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CPE-003 · synthetic case CKD-FX-019
Possible obstructive kidney process
Possible obstructive kidney process
Purpose: Detect reversible etiologic concern
Inputs the engine received
Patient
- Age
- 68 years
Context
- Sex for equation
- male
- Hydronephrosis
- present
- Urinary retention
- present
Laboratory
- eGFR selected
- 32 mL/min/1.73 m²
What the engine reports
A potentially reversible obstructive process: prompt clinician-directed imaging and urologic evaluation are required.
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 G3bA? (not a classification)
- Pattern: Possible obstructive uropathy
Clinical summary
Priority safety finding: possible obstructive uropathy. Physician adjudication required.
Why this pattern was identified
- Estimated GFR. 32 mL/min/1.73 m² (externally reported), category G3b (30–44).
Calculations
- eGFR (externally reported)
- 32 mL/min/1.73 m²
Patterns for physician adjudication
Evidence shown, not scored: pattern weights are not clinically validated.
Possible obstructive uropathy pattern
Supporting
- Reduced kidney function (eGFR 32)
- Hydronephrosis
- Urinary retention
Contradicting or missing
- Imaging and bladder assessment not yet reviewed by a physician
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Prompt clinician-directed imaging and urologic evaluation for possible obstruction.
- 2Specialist kidney-care referral per triggered criterion: Urgent safety pattern present.KDIGO 2024 referral criteria.
Missing information
- UACR (required for the A category, risk assessment and a complete classification).
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 · 4 rules
SAFE-OBS-001Possible obstructive uropathy
Inputs: eGFR 32 · hydronephrosis · urinary retention
urgent_red_flag: possible obstructive uropathy
DET-001Kidney abnormality detected
Inputs: eGFR 32 (<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
REF-001Nephrology referral triggers
Inputs: 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.
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)
32
externally reported
| GFR \ ALB | A1<30 | A230–300 | A3>300 |
|---|---|---|---|
| G1≥90 | |||
| G260–89 | |||
| G3a45–59 | |||
| G3b30–44 | |||
| G415–29 | |||
| G5<15 |
Indicative cell G3bA? 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
This case also carries values that have no field here: eGFR_selected. They are included in the calculation until you clear the form.
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Persistent moderately increased albuminuria with preserved GFR
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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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