acute renal failure and hypertensive ckd

kimch73@yahoo.com

question on sequencing if have patient admitted with acute renal failure with hypertensive ckd stage 3.   Which do you use as pdx  the acute renal failure since it is the acute condition or the hypertensive ckd stage 3 with the acute renal failure as secondary dx? 

bbogda@morrishospital.org

If the patient was admitted and treated for acute renal failure, we would assign that as PDx with the hypertensive CKD as secondary.  Which is aggravating, because if the patient has CKD 4 or 5, it is disallowed as cc with the aki as PDx.