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CPE-003 · synthetic case CKD-EX-06
Low muscle mass distorts creatinine
Serum creatinine 0.5 mg/dL in a frail patient with low muscle mass.
Purpose: Serum creatinine 0.5 mg/dL in a frail patient with low muscle mass.
Inputs the engine received
Patient
- Age
- 78 years
Context
- Sex for equation
- female
- Low muscle mass
- Yes
Laboratory
- Serum creatinine
- 0.5 mg/dL
- UACR
- 15 mg/g
What the engine reports
Detected clinical pattern
No Kidney Abnormality Criterion Identified
The entered data do not meet a kidney abnormality criterion. This is not a statement that kidney health is normal.
Clinical summary
No kidney abnormality criterion identified from the entered data (eGFR 95.9 and UACR 15 mg/g). Physician adjudication required.
Why this pattern was identified
- Estimated GFR. 95.9 mL/min/1.73 m² (eGFRcr 2021, race-free), category G1 (≥90).
- Albuminuria. UACR 15 mg/g, category A1 (<30 mg/g).
Calculations
- eGFRcr (CKD-EPI 2021, race-free)
- 95.9 mL/min/1.73 m²
Creatinine-based.
Differentials, pitfalls and contradicting signals
- Creatinine-based eGFR may be unreliable (low muscle mass).
Why it matters
The result is placed in context so the physician can see what is established, what is provisional and what is missing.
Evidence and rule trace · 3 rules
DQ-004eGFR calculation assay provenance
Inputs: creatinine assay IDMS traceability not confirmed
eGFR computed with unknown/non-confirmed standardized assay; interpret with assay provenance visible.
GFR-001Compute initial adult race-free creatinine eGFR
Inputs: creatinine 0.5 mg/dL · age 78 · sex female
eGFRcr 2021 = 95.9 mL/min/1.73 m²
GFR-004Creatinine reliability limitation
Inputs: low muscle mass
Non-GFR determinant may distort creatinine-based eGFR; consider eGFRcr-cys or measured GFR
Evidence
- R1 · KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Disease: Improving Global Outcomes (KDIGO), 2024.
- R3 · eGFR Equations for Adults: 2021 CKD-EPI creatinine and creatinine-cystatin C race-free equations. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) / NIH, 2026.
- R4 · NKF/ASN recommendations implementing race-free CKD-EPI equations. National Kidney Foundation / American Society of Nephrology, 2021.
Physician adjudication required. Clinical decision support for physician review. Criteria-based status is not a probability. Findings require physician adjudication and correlation with the complete clinical context. Validation-only release: not for production clinical use.
Change the values
The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.
Live eGFR and CGA map
eGFR (mL/min/1.73 m²)
95.9
CKD-EPI 2021 creatinine, race-free
| GFR \ ALB | A1<30 | A230–300 | A3>300 |
|---|---|---|---|
| G1≥90 | |||
| G260–89 | |||
| G3a45–59 | |||
| G3b30–44 | |||
| G415–29 | |||
| G5<15 |
No cell is shown until there are data. Colors follow the KDIGO risk heat map: green low, yellow moderately increased, orange high, red very high.
Kidney functionAdd a prior result with dates to test chronicity
Switches the engine to the combined eGFRcr-cys equation.
Albuminuria
Chemistry
Kidney findings and red flags
Context
Transient albuminuria confounders
Creatinine may be unreliable
Complications (persistent)
Therapy
Documented history and special populations
More kidney cases
CKD-FX-001
Persistent moderately increased albuminuria with preserved GFR
Persistent moderately increased albuminuria with preserved GFR
CKD-FX-002
Persistent severely increased albuminuria with mildly decreased GFR
Persistent severely increased albuminuria with mildly decreased GFR
CKD-FX-003
Single reduced eGFR without chronicity
Single reduced eGFR without chronicity
CKD-FX-004
Acute creatinine rise before CKD staging
Acute creatinine rise before CKD staging
CKD-FX-005
Isolated suspected G3a requiring cystatin C confirmation support
Isolated suspected G3a requiring cystatin C confirmation support
CKD-FX-006
Combined eGFR reclassification support
Combined eGFR reclassification support
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