Replay RUN-00045
Live recomputation (nothing written): identical hash
- Stored replay hash
efaafa4eb155c4362d527b1c78dcb18b05eab65fadbd5df68af47ad25acbd62c- Recomputed replay hash
efaafa4eb155c4362d527b1c78dcb18b05eab65fadbd5df68af47ad25acbd62c- Stored output sha256
a648449e33119e7cfc21999928980e1e72368be45075e37714a882a1ed8dc7cf- Recomputed output sha256
a648449e33119e7cfc21999928980e1e72368be45075e37714a882a1ed8dc7cf- Inputs intact
- yes
- Engine
- kidney-engine 2.0
- Trigger
- warm · Fri Nov 13, 2026 04:55 PM · audit entry #5415
| 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… | this tool's comparison rules (both directions) |
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": "2026-11-11T07:00:00-05:00",
"discharge_dt": null,
"encounter_id": "KE-P29",
"setting": "inpatient"
},
"labs": [
{
"collected_dt": "2026-04-25T09:00:00-04:00",
"lab_id": "L-0065",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.05
},
{
"collected_dt": "2026-08-08T09:00:00-04:00",
"lab_id": "L-0066",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.0
},
{
"collected_dt": "2026-11-11T08:00:00-05:00",
"lab_id": "L-0067",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.05
},
{
"collected_dt": "2026-11-12T06:00:00-05:00",
"lab_id": "L-0068",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.1
}
],
"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": "1953-11-16",
"patient_id": "P29",
"sex": "M"
},
"statements": []
}Stored output
{
"aki": {
"abs_rise": [],
"admission": {
"collected_dt": "2026-11-11T08:00:00-05:00",
"lab_id": "L-0067",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.05
},
"assessable": true,
"assessed": true,
"baselines": {
"back_calculated": {
"available": true,
"detail": "eGFR 75 at age 72, sex M",
"lab_ids": [],
"label": "Back-calculated from eGFR 75 (2021 equation, age and sex at admission)",
"value": 1.055
},
"last_outpatient": {
"available": true,
"lab_ids": [
"L-0066"
],
"label": "Most recent outpatient value 7-365 days before admission",
"value": 1.0
},
"lowest_365": {
"available": true,
"lab_ids": [
"L-0066"
],
"label": "Lowest value in the 365 days before admission",
"value": 1.0
},
"median_365": {
"available": true,
"lab_ids": [
"L-0065",
"L-0066"
],
"label": "Median of values in the 365 days before admission",
"value": 1.025
}
},
"clinician_text": "Creatinine 1.05 mg/dL at admission (lab row L-0067), peak 1.1 mg/dL (lab row L-0068). KDIGO creatinine criterion not met: criteria met under 0 of 4 baselines at admission; 0 of 4 at peak. Urine-output criterion not evaluated (no structured source). No acute change by these criteria; nothing documented. 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 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-0065",
"L-0066"
],
"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": "no such rise",
"inputs": {
"dates": [],
"lab_ids": [],
"values": []
},
"label": "Creatinine rise >= 0.3 mg/dL within 48 hours",
"passed": false,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_lowest_365",
"detail": "baseline 1.0 mg/dL; admission stage 0, peak stage 0",
"inputs": {
"dates": [],
"lab_ids": [
"L-0066",
"L-0067",
"L-0068"
],
"values": [
1.0,
1.05,
1.1
]
},
"label": "Creatinine >= 1.5x baseline (lowest value in the 365 days before admission)",
"passed": false,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_last_outpatient",
"detail": "baseline 1.0 mg/dL; admission stage 0, peak stage 0",
"inputs": {
"dates": [],
"lab_ids": [
"L-0066",
"L-0067",
"L-0068"
],
"values": [
1.0,
1.05,
1.1
]
},
"label": "Creatinine >= 1.5x baseline (most recent outpatient value 7-365 days before admission)",
"passed": false,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_median_365",
"detail": "baseline 1.025 mg/dL; admission stage 0, peak stage 0",
"inputs": {
"dates": [],
"lab_ids": [
"L-0065",
"L-0066",
"L-0067",
"L-0068"
],
"values": [
1.025,
1.05,
1.1
]
},
"label": "Creatinine >= 1.5x baseline (median of values in the 365 days before admission)",
"passed": false,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_back_calculated",
"detail": "baseline 1.055 mg/dL; admission stage 0, peak stage 0 (never used alone)",
"inputs": {
"dates": [],
"lab_ids": [
"L-0067",
"L-0068"
],
"values": [
1.055,
1.05,
1.1
]
},
"label": "Creatinine >= 1.5x baseline (back-calculated from egfr 75 (2021 equation, age and sex at admission))",
"passed": false,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "reverse_ge_1_5x_later_nadir",
"detail": "L-0067 1.05 mg/dL vs L-0068 1.1 mg/dL: 0.95x",
"inputs": {
"dates": [],
"lab_ids": [
"L-0067",
"L-0068"
],
"values": [
1.05,
1.1
]
},
"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": "NONE",
"episode_lab_ids": [],
"exclusions": [],
"k_admission": 0,
"k_peak": 0,
"n_baselines": 4,
"note_spans": 0,
"note_status": "silent",
"peak": {
"collected_dt": "2026-11-12T06:00:00-05:00",
"lab_id": "L-0068",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.1
},
"per_baseline": {
"back_calculated": {
"admission": {
"met": false,
"ratio": 1.0,
"stage": 0
},
"peak": {
"lab_id": "L-0068",
"met": false,
"ratio": 1.04,
"stage": 0
}
},
"last_outpatient": {
"admission": {
"met": false,
"ratio": 1.05,
"stage": 0
},
"peak": {
"lab_id": "L-0068",
"met": false,
"ratio": 1.1,
"stage": 0
}
},
"lowest_365": {
"admission": {
"met": false,
"ratio": 1.05,
"stage": 0
},
"peak": {
"lab_id": "L-0068",
"met": false,
"ratio": 1.1,
"stage": 0
}
},
"median_365": {
"admission": {
"met": false,
"ratio": 1.02,
"stage": 0
},
"peak": {
"lab_id": "L-0068",
"met": false,
"ratio": 1.07,
"stage": 0
}
}
},
"pre_admission_baseline": true,
"reason": "",
"reason_code": null,
"reverse": {
"days": 7,
"from": "L-0067",
"from_value": 1.05,
"met": false,
"ratio": 0.95,
"to": "L-0068",
"to_value": 1.1
},
"robustness": "criteria met under 0 of 4 baselines at admission; 0 of 4 at peak",
"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": "NONE: nothing documented; computed no persistent CKD (2021 equation); criteria met under 0 of 2 eGFR equations (2021 race-free, 2009).",
"clinician_text": "eGFR 71.3 on 2026-11-12 (lab row L-0068); eGFR 75.4 on 2026-11-11 (lab row L-0067); eGFR 80.0 on 2026-08-08 (lab row L-0066). KDIGO persistence: not met (two values of 60 or more 201 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": "NONE: nothing documented; N17.9 ladder applies only if the clinician documents it; criteria met under 0 of 4 baselines at admission; 0 of 4 at peak.",
"clinician_text": "Creatinine 1.05 mg/dL at admission (lab row L-0067), peak 1.1 mg/dL (lab row L-0068). KDIGO creatinine criterion not met: criteria met under 0 of 4 baselines at admission; 0 of 4 at peak. Urine-output criterion not evaluated (no structured source). No acute change by these criteria; nothing documented. Nothing to review.",
"direction": "NONE",
"family": "aki",
"robustness": "criteria met under 0 of 4 baselines at admission; 0 of 4 at peak"
}
],
"kidney": {
"acr": [],
"acute_change": {
"flag": false,
"latest": "L-0068",
"latest_value": 1.1,
"lookback_days": 365,
"lowest": "L-0066",
"lowest_value": 1.0,
"ratio": 1.1
},
"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": "2026-11-12",
"g": "G2",
"lab_id": "L-0068",
"value": 66.7
},
"met": false,
"normal_pair": [
"L-0065",
"L-0068"
],
"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 201 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": "2026-11-12",
"g": "G2",
"lab_id": "L-0068",
"value": 71.3
},
"met": false,
"normal_pair": [
"L-0065",
"L-0068"
],
"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 201 days apart, none below 60 after them",
"reason_code": "persistent_normal",
"route": null,
"stage": null,
"status": "not_met"
}
},
"clinician_text": "eGFR 71.3 on 2026-11-12 (lab row L-0068); eGFR 75.4 on 2026-11-11 (lab row L-0067); eGFR 80.0 on 2026-08-08 (lab row L-0066). KDIGO persistence: not met (two values of 60 or more 201 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 201 days apart, none below 60 after them",
"inputs": {
"dates": [
"2026-04-25",
"2026-08-08",
"2026-11-11",
"2026-11-12"
],
"lab_ids": [
"L-0065",
"L-0066",
"L-0067",
"L-0068"
],
"values": [
75.4,
80.0,
75.4,
71.3
]
},
"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 201 days apart, none below 60 after them",
"inputs": {
"dates": [
"2026-04-25",
"2026-08-08",
"2026-11-11",
"2026-11-12"
],
"lab_ids": [
"L-0065",
"L-0066",
"L-0067",
"L-0068"
],
"values": [
70.6,
74.9,
70.6,
66.7
]
},
"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": "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": "1.1 / 1.0 = 1.1x",
"inputs": {
"dates": [],
"lab_ids": [
"L-0066",
"L-0068"
],
"values": [
1.0,
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": 72,
"collected_dt": "2026-04-25T09:00:00-04:00",
"date": "2026-04-25",
"egfr_2009": 70.6,
"egfr_2021": 75.4,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0065",
"scr": 1.05
},
{
"age": 72,
"collected_dt": "2026-08-08T09:00:00-04:00",
"date": "2026-08-08",
"egfr_2009": 74.9,
"egfr_2021": 80.0,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0066",
"scr": 1.0
},
{
"age": 72,
"collected_dt": "2026-11-11T08:00:00-05:00",
"date": "2026-11-11",
"egfr_2009": 70.6,
"egfr_2021": 75.4,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0067",
"scr": 1.05
},
{
"age": 72,
"collected_dt": "2026-11-12T06:00:00-05:00",
"date": "2026-11-12",
"egfr_2009": 66.7,
"egfr_2021": 71.3,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0068",
"scr": 1.1
}
],
"exclusions": [],
"note_spans": 0,
"note_status": "silent",
"reason": "two values of 60 or more 201 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": [],
"admission": {
"collected_dt": "2026-11-11T08:00:00-05:00",
"lab_id": "L-0067",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.05
},
"assessable": true,
"assessed": true,
"baselines": {
"back_calculated": {
"available": true,
"detail": "eGFR 75 at age 72, sex M",
"lab_ids": [],
"label": "Back-calculated from eGFR 75 (2021 equation, age and sex at admission)",
"value": 1.055
},
"last_outpatient": {
"available": true,
"lab_ids": [
"L-0066"
],
"label": "Most recent outpatient value 7-365 days before admission",
"value": 1.0
},
"lowest_365": {
"available": true,
"lab_ids": [
"L-0066"
],
"label": "Lowest value in the 365 days before admission",
"value": 1.0
},
"median_365": {
"available": true,
"lab_ids": [
"L-0065",
"L-0066"
],
"label": "Median of values in the 365 days before admission",
"value": 1.025
}
},
"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-0065",
"L-0066"
],
"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": "no such rise",
"inputs": {
"dates": [],
"lab_ids": [],
"values": []
},
"label": "Creatinine rise >= 0.3 mg/dL within 48 hours",
"passed": false,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_lowest_365",
"detail": "baseline 1.0 mg/dL; admission stage 0, peak stage 0",
"inputs": {
"dates": [],
"lab_ids": [
"L-0066",
"L-0067",
"L-0068"
],
"values": [
1.0,
1.05,
1.1
]
},
"label": "Creatinine >= 1.5x baseline (lowest value in the 365 days before admission)",
"passed": false,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_last_outpatient",
"detail": "baseline 1.0 mg/dL; admission stage 0, peak stage 0",
"inputs": {
"dates": [],
"lab_ids": [
"L-0066",
"L-0067",
"L-0068"
],
"values": [
1.0,
1.05,
1.1
]
},
"label": "Creatinine >= 1.5x baseline (most recent outpatient value 7-365 days before admission)",
"passed": false,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_median_365",
"detail": "baseline 1.025 mg/dL; admission stage 0, peak stage 0",
"inputs": {
"dates": [],
"lab_ids": [
"L-0065",
"L-0066",
"L-0067",
"L-0068"
],
"values": [
1.025,
1.05,
1.1
]
},
"label": "Creatinine >= 1.5x baseline (median of values in the 365 days before admission)",
"passed": false,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "ratio_ge_1_5x_back_calculated",
"detail": "baseline 1.055 mg/dL; admission stage 0, peak stage 0 (never used alone)",
"inputs": {
"dates": [],
"lab_ids": [
"L-0067",
"L-0068"
],
"values": [
1.055,
1.05,
1.1
]
},
"label": "Creatinine >= 1.5x baseline (back-calculated from egfr 75 (2021 equation, age and sex at admission))",
"passed": false,
"rule_id": "kdigo_aki_2012"
},
{
"criterion_key": "reverse_ge_1_5x_later_nadir",
"detail": "L-0067 1.05 mg/dL vs L-0068 1.1 mg/dL: 0.95x",
"inputs": {
"dates": [],
"lab_ids": [
"L-0067",
"L-0068"
],
"values": [
1.05,
1.1
]
},
"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": [],
"exclusions": [],
"k_admission": 0,
"k_peak": 0,
"n_baselines": 4,
"peak": {
"collected_dt": "2026-11-12T06:00:00-05:00",
"lab_id": "L-0068",
"loinc": "2160-0",
"unit": "mg/dL",
"value": 1.1
},
"per_baseline": {
"back_calculated": {
"admission": {
"met": false,
"ratio": 1.0,
"stage": 0
},
"peak": {
"lab_id": "L-0068",
"met": false,
"ratio": 1.04,
"stage": 0
}
},
"last_outpatient": {
"admission": {
"met": false,
"ratio": 1.05,
"stage": 0
},
"peak": {
"lab_id": "L-0068",
"met": false,
"ratio": 1.1,
"stage": 0
}
},
"lowest_365": {
"admission": {
"met": false,
"ratio": 1.05,
"stage": 0
},
"peak": {
"lab_id": "L-0068",
"met": false,
"ratio": 1.1,
"stage": 0
}
},
"median_365": {
"admission": {
"met": false,
"ratio": 1.02,
"stage": 0
},
"peak": {
"lab_id": "L-0068",
"met": false,
"ratio": 1.07,
"stage": 0
}
}
},
"pre_admission_baseline": true,
"reason": "",
"reason_code": null,
"reverse": {
"days": 7,
"from": "L-0067",
"from_value": 1.05,
"met": false,
"ratio": 0.95,
"to": "L-0068",
"to_value": 1.1
},
"robustness": "criteria met under 0 of 4 baselines at admission; 0 of 4 at peak",
"text": "Creatinine 1.05 mg/dL at admission (lab row L-0067), peak 1.1 mg/dL (lab row L-0068). KDIGO creatinine criterion not met: criteria met under 0 of 4 baselines at admission; 0 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-0068",
"latest_value": 1.1,
"lookback_days": 365,
"lowest": "L-0066",
"lowest_value": 1.0,
"ratio": 1.1
},
"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": "G2",
"lab_id": "L-0068",
"value": 66.7
},
"met": false,
"normal_pair": [
"L-0065",
"L-0068"
],
"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 201 days apart, none below 60 after them",
"reason_code": "persistent_normal",
"route": null,
"stage": null,
"status": "not_met"
},
"2021": {
"latest": {
"confirmed": true,
"date": "2026-11-12",
"g": "G2",
"lab_id": "L-0068",
"value": 71.3
},
"met": false,
"normal_pair": [
"L-0065",
"L-0068"
],
"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 201 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 201 days apart, none below 60 after them",
"inputs": {
"dates": [
"2026-04-25",
"2026-08-08",
"2026-11-11",
"2026-11-12"
],
"lab_ids": [
"L-0065",
"L-0066",
"L-0067",
"L-0068"
],
"values": [
75.4,
80.0,
75.4,
71.3
]
},
"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 201 days apart, none below 60 after them",
"inputs": {
"dates": [
"2026-04-25",
"2026-08-08",
"2026-11-11",
"2026-11-12"
],
"lab_ids": [
"L-0065",
"L-0066",
"L-0067",
"L-0068"
],
"values": [
70.6,
74.9,
70.6,
66.7
]
},
"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": "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": "1.1 / 1.0 = 1.1x",
"inputs": {
"dates": [],
"lab_ids": [
"L-0066",
"L-0068"
],
"values": [
1.0,
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": 72,
"collected_dt": "2026-04-25T09:00:00-04:00",
"date": "2026-04-25",
"egfr_2009": 70.6,
"egfr_2021": 75.4,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0065",
"scr": 1.05
},
{
"age": 72,
"collected_dt": "2026-08-08T09:00:00-04:00",
"date": "2026-08-08",
"egfr_2009": 74.9,
"egfr_2021": 80.0,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0066",
"scr": 1.0
},
{
"age": 72,
"collected_dt": "2026-11-11T08:00:00-05:00",
"date": "2026-11-11",
"egfr_2009": 70.6,
"egfr_2021": 75.4,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0067",
"scr": 1.05
},
{
"age": 72,
"collected_dt": "2026-11-12T06:00:00-05:00",
"date": "2026-11-12",
"egfr_2009": 66.7,
"egfr_2021": 71.3,
"excluded": null,
"g_2009": "G2",
"g_2021": "G2",
"lab_id": "L-0068",
"scr": 1.1
}
],
"exclusions": [],
"reason": "two values of 60 or more 201 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 71.3 on 2026-11-12 (lab row L-0068); eGFR 75.4 on 2026-11-11 (lab row L-0067); eGFR 80.0 on 2026-08-08 (lab row L-0066). KDIGO persistence: not met (two values of 60 or more 201 days apart, none below 60 after them)."
},
"rules": {
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"ckd_epi_2021": {
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"version": "1.0"
},
"kdigo_aki_2012": {
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"version": "1.1"
},
"kdigo_ckd_2024": {
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"version": "1.1"
},
"kidney_exclusions": {
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"version": "1.0"
},
"lab_units": {
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"version": "1.1"
}
}
},
"measurement_sha256": "92d525b6eb8f130fb2b422bb490426a44e1f8bf896cfb3d1e6c8e7af598068d2",
"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": {
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"version": "1.0"
},
"lab_units": {
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"version": "1.1"
}
}
}