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Exact Dx synthetic data · demonstration
Exact Dx · Before you sign · P21 synthetic data · demonstration · printed Fri Nov 13, 2026 04:55 PM

All notes

P21 man, 64 · outpatient visit Clinician-typed

Open in the chart

Not assessable Could not check kidney function: maintenance dialysis is on record, and the filtering-rate equation is not reliable then.

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

Follow-up.
S: Hemodialysis Monday, Wednesday and Friday through a left arm fistula. Tolerating sessions.
O: BP 138/82. Fistula with good thrill.
A/P:
1. Dialysis: continue the current schedule.
2. Anemia management per dialysis unit.
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

  • 2026-08-13 creatinine 6.8 mg/dL · filtering rate 8.4 (G5 range) (not used)
  • 2026-11-11 creatinine 7.2 mg/dL · filtering rate 7.9 (G5 range) (not used)

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.

  1. Needs a look Haemoglobin Draft · pending review

    The note says Anemia, but no haemoglobin result from 2026-10-14 to 2026-11-13 meets the published definition's criteria for any category that counts (who2024_anaemia@1.0). Results: haemoglobin 134 g/L on 2026-10-22 09:00; haemoglobin 136 g/L on 2026-11-11 09:05.

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

    Show in the note Show the results

    Published definition and source

    Guideline on haemoglobin cutoffs to define anaemia in individuals and populations

    who2024_anaemia@1.0
    Table 3: Adults, 15–65 years, nonpregnant women: No anaemia ≥120; Mild 110–119; Moderate 80–109; Severe <80. Adults, 15–65, years men: ≥130; 110–129; 80–109; <80 (g/L)

    World Health Organization · edition 2024 · Executive summary: Table 2 (PDF page 12), Table 3 (PDF page 13), Table 4 (PDF page 14), Table 5 (PDF page 15) · opened 2026-11-14 · source

    Categories that count (who2024_anaemia@1.0): 'severe' band (haemoglobin < 80 g/L); 'moderate' band (haemoglobin ≥ 80 g/L and haemoglobin < 110 g/L); 'mild' band (haemoglobin ≥ 110 g/L and haemoglobin < 130 g/L).

    Draft definition: pending clinical and coding review.

Show all (3)

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

Sodium and potassium Agrees

  1. Agrees Potassium Draft · pending review

    Potassium 5 mmol/L on 2026-11-11 09:05: in the category “below 5.5 mmol/L” of ukka2026_hyperkalaemia@1.0; the note doesn't mention this. Nothing to review.

    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

    Clinical Practice Guidelines: Treatment of Acute Hyperkalaemia in Adults

    ukka2026_hyperkalaemia@1.0
    It is further classified by severity into mild (5.5-5.9 mmol/l), moderate (6.0-6.4 mmol/l) or severe (≥ 6.5 mmol/l).

    UK Kidney Association · edition updated July 2026 · Introduction, document page 9 (PDF page 10) · opened 2026-11-14 · source

    Categories that count (ukka2026_hyperkalaemia@1.0): 'severe' band (6.5 mmol/L or more) (potassium ≥ 6.5 mmol/L); 'moderate' band (6.0 to 6.4 mmol/L) (potassium ≥ 6 mmol/L and potassium < 6.5 mmol/L); 'mild' band (5.5 to 5.9 mmol/L) (potassium ≥ 5.5 mmol/L and potassium < 6 mmol/L).

    Draft definition: pending clinical and coding review.

Library check LRUN-00021 · library_default_set@1.0 · library-engine 1.0 · replay d3b77c1742ff…

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

Not assessable: maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering. 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
  • not 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)
    maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering
  • not met: Two eGFR < 60 at least 90 days apart, none >= 60 between (2009 eGFR equation) (kdigo_ckd_2024@1.1)
    not assessable: maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering
  • not met: Two eGFR < 60 at least 90 days apart, none >= 60 between (2021 eGFR equation) (kdigo_ckd_2024@1.1)
    not assessable: maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering
  • 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-0047, L-0048
    Rows: L-0047, L-0048

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-00021 · seed · Fri Nov 13, 2026 04:55 PM · audit entry #1621
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: silent
Agreed statements
none
Provenance
Clinician-typed, as declared by the source system (context only: never an input to the rules)
Results side
measurement replay hash e202f1a0f2811363a71fc8b8d16de2c9adfa13a0fb0c9f0931e2ee9ced7abcf9 (computed from structured values only)
Replay hash
8c92a7c383369887c1cafae379fdf6d2f5d1151e4ba44cf600b4442970378d91
Decisions
none yet
Revisions
KN-P21-1
Every creatinine row on file, with the filtering rate by the 2021 equation (and the 2009 equation as a drift check)
RowCollectedCreatinineAge 2021Range2009Used
L-00472026-08-13 09:006.8 648.4G57.8 no: not used: maintenance dialysis on record (the equation is not reliable)
L-00482026-11-11 09:007.2 647.9G57.3 no: not used: maintenance dialysis on record (the equation is not reliable)