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CPE-003 · synthetic case CKD-FX-003
Single reduced eGFR without chronicity
Single reduced eGFR without chronicity
Purpose: Prevent false-positive CKD confirmation
Inputs the engine received
Patient
- Age
- 67 years
Context
- Sex for equation
- female
Laboratory
- Serum creatinine series
- 1.13 mg/dL (2026-05-20)
- UACR
- 10 mg/g
What the engine reports
Detected clinical pattern
Kidney Abnormality Detected — CKD Not Confirmed
A single abnormal result does not establish CKD. Persistence over at least three months and exclusion of acute or transient causes are needed.
- Chronicity: Chronicity unconfirmed
- CGA: Indicative G3aA1 (not a classification)
Clinical summary
A kidney abnormality was detected (eGFR 53.3 and UACR 10 mg/g), but chronicity is not established; CKD is not confirmed. Priority: confirm persistence and exclude acute or transient causes.
Why this pattern was identified
- Estimated GFR. 53.3 mL/min/1.73 m² (eGFRcr 2021, race-free), category G3a (45–59).
- Albuminuria. UACR 10 mg/g, category A1 (<30 mg/g).
Calculations
- eGFRcr (CKD-EPI 2021, race-free)
- 53.3 mL/min/1.73 m²
Creatinine-based.
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Confirm persistence (repeat testing at ≥3 months) and evaluate acute or transient causes before labeling CKD.A single abnormal eGFR or UACR does not establish CKD.
- 2Consider cystatin C (eGFRcr-cys) before final isolated G3a classification, where available and clinically relevant.eGFRcr is the least reliable near the G2/G3a boundary without albuminuria.
Why it matters
Isolated abnormal eGFR or UACR values are common and often transient. Labeling CKD early can misclassify patients, while missing persistent disease delays care. Confirmation at three months balances both.
Evidence and rule trace · 5 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 1.13 mg/dL · age 67 · sex female
eGFRcr 2021 = 53.3 mL/min/1.73 m²
DET-001Kidney abnormality detected
Inputs: eGFR 53.3 (<60)
kidney_abnormality_detected: determine chronicity and evaluate acute causes before confirming CKD
CHR-003Single abnormal result does not confirm CKD
Inputs: abnormality without dated evidence of ≥3 months
kidney_abnormality_unconfirmed: CKD is not confirmed
GFR-003Suggest cystatin C / combined eGFR for isolated possible G3a
Inputs: eGFRcr 53.3 · UACR 10 mg/g · no other damage marker · cystatin C missing
Consider cystatin C for eGFRcr-cys confirmation before final isolated G3a classification
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)
53.3
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 |
Indicative cell G3aA1 only: CKD is not confirmed, so this is not a classification. 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-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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