✓ Agrees
Kidney results 270 days apart are 60 or above (filtering rate 96.4 on 2026-01-14 and 73.1 on 2026-10-11) and the note doesn't mention kidney function.
The note unsigned draft · Wed Nov 11, 2026 09:00 AM
Hospital day 2 progress note.
S: Poor oral intake for 4 days before admission with vomiting. Nausea improving.
O: BP 108/64, HR 96. Dry mucous membranes. Creatinine up overnight.
A/P:
1. AKI, likely prerenal: IV fluids, hold lisinopril, strict intake and output, repeat labs in the morning.
2. Gastroenteritis: antiemetics, advance diet.
Threshold: filtering rate below 60 on two results at least 90 days apart, none of 60 or more between them.
Creatinine change during this stay ✓ Agrees
The note says AKI and creatinine supports it: it rose by 0.7 mg/dL within 22 hours (peak 2.3 mg/dL).
before this stay lowest earlier creatinine 0.8 mg/dL
2026-11-10 08:00 creatinine 1.6 mg/dL (first in this stay)
2026-11-11 06:00 creatinine 2.3 mg/dL (highest)
Threshold: creatinine up by 0.3 mg/dL within 48 hours, or to 1.5 times an earlier value. Urine output is not checked.
Other measurements checked against published definitions
Each definition is a draft pending clinical and coding review unless marked reviewed. You decide what the note says.
● Needs a lookSodiumDraft · pending review
Sodium 131 mmol/L on 2026-11-11 06:00 meets the published definition's criteria for the category “below 135 mmol/L” (ese2014_hyponatraemia@1.0). The note doesn't mention this.
Clinical practice guideline on diagnosis and treatment of hyponatraemia
ese2014_hyponatraemia@1.0
Hyponatraemia, defined as a serum sodium concentration <135 mmol/l
European Society of Intensive Care Medicine, European Society of Endocrinology and European Renal Association – European Dialysis and Transplant Association (ERBP) · edition 2014 (Nephrol Dial Transplant 2014;29 Suppl 2:i1-i39; also Eur J Endocrinol 2014;170:G1-G47) · Abstract · opened 2026-11-14
· source
Threshold for this category (ese2014_hyponatraemia@1.0): sodium < 135 mmol/L.
Draft definition: pending clinical and coding review.
Mode: measurements only (no diagnosis is named).
The check runs the same way on clinician-typed and AI-drafted notes (as declared by the source system).
·eGFR: Nothing to reviewcriteria met under 0 of 2 eGFR equations (2021 race-free, 2009)
eGFR 73.1 on 2026-10-11 (lab row L-0030); eGFR 82.0 on 2026-07-13 (lab row L-0029); eGFR 96.4 on 2026-01-14 (lab row L-0028). KDIGO persistence: not met (two values of 60 or more 270 days apart, none below 60 after them). Note: no kidney-function statement found. Nothing to review.
Both directions
What the labs show that the note doesn't say
✓ Criteria not met; nothing unstated
What the note says that the labs don't support
✓ No statement in the note
✗not met:
Urine ACR >= 30 mg/g on two values at least 90 days apart (needed only when eGFR >= 60) (kdigo_ckd_2024@1.1) no urine ACR on file
✓met:
Latest creatinine below 1.5x the lowest value in the previous 365 days (otherwise: possible acute change; repeat needed) (kdigo_ckd_2024@1.1) 1.1 / 0.8 = 1.38x Rows: L-0028, L-0030
✓met:
No condition on record that makes the estimating equation unreliable (maintenance dialysis, kidney transplant, pregnancy, limb amputation or another extreme of muscle mass) (kidney_exclusions@1.0) none on record for this encounter date
✗not met:
Two eGFR < 60 at least 90 days apart, none >= 60 between (2009 eGFR equation) (kdigo_ckd_2024@1.1) not met: two values of 60 or more 270 days apart, none below 60 after them Rows: L-0028, L-0029, L-0030
✗not met:
Two eGFR < 60 at least 90 days apart, none >= 60 between (2021 eGFR equation) (kdigo_ckd_2024@1.1) not met: two values of 60 or more 270 days apart, none below 60 after them Rows: L-0028, L-0029, L-0030
✓met:
Values used are steady-state (local convention: values from an admission meeting the creatinine-change criteria are excluded) (kdigo_ckd_2024@1.1) excluded L-0031, L-0032 Rows: L-0031, L-0032
Lowest value in the 365 days before admission (selected)
0.8
2
2
Most recent outpatient value 7-365 days before admission
1.1
0
2
Median of values in the 365 days before admission
1.0
1
2
Back-calculated from eGFR 75 (2021 equation, age and sex at admission)
1.077
0
2
Creatinine 1.6 mg/dL at admission (lab row L-0031), peak 2.3 mg/dL (lab row L-0032). KDIGO creatinine criterion met: criteria met under 2 of 4 baselines at admission; 4 of 4 at peak. Urine-output criterion not evaluated (no structured source). Note: a statement about an acute kidney change is present (quoted below).
From the draft note: AKI
Both directions
What the labs show that the note doesn't say
✓ Criteria met; the note has a statement
What the note says that the labs don't support
✓ Statement present; criteria met
✓met:
Creatinine rise >= 0.3 mg/dL within 48 hours (kdigo_aki_2012@1.1) L-0031 -> L-0032: +0.7 mg/dL in 22.0 h Rows: L-0031, L-0032
✓met:
No condition on record that makes the creatinine-change criteria unreliable (maintenance dialysis, kidney transplant, pregnancy) (kidney_exclusions@1.0) none on record for this encounter date
✓met:
A creatinine value before admission is available (needed before a statement can be called not supported) (kdigo_aki_2012@1.1) available Rows: L-0028, L-0029, L-0030
✓met:
Creatinine >= 1.5x baseline (back-calculated from egfr 75 (2021 equation, age and sex at admission)) (kdigo_aki_2012@1.1) baseline 1.077 mg/dL; admission stage 0, peak stage 2 (never used alone) Rows: L-0031, L-0032
✓met:
Creatinine >= 1.5x baseline (most recent outpatient value 7-365 days before admission) (kdigo_aki_2012@1.1) baseline 1.1 mg/dL; admission stage 0, peak stage 2 Rows: L-0030, L-0031, L-0032
✓met:
Creatinine >= 1.5x baseline (lowest value in the 365 days before admission) (kdigo_aki_2012@1.1) baseline 0.8 mg/dL; admission stage 2, peak stage 2 Rows: L-0028, L-0031, L-0032
✓met:
Creatinine >= 1.5x baseline (median of values in the 365 days before admission) (kdigo_aki_2012@1.1) baseline 1.0 mg/dL; admission stage 1, peak stage 2 Rows: L-0028, L-0029, L-0030, L-0031, L-0032
✗not met:
Reverse comparison: admission or peak creatinine >= 1.5x the lowest value in the following 7 days (kdigo_aki_2012@1.1) L-0031 1.6 mg/dL vs L-0032 2.3 mg/dL: 0.7x Rows: L-0031, L-0032
Try one creatinine value
One value is never a confirmed stage: the persistence rule needs a repeat at least 90 days later.