Replay RUN-00024
Live recomputation (nothing written): identical hash
- Stored replay hash
71cfe343504388231e5c4c24a19ca7da6a7e8c77e029b97f1ea77ca8eec3394e- Recomputed replay hash
71cfe343504388231e5c4c24a19ca7da6a7e8c77e029b97f1ea77ca8eec3394e- Stored output sha256
44bba00b5c73e1f92d076130efc79e6f9ad1b81866a1281eb6b5270ade0ef5c1- Recomputed output sha256
44bba00b5c73e1f92d076130efc79e6f9ad1b81866a1281eb6b5270ade0ef5c1- Inputs intact
- yes
- Engine
- kidney-engine 2.0
- Trigger
- seed · Fri Nov 13, 2026 04:55 PM · audit entry #1633
| 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": [
{
"condition_id": "KC-P24-1",
"end_date": null,
"kind": "amputation",
"source": "procedure_history",
"start_date": "2018-08-25"
}
],
"encounter": {
"admit_dt": "2026-11-11T11:00:00-05:00",
"discharge_dt": "2026-11-11T11:40:00-05:00",
"encounter_id": "KE-P24",
"setting": "outpatient"
},
"labs": [
{
"collected_dt": "2026-04-25T09:00:00-04:00",
"lab_id": "L-0053",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 0.7
},
{
"collected_dt": "2026-11-11T09:00:00-05:00",
"lab_id": "L-0054",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 0.75
}
],
"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": "1955-11-17",
"patient_id": "P24",
"sex": "M"
},
"statements": []
}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": 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": "NOT_ASSESSABLE: nothing documented; limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering.",
"clinician_text": "Not assessable: limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering. Nothing to review until the data can decide.",
"direction": "NOT_ASSESSABLE",
"family": "kidney",
"robustness": "not assessable"
},
{
"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,
"ratio": null
},
"albuminuria": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"by_equation": {
"2009": {
"direction": "NOT_ASSESSABLE",
"direction_why": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"latest": null,
"met": false,
"persistence": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"reason": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"reason_code": "exclusion",
"route": null,
"stage": null,
"status": "not_assessable"
},
"2021": {
"direction": "NOT_ASSESSABLE",
"direction_why": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"latest": null,
"met": false,
"persistence": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"reason": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"reason_code": "exclusion",
"route": null,
"stage": null,
"status": "not_assessable"
}
},
"clinician_text": "Not assessable: limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering. Nothing to review until the data can decide.",
"criteria": [
{
"criterion_key": "no_exclusion_on_record",
"detail": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"inputs": {
"condition_ids": [
"KC-P24-1"
],
"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": false,
"rule_id": "kidney_exclusions"
},
{
"criterion_key": "persistence_egfr_lt60_ge90d_ckd_epi_2021",
"detail": "not assessable: limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"inputs": {
"dates": [],
"lab_ids": [],
"values": []
},
"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 assessable: limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"inputs": {
"dates": [],
"lab_ids": [],
"values": []
},
"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-0053, L-0054",
"inputs": {
"dates": [],
"lab_ids": [
"L-0053",
"L-0054"
],
"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"
}
],
"direction": "NOT_ASSESSABLE",
"direction_why": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"drift": false,
"egfr": [
{
"age": 70,
"collected_dt": "2026-04-25T09:00:00-04:00",
"date": "2026-04-25",
"egfr_2009": 95.6,
"egfr_2021": 99.1,
"excluded": "not used: limb amputation on record (the equation is not reliable)",
"g_2009": "G1",
"g_2021": "G1",
"lab_id": "L-0053",
"scr": 0.7
},
{
"age": 70,
"collected_dt": "2026-11-11T09:00:00-05:00",
"date": "2026-11-11",
"egfr_2009": 92.9,
"egfr_2021": 97.1,
"excluded": "not used: limb amputation on record (the equation is not reliable)",
"g_2009": "G1",
"g_2021": "G1",
"lab_id": "L-0054",
"scr": 0.75
}
],
"exclusions": [
{
"condition_id": "KC-P24-1",
"end_date": null,
"families": [
"kidney"
],
"kind": "amputation",
"label": "limb amputation",
"source": "procedure_history",
"start_date": "2018-08-25",
"why": "reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering"
}
],
"note_spans": 0,
"note_status": "silent",
"reason": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"robustness": "not assessable",
"stated_stage": null,
"statement": null,
"status": "not_assessable"
},
"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,
"ratio": null
},
"albuminuria": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"by_equation": {
"2009": {
"latest": null,
"met": false,
"persistence": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"reason": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"reason_code": "exclusion",
"route": null,
"stage": null,
"status": "not_assessable"
},
"2021": {
"latest": null,
"met": false,
"persistence": {
"days_apart": null,
"latest": null,
"met": false,
"pair": null,
"pair_values": null,
"persistent_value": null,
"reason": "no qualifying value"
},
"reason": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"reason_code": "exclusion",
"route": null,
"stage": null,
"status": "not_assessable"
}
},
"criteria": [
{
"criterion_key": "no_exclusion_on_record",
"detail": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"inputs": {
"condition_ids": [
"KC-P24-1"
],
"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": false,
"rule_id": "kidney_exclusions"
},
{
"criterion_key": "persistence_egfr_lt60_ge90d_ckd_epi_2021",
"detail": "not assessable: limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"inputs": {
"dates": [],
"lab_ids": [],
"values": []
},
"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 assessable: limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"inputs": {
"dates": [],
"lab_ids": [],
"values": []
},
"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-0053, L-0054",
"inputs": {
"dates": [],
"lab_ids": [
"L-0053",
"L-0054"
],
"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"
}
],
"drift": false,
"egfr": [
{
"age": 70,
"collected_dt": "2026-04-25T09:00:00-04:00",
"date": "2026-04-25",
"egfr_2009": 95.6,
"egfr_2021": 99.1,
"excluded": "not used: limb amputation on record (the equation is not reliable)",
"g_2009": "G1",
"g_2021": "G1",
"lab_id": "L-0053",
"scr": 0.7
},
{
"age": 70,
"collected_dt": "2026-11-11T09:00:00-05:00",
"date": "2026-11-11",
"egfr_2009": 92.9,
"egfr_2021": 97.1,
"excluded": "not used: limb amputation on record (the equation is not reliable)",
"g_2009": "G1",
"g_2021": "G1",
"lab_id": "L-0054",
"scr": 0.75
}
],
"exclusions": [
{
"condition_id": "KC-P24-1",
"end_date": null,
"families": [
"kidney"
],
"kind": "amputation",
"label": "limb amputation",
"source": "procedure_history",
"start_date": "2018-08-25",
"why": "reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering"
}
],
"reason": "limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering",
"robustness": "not assessable",
"status": "not_assessable",
"text": "Not assessable: limb amputation on record (procedure history, since 2018-08-25): reduced muscle mass lowers creatinine, so the equation overestimates kidney filtering."
},
"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": "9f48fd414f4e2cd27defd3802a15b628f9771bca3ac7a5f40438fdce4f812008",
"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"
}
}
}