Replay RUN-00013
Live recomputation (nothing written): identical hash
- Stored replay hash
72c0007565e54f49a482b671052c3628b41ea9f2f605f94105ff413f52124064- Recomputed replay hash
72c0007565e54f49a482b671052c3628b41ea9f2f605f94105ff413f52124064- Stored output sha256
1054bf974ba6246195c570081a144a54e431583b8e5ac0461689e82b611b68ce- Recomputed output sha256
1054bf974ba6246195c570081a144a54e431583b8e5ac0461689e82b611b68ce- Inputs intact
- yes
- Engine
- kidney-engine 2.0
- Trigger
- seed · Fri Nov 13, 2026 04:55 PM · audit entry #1589
| Rule | Version | Body sha256 | Source |
|---|---|---|---|
ckd_epi_2009 | 1.0 | fee2ce2be035c1b6… | Levey et al., Ann Intern Med 2009;150:604-12 (2009 eGFR equation, drift check) |
ckd_epi_2021 | 1.0 | 2bc35edbf2f801a1… | Inker et al., N Engl J Med 2021;385:1737-49 (2021 race-free eGFR equation) |
kdigo_aki_2012 | 1.1 | 6927ab44b3d40429… | KDIGO 2012 guideline, Kidney Int Suppl 2012;2:1-138 (Rec 2.1.1-2.1.2, Table 2) |
kdigo_ckd_2024 | 1.1 | 1a5087a17cd1b339… | KDIGO 2024 guideline, Kidney Int 2024;105(4S):S117-S314 (G/A categories, >3 months) |
kidney_compare | 1.1 | 23fd394b4f02789e… | Two-sided comparison (this tool); ICD-10-CM guideline I.A.19; ACDIS/AHIMA compliant query practice, 2026 update |
kidney_exclusions | 1.0 | 98e08ca8b6f5a7f7… | KDIGO 2024 guideline, limitations of creatinine-based eGFR (muscle mass, pregnancy, kidney replacement); local list |
kidney_staff | 1.0 | fb90888ec6577619… | ICD-10-CM FY2026 guidelines I.A.15, I.C.9.a.2; CMS FY2026 Tables 6I/6J (staff view only) |
lab_units | 1.1 | a53d26a712b0777f… | KDIGO 2012 and 2024 guidelines, unit conversion (creatinine 1 mg/dL = 88.4 umol/L; ACR 1 mg/mmol = 8.84 mg/g) |
Replay history
- Not yet replayed.
Stored inputs (exactly what the rules read)
{
"conditions": [],
"encounter": {
"admit_dt": "2026-11-12T14:00:00-05:00",
"discharge_dt": "2026-11-12T14:40:00-05:00",
"encounter_id": "KE-P13",
"setting": "outpatient"
},
"labs": [
{
"collected_dt": "2026-07-15T09:00:00-04:00",
"lab_id": "L-0026",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.28
},
{
"collected_dt": "2026-11-12T13:00:00-05:00",
"lab_id": "L-0027",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.3
}
],
"note_reading": {
"aki": {
"faults": [],
"spans": [],
"status": "silent"
},
"kidney": {
"faults": [],
"spans": [],
"status": "silent"
},
"lexicon": "kidney-lexicon 1.0",
"model_status": "ok",
"reader": "lexicon+model"
},
"patient": {
"birth_date": "1960-11-17",
"patient_id": "P13",
"sex": "M"
},
"statements": [
{
"dx_id": "KD-P13-L1",
"icd10": "N18.31",
"note_id": null,
"quoted_text": "CKD stage 3a (from an outside lab report)",
"source": "encounter_list",
"span_end": null,
"span_start": null
}
]
}Stored output
{
"aki": {
"assessed": false,
"clinician_text": "Not assessed: outpatient visit: the creatinine-change check runs on inpatient encounters only.",
"criteria": [],
"direction": "NOT_ASSESSED",
"note_spans": 0,
"note_status": "silent",
"reason": "outpatient visit: the creatinine-change check runs on inpatient encounters only",
"statement": null
},
"cdis": {
"computed_code": null,
"documented_code": "N18.31",
"ladder": [
{
"code": "N18.9",
"computed": false,
"documented": false,
"label": "Chronic kidney disease, unspecified",
"level": "non-CC"
},
{
"code": "N18.30",
"computed": false,
"documented": false,
"label": "Chronic kidney disease, stage 3 unspecified",
"level": "non-CC"
},
{
"code": "N18.31",
"computed": false,
"documented": true,
"label": "Chronic kidney disease, stage 3a",
"level": "non-CC"
},
{
"code": "N18.32",
"computed": false,
"documented": false,
"label": "Chronic kidney disease, stage 3b",
"level": "non-CC"
},
{
"code": "N18.4",
"computed": false,
"documented": false,
"label": "Chronic kidney disease, stage 4 (severe)",
"level": "CC"
},
{
"code": "N18.5",
"computed": false,
"documented": false,
"label": "Chronic kidney disease, stage 5",
"level": "CC"
},
{
"code": "N18.6",
"computed": false,
"documented": false,
"label": "End stage renal disease",
"level": "MCC"
}
],
"linkage": []
},
"engine": "kidney-engine 2.0",
"findings": [
{
"cdis_text": "DEFINITIONS_DISAGREE: documented N18.31; computed no persistent CKD (2021 equation); criteria met under 1 of 2 eGFR equations (2021 race-free, 2009).",
"clinician_text": "eGFR 61.0 on 2026-11-12 (lab row L-0027); eGFR 62.1 on 2026-07-15 (lab row L-0026). KDIGO persistence: not met (two values of 60 or more 120 days apart, none below 60 after them). 2009 eGFR equation (drift check): persistence met, GFR category G3a. The two equations lead to different results; the tool does not choose.",
"direction": "DEFINITIONS_DISAGREE",
"family": "kidney",
"robustness": "criteria met under 1 of 2 eGFR equations (2021 race-free, 2009)"
},
{
"cdis_text": "NOT_ASSESSED: outpatient visit: the creatinine-change check runs on inpatient encounters only.",
"clinician_text": "Not assessed: outpatient visit: the creatinine-change check runs on inpatient encounters only.",
"direction": "NOT_ASSESSED",
"family": "aki",
"robustness": "outpatient visit: the creatinine-change check runs on inpatient encounters only"
}
],
"kidney": {
"acr": [],
"acute_change": {
"flag": false,
"latest": "L-0027",
"latest_value": 1.3,
"lookback_days": 365,
"lowest": "L-0026",
"lowest_value": 1.28,
"ratio": 1.02
},
"albuminuria": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"by_equation": {
"2009": {
"direction": "CONSISTENT",
"direction_why": "",
"latest": {
"confirmed": true,
"date": "2026-11-12",
"g": "G3a",
"lab_id": "L-0027",
"value": 57.3
},
"met": true,
"persistence": {
"days_apart": 120,
"latest": "L-0027",
"latest_value": 57.3,
"met": true,
"pair": [
"L-0026",
"L-0027"
],
"pair_dates": [
"2026-07-15",
"2026-11-12"
],
"pair_values": [
58.3,
57.3
],
"persistent_value": 58.3,
"reason": "met"
},
"reason": "two values below 60 at least 90 days apart, none of 60 or more between",
"reason_code": "met",
"route": "egfr",
"stage": "G3a",
"status": "met"
},
"2021": {
"direction": "UNSUPPORTED",
"direction_why": "",
"latest": {
"confirmed": true,
"date": "2026-11-12",
"g": "G2",
"lab_id": "L-0027",
"value": 61.0
},
"met": false,
"normal_pair": [
"L-0026",
"L-0027"
],
"persistence": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"reason": "two values of 60 or more 120 days apart, none below 60 after them",
"reason_code": "persistent_normal",
"route": null,
"stage": null,
"status": "not_met"
}
},
"clinician_text": "eGFR 61.0 on 2026-11-12 (lab row L-0027); eGFR 62.1 on 2026-07-15 (lab row L-0026). KDIGO persistence: not met (two values of 60 or more 120 days apart, none below 60 after them). 2009 eGFR equation (drift check): persistence met, GFR category G3a. The two equations lead to different results; the tool does not choose.",
"criteria": [
{
"criterion_key": "no_exclusion_on_record",
"detail": "none on record for this encounter date",
"inputs": {
"condition_ids": [],
"dates": [],
"lab_ids": [],
"values": []
},
"label": "No condition on record that makes the estimating equation unreliable (maintenance dialysis, kidney transplant, pregnancy, limb amputation or another extreme of muscle mass)",
"passed": true,
"rule_id": "kidney_exclusions"
},
{
"criterion_key": "persistence_egfr_lt60_ge90d_ckd_epi_2021",
"detail": "not met: two values of 60 or more 120 days apart, none below 60 after them",
"inputs": {
"dates": [
"2026-07-15",
"2026-11-12"
],
"lab_ids": [
"L-0026",
"L-0027"
],
"values": [
62.1,
61.0
]
},
"label": "Two eGFR < 60 at least 90 days apart, none >= 60 between (2021 eGFR equation)",
"passed": false,
"rule_id": "kdigo_ckd_2024"
},
{
"criterion_key": "persistence_egfr_lt60_ge90d_ckd_epi_2009",
"detail": "pair L-0026 (58.3, 2026-07-15) and L-0027 (57.3, 2026-11-12), 120 days apart; persistent category G3a (the range both values meet)",
"inputs": {
"dates": [
"2026-07-15",
"2026-11-12"
],
"lab_ids": [
"L-0026",
"L-0027"
],
"values": [
58.3,
57.3
]
},
"label": "Two eGFR < 60 at least 90 days apart, none >= 60 between (2009 eGFR equation)",
"passed": true,
"rule_id": "kdigo_ckd_2024"
},
{
"criterion_key": "albuminuria_a2_a3_persistent",
"detail": "no urine ACR on file",
"inputs": {
"dates": [],
"lab_ids": [],
"values": []
},
"label": "Urine ACR >= 30 mg/g on two values at least 90 days apart (needed only when eGFR >= 60)",
"passed": false,
"rule_id": "kdigo_ckd_2024"
},
{
"criterion_key": "steady_state_values",
"detail": "no values excluded",
"inputs": {
"dates": [],
"lab_ids": [],
"values": []
},
"label": "Values used are steady-state (local convention: values from an admission meeting the creatinine-change criteria are excluded)",
"passed": true,
"rule_id": "kdigo_ckd_2024"
},
{
"criterion_key": "latest_lt_1_5x_prior_lowest",
"detail": "1.3 / 1.28 = 1.02x",
"inputs": {
"dates": [],
"lab_ids": [
"L-0026",
"L-0027"
],
"values": [
1.28,
1.3
]
},
"label": "Latest creatinine below 1.5x the lowest value in the previous 365 days (otherwise: possible acute change; repeat needed)",
"passed": true,
"rule_id": "kdigo_ckd_2024"
}
],
"direction": "DEFINITIONS_DISAGREE",
"direction_why": "",
"drift": true,
"egfr": [
{
"age": 65,
"collected_dt": "2026-07-15T09:00:00-04:00",
"date": "2026-07-15",
"egfr_2009": 58.3,
"egfr_2021": 62.1,
"excluded": null,
"g_2009": "G3a",
"g_2021": "G2",
"lab_id": "L-0026",
"scr": 1.28
},
{
"age": 65,
"collected_dt": "2026-11-12T13:00:00-05:00",
"date": "2026-11-12",
"egfr_2009": 57.3,
"egfr_2021": 61.0,
"excluded": null,
"g_2009": "G3a",
"g_2021": "G2",
"lab_id": "L-0027",
"scr": 1.3
}
],
"exclusions": [],
"note_spans": 0,
"note_status": "silent",
"reason": "two values of 60 or more 120 days apart, none below 60 after them",
"robustness": "criteria met under 1 of 2 eGFR equations (2021 race-free, 2009)",
"stated_stage": "G3a",
"statement": {
"dx_id": "KD-P13-L1",
"icd10": "N18.31",
"note_id": null,
"quoted_text": "CKD stage 3a (from an outside lab report)",
"source": "encounter_list",
"span_end": null,
"span_start": null
},
"status": "not_met"
},
"measurement": {
"aki": {
"assessed": false,
"criteria": [],
"reason": "outpatient visit: the creatinine-change check runs on inpatient encounters only",
"text": "Not assessed: outpatient visit: the creatinine-change check runs on inpatient encounters only."
},
"data_notes": [],
"engine": "kidney-engine 2.0",
"kidney": {
"acr": [],
"acute_change": {
"flag": false,
"latest": "L-0027",
"latest_value": 1.3,
"lookback_days": 365,
"lowest": "L-0026",
"lowest_value": 1.28,
"ratio": 1.02
},
"albuminuria": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"by_equation": {
"2009": {
"latest": {
"confirmed": true,
"date": "2026-11-12",
"g": "G3a",
"lab_id": "L-0027",
"value": 57.3
},
"met": true,
"persistence": {
"days_apart": 120,
"latest": "L-0027",
"latest_value": 57.3,
"met": true,
"pair": [
"L-0026",
"L-0027"
],
"pair_dates": [
"2026-07-15",
"2026-11-12"
],
"pair_values": [
58.3,
57.3
],
"persistent_value": 58.3,
"reason": "met"
},
"reason": "two values below 60 at least 90 days apart, none of 60 or more between",
"reason_code": "met",
"route": "egfr",
"stage": "G3a",
"status": "met"
},
"2021": {
"latest": {
"confirmed": true,
"date": "2026-11-12",
"g": "G2",
"lab_id": "L-0027",
"value": 61.0
},
"met": false,
"normal_pair": [
"L-0026",
"L-0027"
],
"persistence": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"reason": "two values of 60 or more 120 days apart, none below 60 after them",
"reason_code": "persistent_normal",
"route": null,
"stage": null,
"status": "not_met"
}
},
"criteria": [
{
"criterion_key": "no_exclusion_on_record",
"detail": "none on record for this encounter date",
"inputs": {
"condition_ids": [],
"dates": [],
"lab_ids": [],
"values": []
},
"label": "No condition on record that makes the estimating equation unreliable (maintenance dialysis, kidney transplant, pregnancy, limb amputation or another extreme of muscle mass)",
"passed": true,
"rule_id": "kidney_exclusions"
},
{
"criterion_key": "persistence_egfr_lt60_ge90d_ckd_epi_2021",
"detail": "not met: two values of 60 or more 120 days apart, none below 60 after them",
"inputs": {
"dates": [
"2026-07-15",
"2026-11-12"
],
"lab_ids": [
"L-0026",
"L-0027"
],
"values": [
62.1,
61.0
]
},
"label": "Two eGFR < 60 at least 90 days apart, none >= 60 between (2021 eGFR equation)",
"passed": false,
"rule_id": "kdigo_ckd_2024"
},
{
"criterion_key": "persistence_egfr_lt60_ge90d_ckd_epi_2009",
"detail": "pair L-0026 (58.3, 2026-07-15) and L-0027 (57.3, 2026-11-12), 120 days apart; persistent category G3a (the range both values meet)",
"inputs": {
"dates": [
"2026-07-15",
"2026-11-12"
],
"lab_ids": [
"L-0026",
"L-0027"
],
"values": [
58.3,
57.3
]
},
"label": "Two eGFR < 60 at least 90 days apart, none >= 60 between (2009 eGFR equation)",
"passed": true,
"rule_id": "kdigo_ckd_2024"
},
{
"criterion_key": "albuminuria_a2_a3_persistent",
"detail": "no urine ACR on file",
"inputs": {
"dates": [],
"lab_ids": [],
"values": []
},
"label": "Urine ACR >= 30 mg/g on two values at least 90 days apart (needed only when eGFR >= 60)",
"passed": false,
"rule_id": "kdigo_ckd_2024"
},
{
"criterion_key": "steady_state_values",
"detail": "no values excluded",
"inputs": {
"dates": [],
"lab_ids": [],
"values": []
},
"label": "Values used are steady-state (local convention: values from an admission meeting the creatinine-change criteria are excluded)",
"passed": true,
"rule_id": "kdigo_ckd_2024"
},
{
"criterion_key": "latest_lt_1_5x_prior_lowest",
"detail": "1.3 / 1.28 = 1.02x",
"inputs": {
"dates": [],
"lab_ids": [
"L-0026",
"L-0027"
],
"values": [
1.28,
1.3
]
},
"label": "Latest creatinine below 1.5x the lowest value in the previous 365 days (otherwise: possible acute change; repeat needed)",
"passed": true,
"rule_id": "kdigo_ckd_2024"
}
],
"drift": true,
"egfr": [
{
"age": 65,
"collected_dt": "2026-07-15T09:00:00-04:00",
"date": "2026-07-15",
"egfr_2009": 58.3,
"egfr_2021": 62.1,
"excluded": null,
"g_2009": "G3a",
"g_2021": "G2",
"lab_id": "L-0026",
"scr": 1.28
},
{
"age": 65,
"collected_dt": "2026-11-12T13:00:00-05:00",
"date": "2026-11-12",
"egfr_2009": 57.3,
"egfr_2021": 61.0,
"excluded": null,
"g_2009": "G3a",
"g_2021": "G2",
"lab_id": "L-0027",
"scr": 1.3
}
],
"exclusions": [],
"reason": "two values of 60 or more 120 days apart, none below 60 after them",
"robustness": "criteria met under 1 of 2 eGFR equations (2021 race-free, 2009)",
"status": "not_met",
"text": "eGFR 61.0 on 2026-11-12 (lab row L-0027); eGFR 62.1 on 2026-07-15 (lab row L-0026). KDIGO persistence: not met (two values of 60 or more 120 days apart, none below 60 after them). 2009 eGFR equation (drift check): persistence met, GFR category G3a. The two equations lead to different results; the tool does not choose."
},
"rules": {
"ckd_epi_2009": {
"body_sha256": "fee2ce2be035c1b64d4404d5f2e9cfa8cdd37c98dac9d20c4148c9d2c45560d5",
"version": "1.0"
},
"ckd_epi_2021": {
"body_sha256": "2bc35edbf2f801a13194a537bb67b28d8c3b0175462b716b9f23c6c51f581517",
"version": "1.0"
},
"kdigo_aki_2012": {
"body_sha256": "6927ab44b3d4042994ba6f31a985cbae46ff27734c13546c8469110473baec49",
"version": "1.1"
},
"kdigo_ckd_2024": {
"body_sha256": "1a5087a17cd1b339f06da694dd8fcb92fe2f13fdbce57b886716763289bd95ad",
"version": "1.1"
},
"kidney_exclusions": {
"body_sha256": "98e08ca8b6f5a7f7a68b225b57239006b4664aa533200feaca96e84c0430217b",
"version": "1.0"
},
"lab_units": {
"body_sha256": "a53d26a712b0777f23b4b72dff9d65a8567ca57dadd924bc1ecf0cebc9ac2b18",
"version": "1.1"
}
}
},
"measurement_sha256": "e1e37d584b744daa0eee049127b1896d1835cee7afe9d675aee8ab9eed98ff53",
"note_reading": {
"aki": {
"faults": [],
"spans": [],
"status": "silent"
},
"kidney": {
"faults": [],
"spans": [],
"status": "silent"
},
"lexicon": "kidney-lexicon 1.0",
"model_status": "ok",
"reader": "lexicon+model"
},
"rules": {
"ckd_epi_2009": {
"body_sha256": "fee2ce2be035c1b64d4404d5f2e9cfa8cdd37c98dac9d20c4148c9d2c45560d5",
"version": "1.0"
},
"ckd_epi_2021": {
"body_sha256": "2bc35edbf2f801a13194a537bb67b28d8c3b0175462b716b9f23c6c51f581517",
"version": "1.0"
},
"kdigo_aki_2012": {
"body_sha256": "6927ab44b3d4042994ba6f31a985cbae46ff27734c13546c8469110473baec49",
"version": "1.1"
},
"kdigo_ckd_2024": {
"body_sha256": "1a5087a17cd1b339f06da694dd8fcb92fe2f13fdbce57b886716763289bd95ad",
"version": "1.1"
},
"kidney_compare": {
"body_sha256": "23fd394b4f02789eec020368dcfc30acab0cb62e411c3f4651d2bc778e3ee6cf",
"version": "1.1"
},
"kidney_exclusions": {
"body_sha256": "98e08ca8b6f5a7f7a68b225b57239006b4664aa533200feaca96e84c0430217b",
"version": "1.0"
},
"kidney_staff": {
"body_sha256": "fb90888ec65776194e9b5fd58c973b451f4072b64dc12409453c6cd4a8042281",
"version": "1.0"
},
"lab_units": {
"body_sha256": "a53d26a712b0777f23b4b72dff9d65a8567ca57dadd924bc1ecf0cebc9ac2b18",
"version": "1.1"
}
}
}