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Exact Dx synthetic data · demonstration
Exact Dx · Before you sign · P25 synthetic data · demonstration · printed Fri Nov 13, 2026 04:55 PM

All notes

P25 man, 60 · inpatient visit Clinician-typed

Open in the chart

Not assessable Could not check kidney function yet: there are not two results at least 90 days apart.

The note unsigned draft · Wed Nov 11, 2026 09:00 AM

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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

  • 2026-11-10 creatinine 1.3 mg/dL · filtering rate 62.9 (G2 range)
  • 2026-11-11 creatinine 1.3 mg/dL · filtering rate 62.9 (G2 range)

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 Not assessable

Could not check the creatinine change: there is no result from before this stay, and creatinine did not rise or fall enough during it.

  • 2026-11-10 08:00 creatinine 1.3 mg/dL (first in this stay)
  • 2026-11-11 06:00 creatinine 1.3 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.

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 62.9 on 2026-11-11 (lab row L-0056); eGFR 62.9 on 2026-11-10 (lab row L-0055). Not assessable: fewer than two values of 60 or more at least 90 days apart. Lookback: every creatinine result on file before this note. Nothing to review until the data can decide.

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: Latest creatinine below 1.5x the lowest value in the previous 365 days (otherwise: possible acute change; repeat needed) (kdigo_ckd_2024@1.1)
    1.3 / 1.3 = 1.0x
    Rows: L-0055, L-0056
  • 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: values below 60 span only 1 days (persistence needs at least 90)
    Rows: L-0055, L-0056
  • not met: Two eGFR < 60 at least 90 days apart, none >= 60 between (2021 eGFR equation) (kdigo_ckd_2024@1.1)
    not assessable: fewer than two values of 60 or more at least 90 days apart
    Rows: L-0055, L-0056
  • 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: Not assessable: the data cannot decide

Starting value (KDIGO does not define one; pick to compare) Lowest value in the 365 days before admission Most recent outpatient value 7-365 days before admission Median of values in the 365 days before admission Back-calculated from eGFR 75 (2021 equation, age and sex at admission)
Starting value
not available
KDIGO stage at admission
0
KDIGO stage at peak
0
Same chart, four starting values
Starting valuemg/dLStage at admissionStage at peak
Lowest value in the 365 days before admission (selected) — 00
Most recent outpatient value 7-365 days before admission — 00
Median of values in the 365 days before admission — 00
Back-calculated from eGFR 75 (2021 equation, age and sex at admission) 1.123 00

Creatinine 1.3 mg/dL at admission (lab row L-0055), peak 1.3 mg/dL (lab row L-0056). Not assessable: no creatinine before admission and no 48-hour rise or fall during the stay; the back-calculated baseline is never used alone. Urine-output criterion not evaluated (no structured source). Note: a statement about an acute kidney change is present (quoted below); it cannot be checked against these values.

From the draft note: AKI

Both directions
Both directions Not assessable: the data cannot decide (reason above). Nothing is flagged either way.
  • not met: Creatinine rise >= 0.3 mg/dL within 48 hours (kdigo_aki_2012@1.1)
    no such rise
  • 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
  • not met: A creatinine value before admission is available (needed before a statement can be called not supported) (kdigo_aki_2012@1.1)
    none in the 365 days before admission
  • not met: Creatinine >= 1.5x baseline (back-calculated from egfr 75 (2021 equation, age and sex at admission)) (kdigo_aki_2012@1.1)
    baseline 1.123 mg/dL; admission stage 0, peak stage 0 (never used alone)
    Rows: L-0055, L-0055
  • not met: Creatinine >= 1.5x baseline (most recent outpatient value 7-365 days before admission) (kdigo_aki_2012@1.1)
    baseline not available; peak stage 0 from the 48-hour rise only
    Rows: L-0055, L-0055
  • not met: Creatinine >= 1.5x baseline (lowest value in the 365 days before admission) (kdigo_aki_2012@1.1)
    baseline not available; peak stage 0 from the 48-hour rise only
    Rows: L-0055, L-0055
  • not met: Creatinine >= 1.5x baseline (median of values in the 365 days before admission) (kdigo_aki_2012@1.1)
    baseline not available; peak stage 0 from the 48-hour rise only
    Rows: L-0055, L-0055
  • not met: Reverse comparison: admission or peak creatinine >= 1.5x the lowest value in the following 7 days (kdigo_aki_2012@1.1)
    L-0055 1.3 mg/dL vs L-0056 1.3 mg/dL: 1.0x
    Rows: L-0055, L-0056

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-00025 · seed · Fri Nov 13, 2026 04:55 PM · audit entry #1637
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: silent · creatinine change: stated
Agreed statements
AKI (characters 117-120)
Provenance
Clinician-typed, as declared by the source system (context only: never an input to the rules)
Results side
measurement replay hash 55e20c1109dc3be1b4490215dc8049d735acdee7335821e5fad0832abdfcc81b (computed from structured values only)
Replay hash
1c2451784d1489a4c46052fc5e0d5658af5d37d4ce418d6867a1fa56a426c340
Decisions
none yet
Revisions
KN-P25-1
Every creatinine row on file, with the filtering rate by the 2021 equation (and the 2009 equation as a drift check)
RowCollectedCreatinineAge 2021Range2009Used
L-00552026-11-10 08:001.3 6062.9G259.3 yes
L-00562026-11-11 06:001.3 6062.9G259.3 yes