Clinical Practice Guidelines
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This page is part of the Clinical Guidelines (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: CKD Referral Nephrology - XML Representation

Active as of 2024-11-26

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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 class="res-header-id"><b>Generated Narrative: ActivityDefinition cc-cpg-activity-referral-nephrology</b></p><a name="cc-cpg-activity-referral-nephrology"> </a><a name="hccc-cpg-activity-referral-nephrology"> </a><a name="cc-cpg-activity-referral-nephrology-en-US"> </a><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>url</b>: <a href="ActivityDefinition-cc-cpg-activity-referral-nephrology.html">ActivityDefinition ReferralNephrology</a></p><p><b>identifier</b>: <a href="http://terminology.hl7.org/6.1.0/NamingSystem-uri.html" title="As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt 

This oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: 

Note that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.

This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.48.11.21</p><p><b>version</b>: 2.0.0</p><p><b>name</b>: ReferralNephrology</p><p><b>status</b>: Active</p><p><b>experimental</b>: true</p><p><b>date</b>: 2024-11-26 17:38:52+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>: </p><div><p>Referral: Nephrology; History: [add diagnosis, symptom(s)]; Question: [add reason for referral]</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><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&amp;sup2;/year)



	Acute kidney injury or abrupt sustained fall in GFR



	GFR less than 30 mL/minute/1.73 m&amp;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


&amp;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>: </p><div><p>Chronic Kidney Disease Clinical Overview. ClinicalKey. Source</p>
</div><p><b>url</b>: <a href="http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325">http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325</a></p><h3>Documents</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Url</b></td></tr><tr><td style="display: none">*</td><td><a href="http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325">http://himss19.ordersetsmanager.com/evidenceviewer/#/7CBBBE9B75E10232E05352E3610A5325/7CBBBE9B75DA0232E05352E3610A5325</a></td></tr></table></blockquote><p><b>kind</b>: ServiceRequest</p><p><b>code</b>: <span title="Codes:{http://snomed.info/sct 306286007}">Referral to nephrologist</span></p><p><b>intent</b>: Proposal</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>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
    <valueCode value="shareable"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
    <valueCode value="computable"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
    <valueCode value="publishable"/>
  </extension>
  <url
       value="http://hl7.org/fhir/uv/cpg/ActivityDefinition/cc-cpg-activity-referral-nephrology"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.40.48.11.21"/>
  </identifier>
  <version value="2.0.0"/>
  <name value="ReferralNephrology"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2024-11-26T17:38:52+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&amp;sup2;/year)



	Acute kidney injury or abrupt sustained fall in GFR



	GFR less than 30 mL/minute/1.73 m&amp;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


&amp;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>