ARF (APACHE): Difference between revisions

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~~This~~ applies to the '''[[:Category:APACHE II| APACHE II]] ARF ~~checkbox~~''' only.

''Information on this page applies to the '''[[:Category:APACHE II| APACHE II]] ARF dropdown''' only; for the diagnosis code see any one of the several ICD10 codes for types/causes of ARF.

{{Data_element

| field_name = Ap_ARF

| CCMDB_label = ARF

| CCMDB_tab = Apache

| element_description = The ARF checkbox is checked/true if patient is in Acute Renal Failure as per the APACHE definition.

| in_table = L_Log table

| data_type = number

| datafield_length = single

| program_collecting = CC

| created_raw = Raw

| data_element_sort_index = 77

}}

~~Put a check mark in '''Acute Renal Failure (~~ARF~~)''' checkbox~~ for ~~ICU~~ APACHE ~~if the following conditions are met:~~

== Additional Info ==

* for 8 hrs consecutively in the first 24 hrs of ICU admission:

Use the following uniform definition for ARF/AKI everywhere, including for APACHE II.

** creatinine > 133 mmols and

** urine < 135 cc

~~There are a number of coding rules related to renal diagnoses, centralized info about them is in [[Renal Coding Considerations]].~~

==~~Related Articles~~ ==

== Coding Guideline ==

~~also see~~

* For critical care only: The ARF ('''A'''cute '''R'''enal '''F'''ailure) dropdown for APACHE defaults to "enter"; you won't be able to send unless you change it to one of the following:

* [[ARF (~~Diagnosis~~)]] for ~~Diagnosis coding~~

* '''Choose "no"''' if the pt

* [[~~ATN~~]] ~~for Diagnosis coding~~

** does not meet the [[#KDIGO Guidelines for Acute Kidney Injury (AKI)]] '''or'''

* [[~~CRF~~ - ~~Chronic Renal Failure~~]] ~~for Diagnosis coding~~

** has a diagnosis of [[Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15]] (with or without dialysis)

* [[~~ARI~~]] for ~~Diagnosis coding~~

*** Special Case- If a patient comes to ICU with a past history of [[Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15]] and had a kidney transplant during this admission. As per Allan, unless the transplanted kidney was truly working postop (i.e. didn't need dialysis for at least a week or two) then do not code ARF.

* otherwise choose "yes"'''

== Data Use ==

ARF is one component used to generate the [[:Category:APACHE II| APACHE II]] score.

Specifically, '''double points are assigned for the Creatinine score''' if the patient has ARF . (see [[APACHE_II_Background#Weighting_of_scores]] and [[APACHE Scoring table#Physiological Variables]])

== Historical==

*In original APACHE II there were no criteria given for what constitutes Acute Renal Failure. So, from 1988 until 2018 we used a set of simple criteria based only on the admission serum creatinine and absolute urine output. But, when on January 1, 2019 we moved to ICD10 and CCI coding, we decided to use a

*there were criteria for ARF in the APACHE II user manual 1986, from George Washington University, Ver 1.0, that we applied when we started in 1988, they were:

**creatinine PLUS oliguria. Oliguria was defined as: urine output of less than 135 cc over a consecutive 8 hr period in the first 24 hrs of ICU admission.

**Copy of this APACHE II User Manual can be found in the article archives library located in HSC JJ387.

== Related articles ==

[[Category:APACHE II Physiological Variables]]

[[Category:Renal Problem]]

[[Category:Renal Problem (old)]]

@@ Line 1: / Line 1: @@
-This applies to the '''[[:Category:APACHE II| APACHE II]] ARF checkbox''' only.
+''Information on this page applies to the '''[[:Category:APACHE II| APACHE II]] ARF dropdown''' only; for the diagnosis code see any one of the several ICD10 codes for types/causes of ARF.
+{{Data_element
+| field_name = Ap_ARF
+| CCMDB_label = ARF
+| CCMDB_tab = Apache
+| element_description = The ARF checkbox is checked/true if patient is in Acute Renal Failure as per the APACHE definition.
+| in_table = L_Log table
+| data_type = number
+| datafield_length = single
+| program_collecting = CC
+| created_raw = Raw
+| data_element_sort_index = 77
+}}
-Put a check mark in '''Acute Renal Failure (ARF)''' checkbox for ICU APACHE if the following conditions are met:
+== Additional Info ==
-* for 8 hrs consecutively in the first 24 hrs of ICU admission:
+Use the following uniform definition for ARF/AKI everywhere, including for APACHE II.
-** creatinine > 133 mmols  and
-** urine < 135 cc
-{{Data Integrity Rules}}
+{{ICD10 Guideline KDIGO Guidelines for Acute Renal Failure}}
-There are a number of coding rules related to renal diagnoses, centralized info about them is in [[Renal Coding Considerations]].
-==Related Articles ==
+== Coding Guideline ==
-also see
+* For critical care only: The ARF ('''A'''cute '''R'''enal '''F'''ailure) dropdown for APACHE defaults to "enter"; you won't be able to send unless you change it to one of the following:
-* [[ARF (Diagnosis)]] for Diagnosis coding
+* '''Choose "no"''' if the pt
-* [[ATN]] for Diagnosis coding
+** does not meet the [[#KDIGO Guidelines for Acute Kidney Injury (AKI)]] '''or'''
-* [[CRF - Chronic Renal Failure]] for Diagnosis coding
+** has a diagnosis of [[Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15]] (with or without dialysis)
-* [[ARI]] for Diagnosis coding
+*** Special Case- If a patient comes to ICU with a past history of [[Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15]] and had a kidney transplant during this admission.  As per Allan, unless the transplanted kidney was truly working postop (i.e. didn't need dialysis for at least a week or two) then do not code ARF.
+* otherwise choose "yes"'''
+== Data Use ==
+ARF is one component used to generate the [[:Category:APACHE II| APACHE II]] score.
+Specifically, '''double points are assigned for the Creatinine score''' if the patient has ARF . (see [[APACHE_II_Background#Weighting_of_scores]] and  [[APACHE Scoring table#Physiological Variables]])
+{{Data Integrity Check List}}
+== Historical==
+*In original APACHE II there were no criteria given for what constitutes Acute Renal Failure.  So, from 1988 until 2018 we used a set of simple criteria based only on the admission serum creatinine and absolute urine output. But, when on January 1, 2019 we moved to ICD10 and CCI coding, we decided to use a
+*there were criteria for ARF in the APACHE II user manual 1986, from George Washington University, Ver 1.0, that we applied when we started in 1988, they were:
+**creatinine PLUS oliguria.  Oliguria was defined as: urine output of less than 135 cc over a consecutive 8 hr period in the first 24 hrs of ICU admission.
+**Copy of this APACHE II User Manual can be found in the article archives library located in HSC JJ387.
+== Related articles ==
+{{Related Articles}}
 [[Category:APACHE II Physiological Variables]]
-[[Category:Renal Problem]]
+[[Category:Renal Problem (old)]]