Abel Oakhurst · Notes · Demo Health Record (demonstration)

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Demo Health Record Riverbend Community Hospital (fictional) synthetic data · demonstration

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Clinic visit note

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Type: Clinic visit
Date: 2026-01-14 10:15
Author: Dr. Imogen Vale
Status: Signed 2026-01-14 10:27

Follow-up visit. S: Doing well. Taking medications as prescribed. O: BP 138/74, HR 82. Weight 74.3 kg. A/P: 1. Hypertension: stable; continue current plan. 2. Hyperlipidemia: stable; continue current plan. 3. Insomnia: stable; continue current plan. Labs drawn today: basic metabolic panel and blood count. Return in 3 to 4 months.

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Clinician-typed This draft, as declared by the source system

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Agrees Kidney function over time

Kidney results 270 days apart are 60 or above (filtering rate 96.4 on 2026-01-14 and 73.1 on 2026-10-11) and the note doesn't mention kidney function.

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Agrees Creatinine change during this stay

The note says AKI and creatinine supports it: it rose by 0.7 mg/dL within 22 hours (peak 2.3 mg/dL).

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Needs a look Sodium Draft · pending review

Sodium 131 mmol/L on 2026-11-11 06:00 meets the published definition's criteria for the category “below 135 mmol/L” (ese2014_hyponatraemia@1.0). The note doesn't mention this.

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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

Threshold for this category (ese2014_hyponatraemia@1.0): sodium < 135 mmol/L.

Draft definition: pending clinical and coding review.

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Details

Thresholds

Kidney function over time: 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: Threshold: creatinine up by 0.3 mg/dL within 48 hours, or to 1.5 times an earlier value. Urine output is not checked.

Rules and published sources

ckd_epi_2009@1.0 Levey et al., Ann Intern Med 2009;150:604-12 (2009 eGFR equation, drift check) · source
ckd_epi_2021@1.0 Inker et al., N Engl J Med 2021;385:1737-49 (2021 race-free eGFR equation) · source
kdigo_aki_2012@1.1 KDIGO 2012 guideline, Kidney Int Suppl 2012;2:1-138 (Rec 2.1.1-2.1.2, Table 2) · source
kdigo_ckd_2024@1.1 KDIGO 2024 guideline, Kidney Int 2024;105(4S):S117-S314 (G/A categories, >3 months) · source
kidney_compare@1.1 Two-sided comparison (this tool); ICD-10-CM guideline I.A.19; ACDIS/AHIMA compliant query practice, 2026 update · source
kidney_exclusions@1.0 KDIGO 2024 guideline, limitations of creatinine-based eGFR (muscle mass, pregnancy, kidney replacement); local list · source
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) · source
ese2014_hyponatraemia@1.0 draft, pending review · source

Record

Check RUN-00014 · kidney-engine 2.0 · replay e85c2205b031…. Data for this sidebar (JSON).

Library check LRUN-00014 · library_default_set@1.0 · library-engine 1.0 · replay 930e4d37f310….

Decision support only: you decide and you write the note. Exact Dx 1.0.0 · data as of Fri Nov 13, 2026 04:55 PM