Replay RUN-00014
Live recomputation (nothing written): identical hash
- Stored replay hash
e85c2205b031110ba21c997553d043efc5123d40586c10b2442f77014b999bb6- Recomputed replay hash
e85c2205b031110ba21c997553d043efc5123d40586c10b2442f77014b999bb6- Stored output sha256
7fce9d7cad62790e838441b0aa607c379c1445bec8ea75f08861ba456abfd1ca- Recomputed output sha256
7fce9d7cad62790e838441b0aa607c379c1445bec8ea75f08861ba456abfd1ca- Inputs intact
- yes
- Engine
- kidney-engine 2.0
- Trigger
- seed · Fri Nov 13, 2026 04:55 PM · audit entry #1593
| 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": "2026-11-10T07:00:00-05:00",
"discharge_dt": null,
"encounter_id": "KE-P14",
"setting": "inpatient"
},
"labs": [
{
"collected_dt": "2026-01-14T09:00:00-05:00",
"lab_id": "L-0028",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 0.8
},
{
"collected_dt": "2026-07-13T09:00:00-04:00",
"lab_id": "L-0029",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.0
},
{
"collected_dt": "2026-10-11T09:00:00-04:00",
"lab_id": "L-0030",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.1
},
{
"collected_dt": "2026-11-10T08:00:00-05:00",
"lab_id": "L-0031",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.6
},
{
"collected_dt": "2026-11-11T06:00:00-05:00",
"lab_id": "L-0032",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 2.3
}
],
"note_reading": {
"aki": {
"faults": [],
"spans": [
{
"assertion": "affirmed",
"end": 190,
"kind": "acute",
"origin": "both",
"stage": null,
"start": 187
}
],
"status": "stated"
},
"kidney": {
"faults": [],
"spans": [],
"status": "silent"
},
"lexicon": "kidney-lexicon 1.0",
"model_status": "ok",
"reader": "lexicon+model"
},
"patient": {
"birth_date": "1957-11-15",
"patient_id": "P14",
"sex": "M"
},
"statements": [
{
"dx_id": "KD-KN-P14-1-S01",
"icd10": "N17.9",
"note_id": "KN-P14-1",
"quoted_text": "AKI",
"source": "note_extraction",
"span_end": 190,
"span_start": 187
}
]
}Stored output
{
"aki": {
"abs_rise": [
{
"from": "L-0031",
"hours": 22.0,
"rise": 0.7,
"to": "L-0032"
}
],
"admission": {
"collected_dt": "2026-11-10T08:00:00-05:00",
"lab_id": "L-0031",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.6
},
"assessable": true,
"assessed": true,
"baselines": {
"back_calculated": {
"available": true,
"detail": "eGFR 75 at age 68, sex M",
"lab_ids": [],
"label": "Back-calculated from eGFR 75 (2021 equation, age and sex at admission)",
"value": 1.077
},
"last_outpatient": {
"available": true,
"lab_ids": [
"L-0030"
],
"label": "Most recent outpatient value 7-365 days before admission",
"value": 1.1
},
"lowest_365": {
"available": true,
"lab_ids": [
"L-0028"
],
"label": "Lowest value in the 365 days before admission",
"value": 0.8
},
"median_365": {
"available": true,
"lab_ids": [
"L-0028",
"L-0029",
"L-0030"
],
"label": "Median of values in the 365 days before admission",
"value": 1.0
}
},
"clinician_text": "Creatinine 1.6 mg/dL at admission (lab row L-0031), peak 2.3 mg/dL (lab row L-0032). KDIGO creatinine criterion met: criteria met under 2 of 4 baselines at admission; 4 of 4 at peak. Urine-output criterion not evaluated (no structured source). Note: a statement about an acute kidney change is present (quoted below).",
"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 creatinine-change criteria unreliable (maintenance dialysis, kidney transplant, pregnancy)",
"passed": true,
"rule_id": "kidney_exclusions"
},
{
"criterion_key": "pre_admission_baseline_available",
"detail": "available",
"inputs": {
"dates": [],
"lab_ids": [
"L-0028",
"L-0029",
"L-0030"
],
"values": []
},
"label": "A creatinine value before admission is available (needed before a statement can be called not supported)",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "abs_rise_0_3_in_48h",
"detail": "L-0031 -> L-0032: +0.7 mg/dL in 22.0 h",
"inputs": {
"dates": [],
"lab_ids": [
"L-0031",
"L-0032"
],
"values": [
0.7
]
},
"label": "Creatinine rise >= 0.3 mg/dL within 48 hours",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_lowest_365",
"detail": "baseline 0.8 mg/dL; admission stage 2, peak stage 2",
"inputs": {
"dates": [],
"lab_ids": [
"L-0028",
"L-0031",
"L-0032"
],
"values": [
0.8,
1.6,
2.3
]
},
"label": "Creatinine >= 1.5x baseline (lowest value in the 365 days before admission)",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_last_outpatient",
"detail": "baseline 1.1 mg/dL; admission stage 0, peak stage 2",
"inputs": {
"dates": [],
"lab_ids": [
"L-0030",
"L-0031",
"L-0032"
],
"values": [
1.1,
1.6,
2.3
]
},
"label": "Creatinine >= 1.5x baseline (most recent outpatient value 7-365 days before admission)",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_median_365",
"detail": "baseline 1.0 mg/dL; admission stage 1, peak stage 2",
"inputs": {
"dates": [],
"lab_ids": [
"L-0028",
"L-0029",
"L-0030",
"L-0031",
"L-0032"
],
"values": [
1.0,
1.6,
2.3
]
},
"label": "Creatinine >= 1.5x baseline (median of values in the 365 days before admission)",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_back_calculated",
"detail": "baseline 1.077 mg/dL; admission stage 0, peak stage 2 (never used alone)",
"inputs": {
"dates": [],
"lab_ids": [
"L-0031",
"L-0032"
],
"values": [
1.077,
1.6,
2.3
]
},
"label": "Creatinine >= 1.5x baseline (back-calculated from egfr 75 (2021 equation, age and sex at admission))",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "reverse_ge_1_5x_later_nadir",
"detail": "L-0031 1.6 mg/dL vs L-0032 2.3 mg/dL: 0.7x",
"inputs": {
"dates": [],
"lab_ids": [
"L-0031",
"L-0032"
],
"values": [
1.6,
2.3
]
},
"label": "Reverse comparison: admission or peak creatinine >= 1.5x the lowest value in the following 7 days",
"passed": false,
"rule_id": "kdigo_aki_2012"
}
],
"direction": "CONSISTENT",
"episode_lab_ids": [
"L-0031",
"L-0032"
],
"exclusions": [],
"k_admission": 2,
"k_peak": 4,
"n_baselines": 4,
"note_spans": 1,
"note_status": "stated",
"peak": {
"collected_dt": "2026-11-11T06:00:00-05:00",
"lab_id": "L-0032",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 2.3
},
"per_baseline": {
"back_calculated": {
"admission": {
"met": false,
"ratio": 1.49,
"stage": 0
},
"peak": {
"lab_id": "L-0032",
"met": true,
"ratio": 2.14,
"stage": 2
}
},
"last_outpatient": {
"admission": {
"met": false,
"ratio": 1.45,
"stage": 0
},
"peak": {
"lab_id": "L-0032",
"met": true,
"ratio": 2.09,
"stage": 2
}
},
"lowest_365": {
"admission": {
"met": true,
"ratio": 2.0,
"stage": 2
},
"peak": {
"lab_id": "L-0032",
"met": true,
"ratio": 2.87,
"stage": 2
}
},
"median_365": {
"admission": {
"met": true,
"ratio": 1.6,
"stage": 1
},
"peak": {
"lab_id": "L-0032",
"met": true,
"ratio": 2.3,
"stage": 2
}
}
},
"pre_admission_baseline": true,
"reason": "",
"reason_code": null,
"reverse": {
"days": 7,
"from": "L-0031",
"from_value": 1.6,
"met": false,
"ratio": 0.7,
"to": "L-0032",
"to_value": 2.3
},
"robustness": "criteria met under 2 of 4 baselines at admission; 4 of 4 at peak",
"statement": {
"dx_id": "KD-KN-P14-1-S01",
"icd10": "N17.9",
"note_id": "KN-P14-1",
"quoted_text": "AKI",
"source": "note_extraction",
"span_end": 190,
"span_start": 187
}
},
"cdis": {
"computed_code": null,
"documented_code": null,
"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": false,
"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": "NONE: nothing documented; computed no persistent CKD (2021 equation); criteria met under 0 of 2 eGFR equations (2021 race-free, 2009).",
"clinician_text": "eGFR 73.1 on 2026-10-11 (lab row L-0030); eGFR 82.0 on 2026-07-13 (lab row L-0029); eGFR 96.4 on 2026-01-14 (lab row L-0028). KDIGO persistence: not met (two values of 60 or more 270 days apart, none below 60 after them). Note: no kidney-function statement found. Nothing to review.",
"direction": "NONE",
"family": "kidney",
"robustness": "criteria met under 0 of 2 eGFR equations (2021 race-free, 2009)"
},
{
"cdis_text": "CONSISTENT: documented N17.9; N17.9 ladder applies only if the clinician documents it; criteria met under 2 of 4 baselines at admission; 4 of 4 at peak.",
"clinician_text": "Creatinine 1.6 mg/dL at admission (lab row L-0031), peak 2.3 mg/dL (lab row L-0032). KDIGO creatinine criterion met: criteria met under 2 of 4 baselines at admission; 4 of 4 at peak. Urine-output criterion not evaluated (no structured source). Note: a statement about an acute kidney change is present (quoted below).",
"direction": "CONSISTENT",
"family": "aki",
"robustness": "criteria met under 2 of 4 baselines at admission; 4 of 4 at peak"
}
],
"kidney": {
"acr": [],
"acute_change": {
"flag": false,
"latest": "L-0030",
"latest_value": 1.1,
"lookback_days": 365,
"lowest": "L-0028",
"lowest_value": 0.8,
"ratio": 1.38
},
"albuminuria": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"by_equation": {
"2009": {
"direction": "NONE",
"direction_why": "",
"latest": {
"confirmed": true,
"date": "2026-10-11",
"g": "G2",
"lab_id": "L-0030",
"value": 68.6
},
"met": false,
"normal_pair": [
"L-0028",
"L-0030"
],
"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 270 days apart, none below 60 after them",
"reason_code": "persistent_normal",
"route": null,
"stage": null,
"status": "not_met"
},
"2021": {
"direction": "NONE",
"direction_why": "",
"latest": {
"confirmed": true,
"date": "2026-10-11",
"g": "G2",
"lab_id": "L-0030",
"value": 73.1
},
"met": false,
"normal_pair": [
"L-0028",
"L-0030"
],
"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 270 days apart, none below 60 after them",
"reason_code": "persistent_normal",
"route": null,
"stage": null,
"status": "not_met"
}
},
"clinician_text": "eGFR 73.1 on 2026-10-11 (lab row L-0030); eGFR 82.0 on 2026-07-13 (lab row L-0029); eGFR 96.4 on 2026-01-14 (lab row L-0028). KDIGO persistence: not met (two values of 60 or more 270 days apart, none below 60 after them). Note: no kidney-function statement found. Nothing to review.",
"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 270 days apart, none below 60 after them",
"inputs": {
"dates": [
"2026-01-14",
"2026-07-13",
"2026-10-11"
],
"lab_ids": [
"L-0028",
"L-0029",
"L-0030"
],
"values": [
96.4,
82.0,
73.1
]
},
"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": "not met: two values of 60 or more 270 days apart, none below 60 after them",
"inputs": {
"dates": [
"2026-01-14",
"2026-07-13",
"2026-10-11"
],
"lab_ids": [
"L-0028",
"L-0029",
"L-0030"
],
"values": [
91.8,
77.0,
68.6
]
},
"label": "Two eGFR < 60 at least 90 days apart, none >= 60 between (2009 eGFR equation)",
"passed": false,
"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": "excluded L-0031, L-0032",
"inputs": {
"dates": [],
"lab_ids": [
"L-0031",
"L-0032"
],
"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": "1.1 / 0.8 = 1.38x",
"inputs": {
"dates": [],
"lab_ids": [
"L-0028",
"L-0030"
],
"values": [
0.8,
1.1
]
},
"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": "NONE",
"direction_why": "",
"drift": false,
"egfr": [
{
"age": 68,
"collected_dt": "2026-01-14T09:00:00-05:00",
"date": "2026-01-14",
"egfr_2009": 91.8,
"egfr_2021": 96.4,
"excluded": null,
"g_2009": "G1",
"g_2021": "G1",
"lab_id": "L-0028",
"scr": 0.8
},
{
"age": 68,
"collected_dt": "2026-07-13T09:00:00-04:00",
"date": "2026-07-13",
"egfr_2009": 77.0,
"egfr_2021": 82.0,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0029",
"scr": 1.0
},
{
"age": 68,
"collected_dt": "2026-10-11T09:00:00-04:00",
"date": "2026-10-11",
"egfr_2009": 68.6,
"egfr_2021": 73.1,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0030",
"scr": 1.1
},
{
"age": 68,
"collected_dt": "2026-11-10T08:00:00-05:00",
"date": "2026-11-10",
"egfr_2009": 43.6,
"egfr_2021": 46.6,
"excluded": "collected during an admission in which the creatinine-change criteria are met (not steady state)",
"g_2009": "G3b",
"g_2021": "G3a",
"lab_id": "L-0031",
"scr": 1.6
},
{
"age": 68,
"collected_dt": "2026-11-11T06:00:00-05:00",
"date": "2026-11-11",
"egfr_2009": 28.1,
"egfr_2021": 30.2,
"excluded": "collected during an admission in which the creatinine-change criteria are met (not steady state)",
"g_2009": "G4",
"g_2021": "G3b",
"lab_id": "L-0032",
"scr": 2.3
}
],
"exclusions": [],
"note_spans": 0,
"note_status": "silent",
"reason": "two values of 60 or more 270 days apart, none below 60 after them",
"robustness": "criteria met under 0 of 2 eGFR equations (2021 race-free, 2009)",
"stated_stage": null,
"statement": null,
"status": "not_met"
},
"measurement": {
"aki": {
"abs_rise": [
{
"from": "L-0031",
"hours": 22.0,
"rise": 0.7,
"to": "L-0032"
}
],
"admission": {
"collected_dt": "2026-11-10T08:00:00-05:00",
"lab_id": "L-0031",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.6
},
"assessable": true,
"assessed": true,
"baselines": {
"back_calculated": {
"available": true,
"detail": "eGFR 75 at age 68, sex M",
"lab_ids": [],
"label": "Back-calculated from eGFR 75 (2021 equation, age and sex at admission)",
"value": 1.077
},
"last_outpatient": {
"available": true,
"lab_ids": [
"L-0030"
],
"label": "Most recent outpatient value 7-365 days before admission",
"value": 1.1
},
"lowest_365": {
"available": true,
"lab_ids": [
"L-0028"
],
"label": "Lowest value in the 365 days before admission",
"value": 0.8
},
"median_365": {
"available": true,
"lab_ids": [
"L-0028",
"L-0029",
"L-0030"
],
"label": "Median of values in the 365 days before admission",
"value": 1.0
}
},
"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 creatinine-change criteria unreliable (maintenance dialysis, kidney transplant, pregnancy)",
"passed": true,
"rule_id": "kidney_exclusions"
},
{
"criterion_key": "pre_admission_baseline_available",
"detail": "available",
"inputs": {
"dates": [],
"lab_ids": [
"L-0028",
"L-0029",
"L-0030"
],
"values": []
},
"label": "A creatinine value before admission is available (needed before a statement can be called not supported)",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "abs_rise_0_3_in_48h",
"detail": "L-0031 -> L-0032: +0.7 mg/dL in 22.0 h",
"inputs": {
"dates": [],
"lab_ids": [
"L-0031",
"L-0032"
],
"values": [
0.7
]
},
"label": "Creatinine rise >= 0.3 mg/dL within 48 hours",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_lowest_365",
"detail": "baseline 0.8 mg/dL; admission stage 2, peak stage 2",
"inputs": {
"dates": [],
"lab_ids": [
"L-0028",
"L-0031",
"L-0032"
],
"values": [
0.8,
1.6,
2.3
]
},
"label": "Creatinine >= 1.5x baseline (lowest value in the 365 days before admission)",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_last_outpatient",
"detail": "baseline 1.1 mg/dL; admission stage 0, peak stage 2",
"inputs": {
"dates": [],
"lab_ids": [
"L-0030",
"L-0031",
"L-0032"
],
"values": [
1.1,
1.6,
2.3
]
},
"label": "Creatinine >= 1.5x baseline (most recent outpatient value 7-365 days before admission)",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_median_365",
"detail": "baseline 1.0 mg/dL; admission stage 1, peak stage 2",
"inputs": {
"dates": [],
"lab_ids": [
"L-0028",
"L-0029",
"L-0030",
"L-0031",
"L-0032"
],
"values": [
1.0,
1.6,
2.3
]
},
"label": "Creatinine >= 1.5x baseline (median of values in the 365 days before admission)",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_back_calculated",
"detail": "baseline 1.077 mg/dL; admission stage 0, peak stage 2 (never used alone)",
"inputs": {
"dates": [],
"lab_ids": [
"L-0031",
"L-0032"
],
"values": [
1.077,
1.6,
2.3
]
},
"label": "Creatinine >= 1.5x baseline (back-calculated from egfr 75 (2021 equation, age and sex at admission))",
"passed": true,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "reverse_ge_1_5x_later_nadir",
"detail": "L-0031 1.6 mg/dL vs L-0032 2.3 mg/dL: 0.7x",
"inputs": {
"dates": [],
"lab_ids": [
"L-0031",
"L-0032"
],
"values": [
1.6,
2.3
]
},
"label": "Reverse comparison: admission or peak creatinine >= 1.5x the lowest value in the following 7 days",
"passed": false,
"rule_id": "kdigo_aki_2012"
}
],
"episode_lab_ids": [
"L-0031",
"L-0032"
],
"exclusions": [],
"k_admission": 2,
"k_peak": 4,
"n_baselines": 4,
"peak": {
"collected_dt": "2026-11-11T06:00:00-05:00",
"lab_id": "L-0032",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 2.3
},
"per_baseline": {
"back_calculated": {
"admission": {
"met": false,
"ratio": 1.49,
"stage": 0
},
"peak": {
"lab_id": "L-0032",
"met": true,
"ratio": 2.14,
"stage": 2
}
},
"last_outpatient": {
"admission": {
"met": false,
"ratio": 1.45,
"stage": 0
},
"peak": {
"lab_id": "L-0032",
"met": true,
"ratio": 2.09,
"stage": 2
}
},
"lowest_365": {
"admission": {
"met": true,
"ratio": 2.0,
"stage": 2
},
"peak": {
"lab_id": "L-0032",
"met": true,
"ratio": 2.87,
"stage": 2
}
},
"median_365": {
"admission": {
"met": true,
"ratio": 1.6,
"stage": 1
},
"peak": {
"lab_id": "L-0032",
"met": true,
"ratio": 2.3,
"stage": 2
}
}
},
"pre_admission_baseline": true,
"reason": "",
"reason_code": null,
"reverse": {
"days": 7,
"from": "L-0031",
"from_value": 1.6,
"met": false,
"ratio": 0.7,
"to": "L-0032",
"to_value": 2.3
},
"robustness": "criteria met under 2 of 4 baselines at admission; 4 of 4 at peak",
"text": "Creatinine 1.6 mg/dL at admission (lab row L-0031), peak 2.3 mg/dL (lab row L-0032). KDIGO creatinine criterion met: criteria met under 2 of 4 baselines at admission; 4 of 4 at peak. Urine-output criterion not evaluated (no structured source)."
},
"data_notes": [],
"engine": "kidney-engine 2.0",
"kidney": {
"acr": [],
"acute_change": {
"flag": false,
"latest": "L-0030",
"latest_value": 1.1,
"lookback_days": 365,
"lowest": "L-0028",
"lowest_value": 0.8,
"ratio": 1.38
},
"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": "2026-10-11",
"g": "G2",
"lab_id": "L-0030",
"value": 68.6
},
"met": false,
"normal_pair": [
"L-0028",
"L-0030"
],
"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 270 days apart, none below 60 after them",
"reason_code": "persistent_normal",
"route": null,
"stage": null,
"status": "not_met"
},
"2021": {
"latest": {
"confirmed": true,
"date": "2026-10-11",
"g": "G2",
"lab_id": "L-0030",
"value": 73.1
},
"met": false,
"normal_pair": [
"L-0028",
"L-0030"
],
"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 270 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 270 days apart, none below 60 after them",
"inputs": {
"dates": [
"2026-01-14",
"2026-07-13",
"2026-10-11"
],
"lab_ids": [
"L-0028",
"L-0029",
"L-0030"
],
"values": [
96.4,
82.0,
73.1
]
},
"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": "not met: two values of 60 or more 270 days apart, none below 60 after them",
"inputs": {
"dates": [
"2026-01-14",
"2026-07-13",
"2026-10-11"
],
"lab_ids": [
"L-0028",
"L-0029",
"L-0030"
],
"values": [
91.8,
77.0,
68.6
]
},
"label": "Two eGFR < 60 at least 90 days apart, none >= 60 between (2009 eGFR equation)",
"passed": false,
"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": "excluded L-0031, L-0032",
"inputs": {
"dates": [],
"lab_ids": [
"L-0031",
"L-0032"
],
"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": "1.1 / 0.8 = 1.38x",
"inputs": {
"dates": [],
"lab_ids": [
"L-0028",
"L-0030"
],
"values": [
0.8,
1.1
]
},
"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": false,
"egfr": [
{
"age": 68,
"collected_dt": "2026-01-14T09:00:00-05:00",
"date": "2026-01-14",
"egfr_2009": 91.8,
"egfr_2021": 96.4,
"excluded": null,
"g_2009": "G1",
"g_2021": "G1",
"lab_id": "L-0028",
"scr": 0.8
},
{
"age": 68,
"collected_dt": "2026-07-13T09:00:00-04:00",
"date": "2026-07-13",
"egfr_2009": 77.0,
"egfr_2021": 82.0,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0029",
"scr": 1.0
},
{
"age": 68,
"collected_dt": "2026-10-11T09:00:00-04:00",
"date": "2026-10-11",
"egfr_2009": 68.6,
"egfr_2021": 73.1,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0030",
"scr": 1.1
},
{
"age": 68,
"collected_dt": "2026-11-10T08:00:00-05:00",
"date": "2026-11-10",
"egfr_2009": 43.6,
"egfr_2021": 46.6,
"excluded": "collected during an admission in which the creatinine-change criteria are met (not steady state)",
"g_2009": "G3b",
"g_2021": "G3a",
"lab_id": "L-0031",
"scr": 1.6
},
{
"age": 68,
"collected_dt": "2026-11-11T06:00:00-05:00",
"date": "2026-11-11",
"egfr_2009": 28.1,
"egfr_2021": 30.2,
"excluded": "collected during an admission in which the creatinine-change criteria are met (not steady state)",
"g_2009": "G4",
"g_2021": "G3b",
"lab_id": "L-0032",
"scr": 2.3
}
],
"exclusions": [],
"reason": "two values of 60 or more 270 days apart, none below 60 after them",
"robustness": "criteria met under 0 of 2 eGFR equations (2021 race-free, 2009)",
"status": "not_met",
"text": "eGFR 73.1 on 2026-10-11 (lab row L-0030); eGFR 82.0 on 2026-07-13 (lab row L-0029); eGFR 96.4 on 2026-01-14 (lab row L-0028). KDIGO persistence: not met (two values of 60 or more 270 days apart, none below 60 after them)."
},
"rules": {
"ckd_epi_2009": {
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"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": {
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"version": "1.1"
}
}
},
"measurement_sha256": "44b411d9c1587a3709edcd23c159432b51ba7c87a43a053e4db7897388f61e36",
"note_reading": {
"aki": {
"faults": [],
"spans": [
{
"assertion": "affirmed",
"end": 190,
"kind": "acute",
"origin": "both",
"stage": null,
"start": 187
}
],
"status": "stated"
},
"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"
}
}
}