Gideon Greywood · Notes · Demo Health Record (demonstration)

Summary

Allergies

No known drug allergies

Latest vitals

BP: 132/78
HR: 64
SpO2: 96%
Temp: 37.0 °C
Weight: 70.0 kg

2026-11-12 09:08

Active problems 4

Gout
Hypertension
Vitamin D deficiency
Gastroesophageal reflux

Reminders

Colorectal cancer screening · due
Advance care planning · review due
Influenza vaccine · due this season

Clinic visit note

Unsigned draft

Type: Clinic visit
Date: 2026-11-12 10:00
Author: Dr. Imogen Vale
Status: Unsigned draft
Drafted by: Clinician-typed

Edit note Signing is never blocked.

Chief complaint: follow-up of kidney function. S: Feels well. No urinary symptoms. Avoids anti-inflammatory pain relievers. O: BP 132/78. No edema. A/P: 1. CKD: labs reviewed; continue lisinopril and empagliflozin; recheck creatinine and urine albumin in 3 months. 2. Gout: no flares; continue allopurinol.

Visit diagnoses (as entered by the clinician)

None entered yet for this visit.

Specificity How to read this

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

Needs a look Kidney filtering rate (eGFR) over time Draft · pending review

The note says CKD; the note does not give a stage. Two results 110 days apart are in the G3b range (filtering rate 38.4 on 2026-07-25 and 37.0 on 2026-11-12).

Note read by: AI reader and rule reader agree · words read in the note: CKD

Evidence from the record (4)

Filtering rate 38.4 on 2026-07-25 (G3b range) and 37.0 on 2026-11-12 (G3b range)
Urine albumin-to-creatinine ratio 165 mg/g on 2026-11-12: A2 range
Urine albumin-to-creatinine ratio 140 mg/g on 2026-07-25: A2 range
Albuminuria on two tests at least 90 days apart: yes

Show in the note 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: filtering rate 38.4 on 2026-07-25 and 37.0 on 2026-11-12 (G3b range) · ✗ not met
Needs: filtering rate 60-89 with a kidney damage marker (for example albuminuria on two tests at least 90 days apart) Record: filtering rate 38.4 on 2026-07-25 and 37.0 on 2026-11-12 (G3b range) · ✗ not met
Needs: filtering rate 45-59 on two results at least 90 days apart Record: filtering rate 38.4 on 2026-07-25 and 37.0 on 2026-11-12 (G3b range) · ✗ not met
Needs: filtering rate 30-44 on two results at least 90 days apart Record: filtering rate 38.4 on 2026-07-25 and 37.0 on 2026-11-12 (G3b range) · ✓ met
Needs: filtering rate 15-29 on two results at least 90 days apart Record: filtering rate 38.4 on 2026-07-25 and 37.0 on 2026-11-12 (G3b range) · ✗ not met
Needs: filtering rate below 15 on two results at least 90 days apart Record: filtering rate 38.4 on 2026-07-25 and 37.0 on 2026-11-12 (G3b range) · ✗ not met

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: 3 record items, listed under Evidence above.
Readers: AI reader and rule reader agree
What happened so far: No response yet · shown 1 time before on this visit
Offer OF-000041 in the provenance record

Reference ids (for audit)

Definition version front_kidney_stage_wording@1.0 · run FRUN-00046 · replay 86ba97b8e997…
Input ids: L-0078, L-0081, L-0079

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

10 related items from the whole chart for follow-up of kidney function · related terms for kidney function. Your own words first, then related terms; newest first within each.

Earlier notes 4

Nephrology e-consult 2026-08-04

E-consult for reduced kidney function with albuminuria. (Dr. Saoirse Brannock (nephrology))

Matched on: kidney function (your words) · Nephrology (related word) · Renal (related word)
Clinic visit note 2026-07-25

Recheck kidney function and urine albumin in 3 to 4 months. (Dr. Imogen Vale)

Matched on: kidney function (your words) · Creatinine (related word) · filtering rate (related word) · Urine albumin (related test)
Clinic visit note 2026-04-26

A/P: Kidney function slightly reduced on today's labs (creatinine 1.84 mg/dL); (Dr. Imogen Vale)

Matched on: Kidney function (your words) · creatinine (related word) · urine albumin (related test)
Result review 2026-07-26

Creatinine 1.9 mg/dL (reference 0.74–1.35) (above the reference range). (Dr. Imogen Vale)

Matched on: Creatinine (related word)

Results 3

Urine albumin/creatinine ratio 2026-11-12

165 mg/g on 2026-11-12; 140 mg/g on 2026-07-25

Matched on: Urine albumin (related test) · creatinine (related word)
Urea nitrogen (BUN) 2026-11-12

28 mg/dL on 2026-11-12; 26 mg/dL on 2026-07-25; 25 mg/dL on 2026-04-26

Matched on: BUN (AI-suggested related term)
Creatinine 2026-11-12

1.96 mg/dL on 2026-11-12; 1.9 mg/dL on 2026-07-25; 1.84 mg/dL on 2026-04-26

Matched on: Creatinine (related word)

Imaging and reports 1

Ultrasound, kidneys and bladder 2026-08-14

Right kidney 9.8 cm, left kidney 10.1 cm, both mildly echogenic. (Dr. Petra Quill (radiology))

Matched on: kidney (your words) · Ultrasound, kidneys (related test)

Medications 2

Active · Home medication · started 2026-07-25 2026-07-25

Empagliflozin: 10 mg tablet · 1 by mouth daily

Matched on: Empagliflozin (related medicine (kidney-protective))
Active · Home medication · started 2024-03-14 2024-03-14

Lisinopril: 20 mg tablet · 1 by mouth daily

Matched on: Lisinopril (related medicine (kidney-protective))

AI-suggested terms only widen the search; every item is a real chart item quoted from its own text.

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.

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-00046 · kidney-engine 2.0 · replay 3da85b8944e6…. Data for this panel (JSON).

Specificity check FRUN-00046 · front-engine 1.2 · replay 86ba97b8e997….

Library check LRUN-00046 · library_default_set@1.1 · library-engine 1.1 · replay f415d9cbb1b7….

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