How to Use This Tool
You do not need to fill in everything. Enter only the values that appear on your current lab result. The tool interprets each value against the correct guideline target for your situation, calculates derived values automatically, and generates a PDF you can bring to your doctor.
⚠ Context matters — always set it before interpreting. A potassium of 5.8 mEq/L is Watch for a non-dialysis patient but Flag for a pre-dialysis reading. An HbA1c of 6.4% is borderline for a general patient but Flag for a dialysis patient (hypoglycemia risk). The tool automatically adjusts all thresholds when you tick "On Hemodialysis" or "Very High ASCVD Risk."
What the Color Badges Mean
Every value you enter is assessed against the appropriate guideline target for your clinical context. The colored badge to the right of each field tells you where your result sits at a glance.
Within target range for your condition and clinical context. No immediate action needed — continue current management and monitoring schedule.
Borderline or outside target — not immediately dangerous but requires attention. Note the explanation text, bring it to your next scheduled consultation, and ask your doctor if a medication adjustment is needed.
Significantly out of range — requires prompt medical attention. Do not wait for your next scheduled visit. Contact your doctor or dialysis team.
| Example | Non-dialysis patient | Dialysis patient (pre-HD) |
|---|---|---|
| Potassium 5.8 mEq/L | Watch — high-normal, restrict dietary K | Flag — hyperkalemia pre-HD, cardiac risk |
| HbA1c 6.4% | Watch — pre-diabetes / near ADA target | Flag — too low, hypoglycemia risk in CKD |
| Hemoglobin 110 g/L | Watch — mild anemia, investigate | At Goal — within KDIGO HD target 100–115 |
| Ferritin 350 ng/mL | Watch — elevated, likely inflammatory | At Goal — within KDIGO dialysis target |
| LDL-C 65 mg/dL | At Goal — below 100 mg/dL | At Goal — below 70 mg/dL (very-high-risk <55) |
| iPTH 480 pg/mL | Flag — elevated, active CKD-MBD | At Goal — within KDIGO dialysis range 130–600 |
What Are the Derived Calculations?
Derived values are calculated from two or more of your entered results. They do not appear on a standard lab printout — but they give important clinical information that your doctor uses when making decisions about your care. The tool computes them automatically as you type, grouping them by clinical domain.
19 values calculated automatically
💡 Why is the Mentzer Index (MCV ÷ RBC) clinically important for Filipino patients?
Thalassemia trait is common in the Philippines and Southeast Asia, and it frequently coexists with anemia of CKD — both cause a low MCV. The Mentzer Index distinguishes them: a result below 13 favors thalassemia trait (the RBC count is relatively preserved despite low MCV); above 13 favors iron deficiency anemia. This matters because treating thalassemia trait with iron is unnecessary and can cause iron overload. The tool also incorporates RDW — an elevated RDW favors IDA over thalassemia even when Mentzer is low, which flags a possible mixed pattern.
📐 What is the TyG Index and why does it matter?
The TyG Index (ln[Triglycerides × Fasting Glucose ÷ 2]) is a validated surrogate for insulin resistance — strongly correlated with HOMA-IR but requiring only routine fasting lipid and glucose values, not fasting insulin. A TyG above 9.0 identifies significant insulin resistance and metabolic syndrome with good sensitivity. In CKD patients, insulin resistance is a major driver of cardiovascular risk and CKD progression, and it guides decisions about SGLT2 inhibitor or GLP-1 receptor agonist therapy (subject to eGFR thresholds).
🔄 Understanding the HD Adequacy panel
The HD Adequacy panel unlocks when ESKD on Hemodialysis is selected, or automatically when a dialysis lab PDF is uploaded (Hi-Precision and Singapore Diagnostics formats are supported). It tracks three key measures of dialysis quality:
URR (Urea Reduction Ratio) — the percentage of urea removed in a single session: (Pre-BUN − Post-BUN) ÷ Pre-BUN × 100. KDIGO target ≥65%. A value below 65% means inadequate clearance — the session duration, blood flow rate, or access may need review.
spKt/V (Single-Pool Kt/V) — the most precise measure of dialysis dose. The tool calculates this using the Daugirdas 2nd-generation formula when pre/post BUN, ultrafiltration volume, post-dry weight, and session time are available. Target ≥1.4 (≥1.2 minimum). When your lab reports Kt/V directly — for example Singapore Diagnostics uses the Lowrie formula — the tool reads the machine-reported value and labels which formula was used so you can compare it accurately. A Lowrie Kt/V ≥1.2 is the modern minimum, even though some labs still print ≥1.065 as their reference range.
nPCR (Normalized Protein Catabolic Rate) — an estimate of dietary protein intake derived from the pre-dialysis BUN. Target 1.0–1.4 g/kg/day. A value below 1.0 is a marker of protein-energy wasting (PEW), which is common in dialysis patients and associated with higher mortality. It should prompt a nutritional assessment and consideration of intradialytic parenteral nutrition (IDPN).
The Laboratory Interpreter
Enter your values below. All interpretation happens locally in your browser — your data is never sent to any server or stored anywhere.
Laboratory Interpreter
Reading Trends, Not Just Single Values
The most important skill in reading kidney and metabolic labs is trend recognition — a single value is only a snapshot. A creatinine of 2.0 mg/dL is very different depending on whether it was 1.8 three months ago (mild progression) or 1.2 (rapid decline). This tool is designed for a single time-point. For trend reading, bring at least the last three sets of results to every nephrology visit.
| Scenario | Single value today | 3 months ago | Clinical reading |
|---|---|---|---|
| CKD progression | eGFR 32 | eGFR 38 | Progression ~6 mL/min in 3 months — review RAAS blockade, BP, proteinuria |
| Stable CKD | eGFR 32 | eGFR 31 | Stable — reassuring; continue current management |
| AKI-on-CKD | Cr 2.8 | Cr 2.0 | Acute decline — rule out obstruction, nephrotoxins, hypovolemia; urgent review |
| Worsening anemia | Hgb 88 g/L | Hgb 104 g/L | 16 g/L drop — check iron, ESA dose, occult bleeding |
| Improving bone disease | iPTH 280 | iPTH 520 | Good response to active vitamin D / calcimimetic therapy |
📋 Tip: Use the PDF from this tool as your trend tracker. Download a report at each lab visit and keep them in order. After 3 visits you will have a visual color-coded timeline of every parameter — far more informative than isolated single printouts.
Using This at Your Consultation
The PDF report generated by this tool is designed to replace the raw printout of your lab results as the starting point of your consultation. Here is how to get the most out of it.
✅ Enter your values before you go — not in the waiting room. Give yourself 10 minutes at home to enter all the values from your lab result, check the derived tab, and then download the PDF.
✅ Bring the PDF and the original printout — the PDF shows interpretation and derived values; the original has reference ranges your doctor may want to verify.
✅ Circle or note any Flag results on the PDF before your appointment. This directs the conversation immediately to the most important findings.
✅ Ask specifically about Watch results — these are often the most actionable. A Watch potassium, a Watch phosphorus, or a Watch HbA1c can frequently be improved with a targeted change in diet, medication dose, or fluid restriction.
✅ Keep your old PDFs — three consecutive PDFs are worth more than any single report.
Important: This tool is for patient education and self-understanding. It does not replace a clinical consultation. All results must be interpreted in the context of your full clinical picture, history, examination, and your doctor's judgment. Never change or stop a medication based on this tool alone.
CKD-EPI 2021 Creatinine–Cystatin C eGFR Calculator
This calculator uses the 2021 race-free CKD-EPI creatinine–cystatin C equation (Inker et al., NEJM 2021). Combining two filtration markers makes it more accurate than creatinine alone — especially when creatinine may be misleading because of unusual muscle mass (very muscular athletes, the frail or elderly, amputees, or people with low muscle bulk). Enter your age, sex, serum creatinine, and cystatin C to estimate your kidney function and CKD stage.
⚕ Estimate only — interpret in full clinical context. Equation: Inker LA, Eneanya ND, Coresh J, et al. New Creatinine- and Cystatin C–Based Equations to Estimate GFR without Race. N Engl J Med 2021;385:1737–1749. eGFR requires ≥3 months of stability to define chronic CKD; a single value is not a diagnosis. Discuss results with your physician.
