MedOrqis: Zero-Token Deterministic Medical AI Skills • Evidence-Grounded Decision Support
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Test real clinical scenarios, run deterministic mathematical engines, and inspect step-by-step mathematical derivations without token hallucination.

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Cardiology & Nephrology

Elderly Diabetic Patient with Atrial Fibrillation & CKD

72-year-old male presenting with palpitation and fatigue. Medical history includes hypertension, type 2 diabetes mellitus, and a remote TIA 3 years ago. Baseline serum creatinine is 1.4 mg/dL, weight 78 kg, height 175 cm.

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CKD-EPI 2021 eGFR (Race-Free Creatinine Equation)

2021
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INTERMEDIATE RISK NKF-ASN Task Force 2021 Recommendations for Reassessing the Inclusion of Race in Diagnosing Kidney Diseases (Inker LA et al. NEJM 2021) (2021)

CKD-EPI 2021 eGFR (Race-Free Creatinine Equation)

Applicable Population: Adults (>= 18 years), race-neutral

Calculated Score: 53.4 mL/min/1.73m²
Clinical Interpretation
G3a: Mild-to-moderately decreased (45 - 59 mL/min/1.73m²)
Guideline-Directed Recommendation
Stage 3a CKD. Evaluate albuminuria, adjust renally eliminated drugs, monitor twice yearly.
Clinical Alerts & Safety Warnings
  • Equation assumes steady-state serum creatinine. In acute kidney injury (AKI), eGFR may substantially overestimate actual GFR.
  • For drug dosing adjustments (FDA labels), also compute Cockcroft-Gault CrCl.

Deterministic Execution Trace

Zero-Token Arithmetic
Mathematical Formula \text{eGFR} = 142 \times \min\left(\frac{S_{cr}}{\kappa}, 1\right)^\alpha \times \max\left(\frac{S_{cr}}{\kappa}, 1\right)^{-1.200} \times 0.9938^{\text{Age}} \times [1.012 \text{ if female}]
Step-by-Step Formula Progression:
1 Gender coefficient: kappa = 0.9, alpha = -0.302, female factor = 1
2 min(Scr/kappa, 1)^alpha = (1)^-0.302 = 1
3 max(Scr/kappa, 1)^-1.200 = (1.5556)^-1.2 = 0.5885
4 Age decay: 0.9938^72 = 0.639
5 Calculated eGFR: 53.4 mL/min/1.73m²
Invariant Input Payload:
{
    "age_years": 72,
    "biological_sex": "MALE",
    "hx_heart_failure": false,
    "hx_hypertension": true,
    "hx_diabetes": true,
    "hx_stroke_tia_thromboembolism": true,
    "hx_vascular_disease": false,
    "serum_creatinine_mg_dl": 1.4,
    "weight_kg": 78,
    "height_cm": 175,
    "uncontrolled_hypertension_sbp_gt_160": false,
    "abnormal_renal_function": false,
    "abnormal_liver_function": false,
    "stroke_history": true,
    "prior_major_bleeding_or_predisposition": false,
    "labile_inr": false,
    "medications_antiplatelets_nsaids": false,
    "alcohol_excess": false
}
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