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Exact Dx synthetic data · demonstration
Exact Dx · Before you sign · P28 synthetic data · demonstration · printed Fri Nov 13, 2026 04:55 PM

All notes

P28 woman, 62 · outpatient visit Clinician-typed

Open in the chart

Needs a look The note says CKD stage 3a; results 240 days apart are 60 or above (filtering rate 72.3 on 2026-03-16 and 67.7 on 2026-11-11), so the threshold of below 60 is not met.

The note unsigned draft · Wed Nov 11, 2026 10:00 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 Needs a look

  • 2026-03-16 creatinine 0.9 mg/dL · filtering rate 72.3 (G2 range)
  • 2026-11-11 creatinine 0.95 mg/dL · filtering rate 67.7 (G2 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 (3)

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

Sodium and potassium Agrees

  1. Agrees Sodium Draft · pending review

    Sodium 139 mmol/L on 2026-11-11 09:05: in the category “135 mmol/L or above” of ese2014_hyponatraemia@1.0; the note doesn't mention this. Nothing to review.

    The note does not mention this. Show the results

    Published definition and source

    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

    Categories that count (ese2014_hyponatraemia@1.0): below 135 mmol/L (sodium < 135 mmol/L).

    Draft definition: pending clinical and coding review.

Cholesterol Not assessable

  1. Not assessable LDL cholesterol Draft · pending review

    The note says Hyperlipidemia; it could not be checked against aha2018_severe_hypercholesterolaemia@1.0: there is no LDL cholesterol result in the last 730 days.

    Another published definition (atp3_ldl@1.0) cannot decide: there is no usable LDL cholesterol result.

    Show in the note

    Published definition and source

    2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol

    aha2018_severe_hypercholesterolaemia@1.0
    Severe Hypercholesterolemia (LDL-C ≥190 mg/dL [≥4.9 mmol/L])

    American Heart Association / American College of Cardiology and partner societies · edition 2018 (Circulation 2019;139:e1082-e1143, author manuscript PMC7403606) · Section 4.2 heading; Top 10 Take-Home Message 4 · opened 2026-11-14 · source

    Categories that count (aha2018_severe_hypercholesterolaemia@1.0): LDL 190 mg/dL or more (LDL ≥ 190 mg/dL).

    Draft definition: pending clinical and coding review.

Library check LRUN-00028 · library_default_set@1.0 · library-engine 1.0 · replay 6eca41024609…

Show the details

Your decision: Kidney function (eGFR persistence)

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: Documented; the criteria are not met criteria met under 0 of 2 eGFR equations (2021 race-free, 2009)

eGFR 67.7 on 2026-11-11 (lab row L-0064); eGFR 72.3 on 2026-07-14 (lab row L-0063); eGFR 72.3 on 2026-03-16 (lab row L-0062). KDIGO persistence: not met (two values of 60 or more 240 days apart, none below 60 after them). Note: a kidney-function statement is present (quoted below); the persistence criteria are not met.

From the draft note: CKD stage 3a

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 Statement present; criteria not met
  • 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)
    0.95 / 0.9 = 1.06x
    Rows: L-0062, L-0064
  • 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 240 days apart, none below 60 after them
    Rows: L-0062, L-0063, L-0064
  • 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 240 days apart, none below 60 after them
    Rows: L-0062, L-0063, L-0064
  • 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-00028 · seed · Fri Nov 13, 2026 04:55 PM · audit entry #1649
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 stage 3a (characters 48-60)
Provenance
Clinician-typed, as declared by the source system (context only: never an input to the rules)
Results side
measurement replay hash 5e326bc28800b024843cb6c969d612b31d6c6c62f93deaabd578da9a7a9a9e5d (computed from structured values only)
Replay hash
6839b1d6b660e14e4bd20b833ab6e17cb5782e590713868ca8827400b5f172f5
Decisions
none yet
Revisions
KN-P28-1
Every creatinine row on file, with the filtering rate by the 2021 equation (and the 2009 equation as a drift check)
RowCollectedCreatinineAge 2021Range2009Used
L-00622026-03-16 09:000.9 6272.3G268.5 yes
L-00632026-07-14 09:000.9 6272.3G268.5 yes
L-00642026-11-11 09:000.95 6267.7G264.2 yes