Template:ICD10 Guideline ESRD vs Acute renal failure
This template contains info that is relevant to all the acute renal failure diagnoses.
To use:
- {{ICD10 Guideline ESRD vs Acute renal failure}}
ESRD vs Acute renal failure
- AND
- UNLESS the patient has had a renal transplant and the transplanted kidney was functioning (and thus can experience acute renal failure)
About "Acute on Chronic renal failure"
- Our definition for CRF includes two things, as above. If you are on dialysis then it is technically not possible to also have acute renal failure. And while our threshold of creatinine clearance < 15 ml/min USUALLY gets people on dialysis, that's not always the case. In other words, there are some people who don't need to start dialysis until their clearance is <10 or even 8 ml/min. THOSE people who by our definition have Stage 5 CAN get an acute renal injury (ARF) on top of what we allow to be called Stage 5.
- And of course, if you previously had Stage 5, were on dialysis, then got a successful renal transplant, then you CAN get acute renal failure in your graft.
Background/History
This has been discussed repeatedly over time. Here is an attempt at a Chronology, newest first
- In emails on 2022-06-23 Julie, Lisa and Tina decided to hold off on the change from the day before to review reasons why this was changed before.
- 2022-06-22 - At JALT meeting we discussed definition for query Check CRF vs ARF across multiple encounters; instructions were changed to no longer allow ARF to be collected at same time as CRF (I can't remember the reasons, can Julie or Lisa fill in?)
- 2020-01-23 - Task(10) we discussed this at task: Some mild Chronic kidney disease (end-stage renal/kidney disease, ESRD), Stage 5, GFR LT 15 cases can have AKI following Template:ICD10 Guideline KDIGO Guidelines for Acute Renal Failure, so we allowed entering them together (query check_ICD10_ESRD_vs_ARF disabled, deleted this template page ICD10 Guideline ESRD vs Acute renal failure
- 2019-08-22 - Discussed in context of Check CRF vs ARF across multiple encounters and decided that, since people can come off dialysis, there might really be a new acute after having been on dialysis; messy so decided not to implement this
- at some point we defined AKI by Template:ICD10 Guideline KDIGO Guidelines for Acute Renal Failure
- at some point we defined Chronic kidney disease (chronic renal insufficiency, uremia) Stage 1, GFR GT 90 rather than defining
- when we moved to ICD10 there was a desire to maintain that rule
- pre/ancient: In our old coding schema we defined CRF as being "on dialysis" and ARF as "newly dialyzed", so combining the two by definition did not make sense; there were some exceptions for patients who had a kidney transplant and came off dialysis; there was talk about some fairly complex cross checks between encounters - Julie may have had these in SAS but AFAIK they were never implemented in CFE. There was much discussion whether the re-set for chronic state should be this ward stay, this hospitalization, this hospitalization across the city.
see more details for dx schema |
We used to not allow this in the old dx coding schema:
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