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CPE-003 · synthetic case CKD-FX-008
Active glomerular disease red flag
Active glomerular disease red flag
Purpose: Flag urgent glomerular pattern rather than benign CKD stage only
Inputs the engine received
Patient
- Age
- 39 years
Context
- Sex for equation
- male
- Persistent hematuria
- Yes
- RBC casts
- present
Laboratory
- Serum creatinine
- 2 mg/dL
- UACR
- 920 mg/g
What the engine reports
Urgent nephrology evaluation is indicated.
Detected clinical pattern
Urgent Red Flag — Priority Safety Review
A safety rule requires urgent clinician review. Safety findings precede any classification.
- Chronicity: Chronicity unconfirmed
- CGA: Indicative G3bA3 (not a classification)
- Pattern: Possible active glomerular disease
Clinical summary
Priority safety finding: active glomerular disease pattern. Physician adjudication required.
Why this pattern was identified
- Estimated GFR. 42.7 mL/min/1.73 m² (eGFRcr 2021, race-free), category G3b (30–44).
- Albuminuria. UACR 920 mg/g, category A3 (>300 mg/g).
Calculations
- eGFRcr (CKD-EPI 2021, race-free)
- 42.7 mL/min/1.73 m²
Creatinine-based.
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Urgent nephrology evaluation for a possible active glomerular process.
- 2Specialist kidney-care referral per triggered criterion: UACR >300 with hematuria; Urgent safety pattern present.KDIGO 2024 referral criteria.
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 · 6 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 2 mg/dL · age 39 · sex male
eGFRcr 2021 = 42.7 mL/min/1.73 m²
SAFE-GN-001Active glomerular disease red flag
Inputs: RBC casts present
urgent_red_flag: possible active glomerular disease
DET-001Kidney abnormality detected
Inputs: eGFR 42.7 (<60) · UACR 920 mg/g (≥30) · persistent hematuria
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
REF-001Nephrology referral triggers
Inputs: UACR >300 with hematuria · Urgent safety pattern present
Specialist kidney care referral indicated or to be considered per the triggered criterion
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)
42.7
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 G3bA3 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-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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