Query - Acute Tubular Necrosis (ATN)

Sample Query form for Acute Tubular Necrosis / Query example form for Acute Tubular Necrosis / When to query Acute Tubular Necrosis / Query format for Acute Tubular Necrosis.

Acute Tubular Necrosis (ATN) Query form

Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having ACUTE KIDNEY INJURY. The following is also documented in the medical record:

• ·       Creatinine levels [list all and dates]
• ·       FENa =
• ·       Urine sodium concentration =
• ·       Urine output of _________ over ___ hours
• ·       IV contrast
• ·       Medication [if potentially neurotoxic]:
• ·       Other:

Based on your medical judgment, can you further clarify in the progress notes confirmed or suspected underlying cause for this patient’s condition such as:

• ·       Acute Tubular Necrosis
• ·       Acute Cortical Necrosis
• ·       Acute Glomerulonephritis
• ·       Pre-Renal Acute Kidney Injury
• ·       Other condition: (please specify)
• ·       None of the above /Not applicable

In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected.

Thank you!