Milo Birchall · Notes · Demo Health Record (demonstration)

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

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Nursing shift note

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Type: Nursing note
Date: 2026-11-10 06:40
Author: Joss Penrose, RN
Status: Signed 2026-11-10 06:52

Night shift summary. Vital signs stable: BP 118/70, HR 88, SpO2 97%. Slept in intervals. Pain controlled. Intake and output recorded. Call light within reach; bed alarm on. Morning labs drawn and sent.

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

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Not assessable Kidney function over time

Could not check kidney function: there is no usable creatinine result outside an acute change.

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Agrees Creatinine change during this stay

The note says AKI and creatinine supports it: it fell from 2.4 to 1.2 mg/dL during the stay.

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Needs a look Haemoglobin Draft · pending review

Haemoglobin 112 g/L on 2026-11-09 08:05 meets the published definition's criteria for the category “'mild' band” (who2024_anaemia@1.0). The note doesn't mention this.

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

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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

Threshold for this category (who2024_anaemia@1.0): haemoglobin ≥ 110 g/L and haemoglobin < 130 g/L.

Draft definition: pending clinical and coding review.

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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
who2024_anaemia@1.0 draft, pending review · source

Record

Check RUN-00026 · kidney-engine 2.0 · replay 3ef56c197e0a…. Data for this sidebar (JSON).

Library check LRUN-00026 · library_default_set@1.0 · library-engine 1.0 · replay a7ae35573e52….

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