✓ Agrees: nothing to do
Kidney results 201 days apart are 60 or above (filtering rate 75.4 on 2026-04-25 and 71.3 on 2026-11-12) and the note doesn't mention kidney function.
The note unsigned draft · Thu Nov 12, 2026 09:00 AM
Hospital day 2 progress note.
Reason for admission: shortness of breath and leg swelling.
S: Breathing easier after diuresis overnight. Still sleeps on two pillows. No chest pain.
O: BP 128/76, HR 86, SpO2 95% on room air. Weight 86.1 kg (admission 86.9 kg). Bilateral ankle edema, improving. Crackles at both bases.
A/P:
1. CHF exacerbation: continue IV furosemide 40 mg twice daily; daily weights; strict intake and output; fluid restriction.
2. Atrial fibrillation: rate controlled; continue apixaban.
3. Disposition: home when euvolemic on oral diuretic.
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 ✓ Agrees: nothing to do
Creatinine did not rise enough (admission 1.05, peak 1.1 mg/dL) and the note doesn't mention a change.
before this stay lowest earlier creatinine 1.0 mg/dL
2026-11-11 08:00 creatinine 1.05 mg/dL (first in this stay)
2026-11-12 06:00 creatinine 1.1 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.
Who read this note
Heart pumping fraction (ejection fraction, EF) · Read by AI reader and rule reader agree · AI reader quoted CHF exacerbation(openrouter · openai/gpt-6.1-terra, openai/gpt-6.1-terra)
Kidney filtering rate (eGFR) over time · Read by AI reader and rule reader agree
The AI reader only proposes quoted statements; the rule reader must agree or the topic says "read this part yourself". The results never depend on either reader.
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).
·eGFR: Nothing to reviewcriteria met under 0 of 2 eGFR equations (2021 race-free, 2009)
eGFR 71.3 on 2026-11-12 (lab row L-0068); eGFR 75.4 on 2026-11-11 (lab row L-0067); eGFR 80.0 on 2026-08-08 (lab row L-0066). KDIGO persistence: not met (two values of 60 or more 201 days apart, none below 60 after them). Note: no kidney-function statement found. Nothing to review.
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
✓ No statement in the note
✗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) 1.1 / 1.0 = 1.1x Rows: L-0066, L-0068
✓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 201 days apart, none below 60 after them Rows: L-0065, L-0066, L-0067, L-0068
✗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 201 days apart, none below 60 after them Rows: L-0065, L-0066, L-0067, L-0068
✓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
Lowest value in the 365 days before admission (selected)
1.0
0
0
Most recent outpatient value 7-365 days before admission
1.0
0
0
Median of values in the 365 days before admission
1.025
0
0
Back-calculated from eGFR 75 (2021 equation, age and sex at admission)
1.055
0
0
Creatinine 1.05 mg/dL at admission (lab row L-0067), peak 1.1 mg/dL (lab row L-0068). KDIGO creatinine criterion not met: criteria met under 0 of 4 baselines at admission; 0 of 4 at peak. Urine-output criterion not evaluated (no structured source). No acute change by these criteria; nothing documented. Nothing to review.
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
✓ No statement in the note
✗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
✓met:
A creatinine value before admission is available (needed before a statement can be called not supported) (kdigo_aki_2012@1.1) available Rows: L-0065, L-0066
✗not met:
Creatinine >= 1.5x baseline (back-calculated from egfr 75 (2021 equation, age and sex at admission)) (kdigo_aki_2012@1.1) baseline 1.055 mg/dL; admission stage 0, peak stage 0 (never used alone) Rows: L-0067, L-0068
✗not met:
Creatinine >= 1.5x baseline (most recent outpatient value 7-365 days before admission) (kdigo_aki_2012@1.1) baseline 1.0 mg/dL; admission stage 0, peak stage 0 Rows: L-0066, L-0067, L-0068
✗not met:
Creatinine >= 1.5x baseline (lowest value in the 365 days before admission) (kdigo_aki_2012@1.1) baseline 1.0 mg/dL; admission stage 0, peak stage 0 Rows: L-0066, L-0067, L-0068
✗not met:
Creatinine >= 1.5x baseline (median of values in the 365 days before admission) (kdigo_aki_2012@1.1) baseline 1.025 mg/dL; admission stage 0, peak stage 0 Rows: L-0065, L-0066, L-0067, L-0068
✗not met:
Reverse comparison: admission or peak creatinine >= 1.5x the lowest value in the following 7 days (kdigo_aki_2012@1.1) L-0067 1.05 mg/dL vs L-0068 1.1 mg/dL: 0.95x Rows: L-0067, L-0068
Try one creatinine value
One value is never a confirmed stage: the persistence rule needs a repeat at least 90 days later.