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Exact Dx synthetic data · demonstration

← How it decides

Exclusion gate: conditions in which creatinine-based estimates or creatinine-change criteria are unreliable

First, check the record for conditions where creatinine misleads (dialysis, kidney transplant, pregnancy, amputation).

Rule and version
kidney_exclusions@1.0
Published source
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int 2024;105(4S):S117-S314 (practice points on the limitations of creatinine-based eGFR). The list of conditions and their effect on each check is this tool's conservative choice and must be confirmed by the clinical reviewer. https://kdigo.org/guidelines/ckd-evaluation-and-management/
Edition
KDIGO 2024 CKD guideline (eGFR limitations); local list
Effective
from 2026-11-12
Role
runs before every kidney rule: an active condition row of a listed kind makes the check 'not assessable' with the reason
Status
draft: encoded from the published source; not yet signed off by a clinical reviewer
Clinical reviewer
—
Coding reviewer
—
Sponsor
none
Body hash
98e08ca8b6f5a7f7a68b225b57239006b4664aa533200feaca96e84c0430217b

Thresholds and parameters

{
  "active": "start_date on or before the encounter date and end_date absent or on or after it",
  "kinds": {
    "amputation": {
      "families": [
        "kidney"
      ],
      "label": "limb amputation",
      "why": "reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering"
    },
    "dialysis": {
      "families": [
        "kidney",
        "aki"
      ],
      "label": "maintenance dialysis",
      "why": "creatinine reflects the dialysis schedule, not kidney filtering"
    },
    "kidney_transplant": {
      "families": [
        "kidney",
        "aki"
      ],
      "label": "kidney transplant",
      "why": "staging and acute change in a transplanted kidney follow transplant-specific assessment"
    },
    "muscle_mass": {
      "families": [
        "kidney"
      ],
      "label": "extreme muscle mass (for example paralysis, severe wasting or very high muscle mass)",
      "why": "creatinine-based estimates are unreliable at extremes of muscle mass"
    },
    "pregnancy": {
      "families": [
        "kidney",
        "aki"
      ],
      "label": "pregnancy",
      "why": "the estimating equations and creatinine thresholds are not validated in pregnancy"
    }
  },
  "source": "structured condition rows only (problem list, procedure history, encounter flags); never the note text"
}

Boundary tests: 4/4 pass