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   <timestamp value="2023-12-15T12:23:19Z"/>
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            <date value="2023-12-15T12:23:19Z"/>
            <author>
               <reference value="urn:uuid:9cb4527c-5b48-4903-b5c0-cb43408d685a"/>
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            <title value="Laboratory Report"/>
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               <title value="Laboratory Report"/>
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                  <title value="Chemistry"/>
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                        <h3>Chemistry</h3>
                        <table class="hl7__eu__lab__report">
                           <thead>
                              <tr>
                                 <th>Test</th>
                                 <th>15-DEC-2023</th>
                                 <th>Reference Range</th>
                                 <th>Unit</th>
                              </tr>
                           </thead>
                           <tbody>
                              <tr>
                                 <td>Glucose [Mass/volume] in Serum or Plasma</td>
                                 <td>78.6</td>
                                 <td>70 - 100</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Urea nitrogen [Mass/volume] in Serum or Plasma</td>
                                 <td>18.8</td>
                                 <td>7 - 20</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Creatinine [Mass/volume] in Serum or Plasma</td>
                                 <td>
                                    <strong>2.0 H</strong>
                                 </td>
                                 <td>0.5 - 1.1</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Calcium [Mass/volume] in Serum or Plasma</td>
                                 <td>9.6</td>
                                 <td>8.6 - 10.2</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Sodium [Moles/volume] in Serum or Plasma</td>
                                 <td>143.3</td>
                                 <td>135 - 145</td>
                                 <td>mmol/L</td>
                              </tr>
                              <tr>
                                 <td>Potassium [Moles/volume] in Serum or Plasma</td>
                                 <td>4.8</td>
                                 <td>3.5 - 5.1</td>
                                 <td>mmol/L</td>
                              </tr>
                              <tr>
                                 <td>Chloride [Moles/volume] in Serum or Plasma</td>
                                 <td>
                                    <strong>107.9 H</strong>
                                 </td>
                                 <td>98 - 107</td>
                                 <td>mmol/L</td>
                              </tr>
                              <tr>
                                 <td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td>
                                 <td>25.0</td>
                                 <td>22 - 29</td>
                                 <td>mmol/L</td>
                              </tr>
                              <tr>
                                 <td>Ketones [Presence] in Urine by Test strip</td>
                                 <td>Urine ketone test = ++</td>
                                 <td/>
                                 <td/>
                              </tr>
                              <tr>
                                 <td>Hemoglobin A1c/Hemoglobin.total in Blood</td>
                                 <td>
                                    <strong>3.4 L</strong>
                                 </td>
                                 <td>4.0 - 5.6</td>
                                 <td>%</td>
                              </tr>
                              <tr>
                                 <td>Glucose [Mass/volume] in Blood</td>
                                 <td>78.6</td>
                                 <td>70 - 100</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Urea nitrogen [Mass/volume] in Blood</td>
                                 <td>18.8</td>
                                 <td>7 - 20</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Creatinine [Mass/volume] in Blood</td>
                                 <td>
                                    <strong>3.8 H</strong>
                                 </td>
                                 <td>0.5 - 1.1</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Calcium [Mass/volume] in Blood</td>
                                 <td>9.6</td>
                                 <td>8.5 - 10.5</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Sodium [Moles/volume] in Blood</td>
                                 <td>143.3</td>
                                 <td>135 - 145</td>
                                 <td>mmol/L</td>
                              </tr>
                              <tr>
                                 <td>Potassium [Moles/volume] in Blood</td>
                                 <td>4.8</td>
                                 <td>3.5 - 5.1</td>
                                 <td>mmol/L</td>
                              </tr>
                              <tr>
                                 <td>Chloride [Moles/volume] in Blood</td>
                                 <td>107.9</td>
                                 <td>98 - 110</td>
                                 <td>mmol/L</td>
                              </tr>
                              <tr>
                                 <td>Carbon dioxide, total [Moles/volume] in Blood</td>
                                 <td>25.0</td>
                                 <td>22 - 29</td>
                                 <td>mmol/L</td>
                              </tr>
                              <tr>
                                 <td>Cholesterol [Mass/volume] in Serum or Plasma</td>
                                 <td>163.8</td>
                                 <td>125 - 200</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Triglyceride [Mass/volume] in Serum or Plasma</td>
                                 <td>125.8</td>
                                 <td>0 - 150</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay</td>
                                 <td>80.5</td>
                                 <td>0 - 100</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Cholesterol in HDL [Mass/volume] in Serum or Plasma</td>
                                 <td>58.1</td>
                                 <td>40 - 60</td>
                                 <td>mg/dL</td>
                              </tr>
                           </tbody>
                        </table>
                     </div>
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                  <entry>
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                  <entry>
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                  <entry>
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               </section>
               <section>
                  <title value="Urinalysis"/>
                  <code>
                     <coding>
                        <system value="http://loinc.org"/>
                        <code value="18729-4"/>
                        <display value="Urinalysis studies (set)"/>
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                     <text value="Urinalysis"/>
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                  <text>
                     <status value="generated"/>
                     <div xmlns="http://www.w3.org/1999/xhtml">
                        <h3>Urinalysis</h3>
                        <table class="hl7__eu__lab__report">
                           <thead>
                              <tr>
                                 <th>Test</th>
                                 <th>15-DEC-2023</th>
                                 <th>Reference Range</th>
                                 <th>Unit</th>
                              </tr>
                           </thead>
                           <tbody>
                              <tr>
                                 <td>Glucose [Mass/volume] in Urine by Test strip</td>
                                 <td>
                                    <strong>1.9 H</strong>
                                 </td>
                                 <td>0 - 0</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Glucose [Presence] in Urine by Test strip</td>
                                 <td>Urine glucose test = ++</td>
                                 <td/>
                                 <td/>
                              </tr>
                              <tr>
                                 <td>Bilirubin.total [Mass/volume] in Urine by Test strip</td>
                                 <td>1.5</td>
                                 <td>0 - 4</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Bilirubin.total [Presence] in Urine by Test strip</td>
                                 <td>Finding of bilirubin in urine</td>
                                 <td/>
                                 <td/>
                              </tr>
                              <tr>
                                 <td>Ketones [Mass/volume] in Urine by Test strip</td>
                                 <td>2.5</td>
                                 <td>0 - 20</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Specific gravity of Urine by Test strip</td>
                                 <td>
                                    <strong>1.0 L</strong>
                                 </td>
                                 <td>1.005 - 1.030</td>
                                 <td>{nominal}</td>
                              </tr>
                              <tr>
                                 <td>pH of Urine by Test strip</td>
                                 <td>6.6</td>
                                 <td>5.0 - 8.0</td>
                                 <td>pH</td>
                              </tr>
                              <tr>
                                 <td>Protein [Mass/volume] in Urine by Test strip</td>
                                 <td>
                                    <strong>325.9 H</strong>
                                 </td>
                                 <td>0 - 20</td>
                                 <td>mg/dL</td>
                              </tr>
                              <tr>
                                 <td>Protein [Presence] in Urine by Test strip</td>
                                 <td>Urine protein test = ++</td>
                                 <td/>
                                 <td/>
                              </tr>
                              <tr>
                                 <td>Nitrite [Presence] in Urine by Test strip</td>
                                 <td>Urine nitrite negative</td>
                                 <td/>
                                 <td/>
                              </tr>
                              <tr>
                                 <td>Hemoglobin [Presence] in Urine by Test strip</td>
                                 <td>Urine blood test = negative</td>
                                 <td/>
                                 <td/>
                              </tr>
                              <tr>
                                 <td>Leukocyte esterase [Presence] in Urine by Test strip</td>
                                 <td>Urine leukocyte test negative</td>
                                 <td/>
                                 <td/>
                              </tr>
                           </tbody>
                        </table>
                     </div>
                  </text>
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                  </entry>
                  <entry>
                     <reference value="urn:uuid:dd07ab88-6247-4e22-874e-8160d0c9244b"/>
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               <section>
                  <title value="Specimen information"/>
                  <code>
                     <coding>
                        <system value="http://loinc.org"/>
                        <code value="LP7846-1"/>
                        <display value="Specimen information"/>
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                     <text value="Specimen information"/>
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                     <status value="generated"/>
                     <div xmlns="http://www.w3.org/1999/xhtml">
                        <h3>Specimen information</h3>
                        <table class="hl7__eu__lab__report">
                           <thead>
                              <tr>
                                 <th>Test</th>
                                 <th>15-DEC-2023</th>
                                 <th>Specimen</th>
                                 <th/>
                              </tr>
                           </thead>
                           <tbody>
                              <tr>
                                 <td>Appearance of Urine</td>
                                 <td>Cloudy urine</td>
                                 <td>Urine</td>
                                 <td/>
                              </tr>
                              <tr>
                                 <td>Odor of Urine</td>
                                 <td>Urine smell ammoniacal</td>
                                 <td>Urine</td>
                                 <td/>
                              </tr>
                              <tr>
                                 <td>Clarity of Urine</td>
                                 <td>Translucent</td>
                                 <td>Urine</td>
                                 <td/>
                              </tr>
                              <tr>
                                 <td>Color of Urine</td>
                                 <td>Brown color</td>
                                 <td>Urine</td>
                                 <td/>
                              </tr>
                           </tbody>
                        </table>
                     </div>
                  </text>
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                  <entry>
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            <section>
               <title value="Annotation comment"/>
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                     <display value="Annotation comment [Interpretation] Narrative"/>
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                     <h3>Annotation</h3>
                     <table class="hl7__eu__lab__report">
                        <tr>
                           <th>Conclusion and Recommendations based on this report and previous findings known to us</th>
                        </tr>
                        <tr>
                           <td>The patient shows markedly elevated creatinine, proteinuria, and abnormal urine findings (cloudy, brown, low specific gravity), suggesting significant renal dysfunction, possibly nephrotic syndrome or acute/chronic kidney disease. Blood glucose is normal, but urine glucose and ketones are present, with a low HbA1c, which may indicate recent metabolic changes or renal glycosuria. No evidence of urinary tract infection. Recommend urgent nephrology evaluation for further assessment and management.</td>
                        </tr>
                     </table>
                  </div>
               </text>
            </section>
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               <display value="Angela Bauer"/>
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                  <code value="433144002"/>
                  <display value="Chronic kidney disease stage 3"/>
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                  <system value="http://snomed.info/sct"/>
                  <code value="157141000119108"/>
                  <display value="Proteinuria due to type 2 diabetes mellitus"/>
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                  <code value="237602007"/>
                  <display value="Metabolic syndrome X"/>
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                  <system value="http://snomed.info/sct"/>
                  <code value="239872002"/>
                  <display value="Osteoarthritis of hip"/>
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            <reasonCode>
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                  <code value="431856006"/>
                  <display value="Chronic kidney disease stage 2"/>
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            <reasonCode>
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                  <system value="http://snomed.info/sct"/>
                  <code value="90781000119102"/>
                  <display value="Microalbuminuria due to type 2 diabetes mellitus"/>
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            <reasonCode>
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                  <code value="127013003"/>
                  <display value="Disorder of kidney due to diabetes mellitus"/>
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            <reasonCode>
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                  <code value="431855005"/>
                  <display value="Chronic kidney disease stage 1"/>
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            <reasonCode>
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                  <code value="59621000"/>
                  <display value="Essential hypertension"/>
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               <div xmlns="http://www.w3.org/1999/xhtml">Provider Role Id: a9d185f3-0177-4386-85ea-17e19bfffbbe</div>
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            <organization>
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               <div xmlns="http://www.w3.org/1999/xhtml">Provider Organization: Dr. Gerald Mair</div>
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            <identifier>
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               <city value="Fügen"/>
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                     <tr>
                        <td>Acellular blood (serum or plasma) specimen</td>
                        <td>
                           <span class="nb">15-Dec-2023</span>
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                        <td>Urine specimen</td>
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                           <span class="nb">15-Dec-2023</span>
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                        <td>Urea nitrogen [Mass/volume] in Serum or Plasma</td>
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                        <th>15-Dec-2023</th>
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