Hugo Valemont · Notes · Demo Health Record (demonstration)

Summary

Allergies

No known drug allergies

Latest vitals

BP: 138/82
HR: 83
SpO2: 98%
Temp: 36.9 °C
Weight: 59.9 kg

2026-11-11 10:08

Active problems 3

Anemia, unspecified
Maintenance dialysis
Insomnia

Reminders

Advance care planning · review due
Influenza vaccine · due this season
Eye examination · due in 2 months

Follow-up visit note

Unsigned draft

Type: Clinic visit
Date: 2026-11-11 11:00
Author: Dr. Imogen Vale
Status: Unsigned draft
Drafted by: Clinician-typed

Edit note Signing is never blocked.

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.

Visit diagnoses (as entered by the clinician)

Anemia, unspecified

Specificity How to read this

“Draft · pending review” means the definition awaits approval by your clinical and coding reviewers.

Not assessable: your judgement Kidney filtering rate (eGFR) over time Draft · pending review

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

Note read by: Stand-in AI reader and rule reader agree · no statement on this found in the note

Evidence from the record (0)

Show the results

Options

Choose wording yourself, or none. Nothing is pre-selected; the list and its order are the same for every patient.

Met / not met only says whether the recorded value falls inside that definition's range. It is not a recommendation; the diagnosis is your judgement.

Needs: filtering rate 90 or above with a kidney damage marker (for example albuminuria on two tests at least 90 days apart) Record: maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering · ∅ not assessable
Needs: filtering rate 60-89 with a kidney damage marker (for example albuminuria on two tests at least 90 days apart) Record: maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering · ∅ not assessable
Needs: filtering rate 45-59 on two results at least 90 days apart Record: maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering · ∅ not assessable
Needs: filtering rate 30-44 on two results at least 90 days apart Record: maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering · ∅ not assessable
Needs: filtering rate 15-29 on two results at least 90 days apart Record: maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering · ∅ not assessable
Needs: filtering rate below 15 on two results at least 90 days apart Record: maintenance dialysis on record (problem list, since 2024-09-02): creatinine reflects the dialysis schedule, not kidney filtering · ∅ not assessable

One click places the wording you choose in the unsigned draft as a new line at the end of the assessment (your existing wording is not changed), highlighted, for you to edit or undo before signing. Your choice and the evidence shown are recorded.

Provenance

This check is stored and can be re-run to the same result.
Inputs: none on file.
Readers: Stand-in AI reader and rule reader agree
What happened so far: No response yet
Offer OF-000017 in the provenance record

Reference ids (for audit)

Definition version front_kidney_stage_wording@1.0 · run FRUN-00021 · replay 33fd73a08f39…
Input ids: none on file

Who read the note

Rule reader: a fixed word list, always on.
AI reader: openrouter · openai/gpt-6.1-terra.
The results side (values, dates, definition) never depends on either reader.

Reference ids (for audit)

Rule reader word list: kidney-lexicon 1.0

Published definition and source

VA/DoD Clinical Practice Guideline for the Primary Care Management of Chronic Kidney Disease, Provider Summary (Version 5.0)

definition version 1.0

Department of Veterans Affairs and Department of Defense · 2025 · Sidebar 6 'Criteria for CKD' (PDF page 16; printed page 13 of 37). Do not use Sidebar 9 (a reproduced third-party figure) · source

Licence: U.S. government work (public domain); filtering-rate stage bands (90, 60, 45, 30, 15) and the G3a/G3b split: cited source, wording is ours; albumin-to-creatinine categories (A1 below 30, A2 30-299, A3 300 mg/g or above): cited source, wording is ours. Source checked: opened (2026-11-14).

Threshold: filtering rate below 60 on two results at least 90 days apart, none of 60 or more between them. Albumin-to-creatinine category: A1 below 30, A2 30-299, A3 300 mg/g or above.

See also: KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease (2024); Estimating Glomerular Filtration Rate: Adults (2025); ICD-10-CM Official Guidelines for Coding and Reporting FY2027 (2026).

Draft definition: pending clinical and coding review. No endorsement by the cited bodies is implied.

Reference ids (for audit)

Definition key front_kidney_stage_wording@1.0

Relevant history

Type at least three letters of the reason for visit to list related items from the whole chart.

Other checks 0

Other measurements checked against published definitions (the extended set).

No other results the checks read apply to this visit. Nothing else was checked; this is not a clean bill of health.

2 more items checked but not shown: the definition is in the extended set, which your documentation team has switched off for clinician screens (its source needs a licence before commercial use).

Details

Thresholds

Kidney filtering rate (eGFR) over time: Threshold: filtering rate below 60 on two results at least 90 days apart, none of 60 or more between them. Albumin-to-creatinine category: A1 below 30, A2 30-299, A3 300 mg/g or above.

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 this tool's comparison rules (both directions) · 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
front_kidney_stage_wording@1.0 draft, pending review

Record

Check RUN-00021 · kidney-engine 2.0 · replay 8c92a7c38336…. Data for this panel (JSON).

Specificity check FRUN-00021 · front-engine 1.2 · replay 33fd73a08f39….

Library check LRUN-00021 · library_default_set@1.1 · library-engine 1.1 · replay 3148b1492e82….

Decision support only: you decide and you write the note. Nothing is inserted unless you click it. DataCrafters 1.0.0 · data as of Fri Nov 13, 2026 04:55 PM