b>version</b>: 2.0.0-ballot</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>: 2023-12-19 19:53:17+0000</p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: HL7 International / Clinical Decision Support: <a href="http://www.hl7.org/Special/committees/dss">http://www.hl7.org/Special/committees/dss</a></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; 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>: 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&sup2;/year)
Acute kidney injury or abrupt sustained fall in GFR
GFR less than 30 mL/minute/1.73 m&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
&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</p><p><b>citation</b>: Chronic Kidney Disease Clinical Overview. ClinicalKey. Source</p><p><b>url</b>: <a href="http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325">http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325</a></p><blockquote><p><b>document</b></p></blockquote></blockquote><p><b>kind</b>: ServiceRequest</p><p><b>code</b>: Referral to nephrologist <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#306286007 "Referral to nephrologist (procedure)")</span></p><p><b>intent</b>: proposal</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>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
<valueCode value="shareable"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
<valueCode value="computable"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
<valueCode value="publishable"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeRepresentationLevel">
<valueCode value="structured"/>
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<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="cds"/>
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<url
value="http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-referral-nephrology"/>
<version value="2.0.0-ballot"/>
<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="2023-12-19T19:53:17+00:00"/>
<publisher value="HL7 International / Clinical Decision Support"/>
<contact>
<name value="HL7 International / Clinical Decision Support"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/dss"/>
</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&sup2;/year)
Acute kidney injury or abrupt sustained fall in GFR
GFR less than 30 mL/minute/1.73 m&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
&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>
<intent value="proposal"/>
<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>
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