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Exact Dx synthetic data · demonstration
Exact Dx · Before you sign · P09 synthetic data · demonstration · printed Fri Nov 13, 2026 04:55 PM

All notes

P09 man, 58 · outpatient visit Clinician-typed

Open in the chart

Not assessable Could not check kidney function yet: only one result is below 60 (filtering rate 53.6 on 2026-11-11); a repeat at least 90 days later is needed.

The note unsigned draft · Wed Nov 11, 2026 04:00 PM

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The results

The note is compared with the patient's own measurements, in both directions. Kidney filtering rate (eGFR) is estimated from creatinine, age and sex.

Kidney function over time Not assessable

  • 2026-11-11 creatinine 1.5 mg/dL · filtering rate 53.6 (G3a range)

Threshold: filtering rate below 60 on two results at least 90 days apart, none of 60 or more between them.

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.

Nothing else needs a look.

Show all (2)

1 more, grouped by what was measured. At most three are shown above at once.

Blood pressure Not assessable

  1. Not assessable Blood pressure readings Draft · pending review

    The note says hypertension; it could not be checked against nhlbi_bp_categories@1.0: only one blood pressure result meets the threshold; the definition needs results on at least two separate dates.

    Another published definition (esc2024_office_bp@1.0) gives the category “office 140/90 or higher”.

    Published bodies disagree on these thresholds; another definition may give a different answer.

    Show in the note Show the results

    Published definition and source

    High Blood Pressure — Diagnosis

    nhlbi_bp_categories@1.0
    Normal: Less than 120 systolic AND Less than 80 diastolic; Elevated: 120 to 129 AND Less than 80; Stage 1: 130 to 139 OR 80 to 89; Stage 2: 140 or higher OR 90 or higher; Hypertensive Crisis: Higher than 180 OR Higher than 120

    National Heart, Lung, and Blood Institute (U.S. National Institutes of Health) · edition page last updated June 26, 2025 · Blood pressure categories table · opened 2026-11-14 · source

    Categories that count (nhlbi_bp_categories@1.0): range above 180 systolic or above 120 diastolic (systolic > 180 mmHg or diastolic > 120 mmHg); stage 2 range (140 or more systolic, or 90 or more diastolic) (systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg); stage 1 range (130 to 139 systolic, or 80 to 89 diastolic) (systolic ≥ 130 mmHg and systolic < 140 mmHg or diastolic ≥ 80 mmHg and diastolic < 90 mmHg); elevated range (120 to 129 systolic and below 80 diastolic) (systolic ≥ 120 mmHg and systolic < 130 mmHg and diastolic < 80 mmHg).

    Draft definition: pending clinical and coding review.

Library check LRUN-00009 · library_default_set@1.0 · library-engine 1.0 · replay 37038d413502…

Show the details

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).

Kidney function (eGFR persistence) · kdigo_ckd_2024@1.1

eGFR: Not assessable: the data cannot decide not assessable

eGFR 53.6 on 2026-11-11 (lab row L-0018). Not assessable: one value below 60 (eGFR 53.6 on 2026-11-11); persistence needs a repeat at least 90 days later. Lookback: every creatinine result on file before this note. Note: a kidney-function statement is present (quoted below); it cannot be checked against these values.

From the draft note: CKD 3

Both directions
Both directions Not assessable: the data cannot decide (reason above). Nothing is flagged either way.
  • 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: 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 assessable: one value below 60 (eGFR 50.6 on 2026-11-11); persistence needs a repeat at least 90 days later
    Rows: L-0018
  • not met: Two eGFR < 60 at least 90 days apart, none >= 60 between (2021 eGFR equation) (kdigo_ckd_2024@1.1)
    not assessable: one value below 60 (eGFR 53.6 on 2026-11-11); persistence needs a repeat at least 90 days later
    Rows: L-0018
  • met: Values used are steady-state (local convention: values from an admission meeting the creatinine-change criteria are excluded) (kdigo_ckd_2024@1.1)
    no values excluded

Creatinine change during this admission · kdigo_aki_2012@1.1

Creatinine change: Does not apply to this visit

Not assessed: outpatient visit: the creatinine-change check runs on inpatient encounters only.

Try one creatinine value

One value is never a confirmed stage: the persistence rule needs a repeat at least 90 days later.

The record of this check

Run
RUN-00009 · seed · Fri Nov 13, 2026 04:55 PM · audit entry #1573
Engine
kidney-engine 2.0
Rule versions
  • ckd_epi_2009@1.0 · Levey et al., Ann Intern Med 2009;150:604-12 (2009 eGFR equation, drift check)
  • ckd_epi_2021@1.0 · Inker et al., N Engl J Med 2021;385:1737-49 (2021 race-free eGFR equation)
  • kdigo_aki_2012@1.1 · KDIGO 2012 guideline, Kidney Int Suppl 2012;2:1-138 (Rec 2.1.1-2.1.2, Table 2)
  • kdigo_ckd_2024@1.1 · KDIGO 2024 guideline, Kidney Int 2024;105(4S):S117-S314 (G/A categories, >3 months)
  • kidney_compare@1.1 · Two-sided comparison (this tool); ICD-10-CM guideline I.A.19; ACDIS/AHIMA compliant query practice, 2026 update
  • kidney_exclusions@1.0 · KDIGO 2024 guideline, limitations of creatinine-based eGFR (muscle mass, pregnancy, kidney replacement); local list
  • lab_units@1.1 · KDIGO 2012 and 2024 guidelines, unit conversion (creatinine 1 mg/dL = 88.4 umol/L; ACR 1 mg/mmol = 8.84 mg/g)
Note reading
word list + model, agreement required · model: ok · kidney function: stated · creatinine change: silent
Agreed statements
CKD 3 (characters 149-154)
Provenance
Clinician-typed, as declared by the source system (context only: never an input to the rules)
Results side
measurement replay hash 43106afbb820cb9463e7f0e7cb6e588816f31225e72748f3d6e2e22d5c68b7fc (computed from structured values only)
Replay hash
1b1921695ee7c7fc26f99962bd161dbe9a2e805e9e6757d2c452a9b2bf1dc941
Decisions
none yet
Revisions
KN-P09-1
Every creatinine row on file, with the filtering rate by the 2021 equation (and the 2009 equation as a drift check)
RowCollectedCreatinineAge 2021Range2009Used
L-00182026-11-11 14:001.5 5853.6G3a50.6 yes