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CPE-003 · synthetic case CKD-FX-001
Persistent moderately increased albuminuria with preserved GFR
Persistent moderately increased albuminuria with preserved GFR
Purpose: Detect confirmed early CKD without reduced eGFR
Inputs the engine received
Patient
- Age
- 48 years
Context
- Sex for equation
- female
Laboratory
- Serum creatinine
- 0.78 mg/dL
- UACR series
- 76 mg/g (2025-12-01, first morning void) → 89 mg/g (2026-04-01, first morning void)
What the engine reports
Detected clinical pattern
Criteria for CKD Met — Classified
Chronicity is documented and the result is classified CKD G1A2. This is criteria-based status, not a probability.
- Chronicity: Chronicity confirmed (≥3 months)
- CGA: CKD G1A2
Clinical summary
CKD G1A2: criteria met on documented chronicity (eGFR 93.6 and UACR 89 mg/g). Priority: complete risk stratification, review etiology and kidney-protective management.
Why this pattern was identified
- Estimated GFR. 93.6 mL/min/1.73 m² (eGFRcr 2021, race-free), category G1 (≥90).
- Albuminuria. UACR 89 mg/g, category A2 (30–300 mg/g).
- Persistence. Abnormal results are dated at least three months apart.
- CKD criteria met. CKD G1A2 on documented chronicity. Criteria-based status, not a probability.
Calculations
- eGFRcr (CKD-EPI 2021, race-free)
- 93.6 mL/min/1.73 m²
Creatinine-based.
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Confirm complete risk stratification (CGA) and review etiology, blood pressure and kidney-protective management.
- 2Monitor eGFR and UACR longitudinally at an interval set by the CGA risk category.
Missing information
- Cystatin C (optional; improves GFR accuracy near decision thresholds).
- Urine sediment / microscopy (supports etiologic adjudication).
Why it matters
CKD with albuminuria and reduced GFR is associated with higher risks of kidney progression and cardiovascular disease, and the CGA category sets monitoring intensity.
Abnormal results are present on dated measurements separated by at least three months, supporting chronicity.
Evidence and rule trace · 8 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 0.78 mg/dL · age 48 · sex female
eGFRcr 2021 = 93.6 mL/min/1.73 m²
DET-001Kidney abnormality detected
Inputs: UACR 89 mg/g (≥30)
kidney_abnormality_detected: determine chronicity and evaluate acute causes before confirming CKD
CHR-001CKD chronicity confirmed through longitudinal evidence
Inputs: UACR ≥30 on 2 dated results spanning 121 days
chronicity_status: confirmed
CGA-001Assign G category from selected indexed eGFR
Inputs: eGFR 93.6 (eGFRcr_2021)
G1 (≥90 mL/min/1.73 m²)
KFRE-002KFRE not used in G1–G2 as release decision tool
Inputs: G1
not_eligible_for_primary_KFRE_output
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)
93.6
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 |
Classified: CKD G1A2. 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-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
CKD-FX-007
Confirmed CKD G3bA3 with diabetes
Confirmed CKD G3bA3 with diabetes
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