Exact Dx · Before you sign · P10 synthetic data · demonstration · printed Fri Nov 13, 2026 04:55 PM

P10 woman, 66 · outpatient visit Clinician-typed

Not assessable Could not check kidney function yet: only one result is below 60 (filtering rate 45.4 on 2026-11-12); a repeat at least 90 days later is needed.

The note unsigned draft · Thu Nov 12, 2026 11:00 AM

Follow-up.
S: Recovered from the stomach virus in summer.
O: BP 122/76.
A/P:
1. CKD 3b: recheck labs.
2. GERD: continue omeprazole.

Edit note

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

2026-08-04 creatinine 1.4 mg/dL · filtering rate 41.5 (G3b range)
2026-10-03 creatinine 0.9 mg/dL · filtering rate 70.5 (G2 range)
2026-11-12 creatinine 1.3 mg/dL · filtering rate 45.4 (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.

Needs a look Ferritin Draft · pending review

Ferritin 11 ug/L on 2026-11-12 09:05 meets the published definition's criteria for the category “band below the ferritin cut-off for this group” (who2020_iron_deficiency_ferritin@1.0). The note doesn't mention this.

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

The note does not mention this. Show the results

Published definition and source

WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations
who2020_iron_deficiency_ferritin@1.0

Table 1, iron deficiency, serum ferritin (µg/L): Children under 5 years <12 (apparently healthy), <30 (infection or inflammation); Adults (20–59 years) <15, <70; Pregnant women <15 (first trimester)

World Health Organization · edition 2020 · Executive summary, recommendations 1.1-1.2 (PDF page 11) and Table 1 (PDF page 12) · opened 2026-11-14 · source

Threshold for this category (who2020_iron_deficiency_ferritin@1.0): ferritin < 15 ug/L.

Draft definition: pending clinical and coding review.

Dismiss with a reason

Reason in your words (needed for "Other")

Library check LRUN-00010 · library_default_set@1.0 · library-engine 1.0 · replay 2b8d6ad0851f…

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 45.4 on 2026-11-12 (lab row L-0021); eGFR 70.5 on 2026-10-03 (lab row L-0020); eGFR 41.5 on 2026-08-04 (lab row L-0019). Not assessable: one value below 60 (eGFR 45.4 on 2026-11-12) since the last value of 60 or more; 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 3b

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 / 0.9 = 1.44x
Rows: L-0020, L-0021
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 42.7 on 2026-11-12) since the last value of 60 or more; persistence needs a repeat at least 90 days later
Rows: L-0019, L-0020, L-0021
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 45.4 on 2026-11-12) since the last value of 60 or more; persistence needs a repeat at least 90 days later
Rows: L-0019, L-0020, L-0021
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-00010 · seed · Fri Nov 13, 2026 04:55 PM · audit entry #1577

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 3b (characters 80-86)

Provenance

Clinician-typed, as declared by the source system (context only: never an input to the rules)

Results side

measurement replay hash 39d9982529eec98d1266ab9f33133acc9fd60887cb993dc53cb0c1bffa15b217 (computed from structured values only)

Replay hash

0da07e1036f172def5bcf7a4ceabc23bf46d393527467cb51e40a35c35cdfa37

Decisions

none yet

Revisions

KN-P10-1

Every creatinine row on file, with the filtering rate by the 2021 equation (and the 2009 equation as a drift check)
Row	Collected	Creatinine	Age	2021	Range	2009	Used
`L-0019`	2026-08-04 09:00	1.4	66	41.5	G3b	39.1	yes
`L-0020`	2026-10-03 09:00	0.9	66	70.5	G2	66.6	yes
`L-0021`	2026-11-12 09:00	1.3	66	45.4	G3a	42.7	yes

P10 woman, 66 · outpatient visit ✎ Clinician-typed