VYZR Care
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Predictive overview
latest obs 26m ago
Patient intelligence · showcase: renal-deterioration

D. Whitfield · 71M

Bed 11 · AKI · hospital day 3 · Dehydration after gastroenteritis; on ACE inhibitor and NSAID at home.

Context: Ramipril (held?) — not confirmed · Ibuprofen at home until admission

VYZR Care RPP Engineconnecting…
Urgent · Rapidly worsening

Creatinine 1.30 → 1.80 → 2.20 → 2.60 mg/dL over 45h (2.6× known baseline 1.00 mg/dL); urine output 56 → 29 → 27 → 25 mL/h over 40h; potassium 4.4 → 4.9 → 5.4 mmol/L over 45h. Rising creatinine with falling urine output is a concordant renal trajectory. If the current slope continues: Cr ≈ 2.86 (2.75–2.98 mg/dL) at 6h; UO ≈ 15 (9–21 mL/h) at 6h, crossing <20 mL/h in ~1h.

Preparing narrative…
01 · Recognized · last 3 d
Urgent · Rapidly worsening

Evolving renal injury

Creatinine 1.30 → 1.80 → 2.20 → 2.60 mg/dL over 45h (2.6× known baseline 1.00 mg/dL); urine output 56 → 29 → 27 → 25 mL/h over 40h; potassium 4.4 → 4.9 → 5.4 mmol/L over 45h. Rising creatinine with falling urine output is a concordant renal trajectory.

Pattern strength84/100 · higher evidence

Experimental explainable index, not a probability. 5 of 5 expected signals available 25 measurements across supporting signals

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NOW−72h+24h
Measured · 5 points · last 1h agoProjected · shaded = uncertainty band

2.60 mg/dL (+0.40 mg/dL since previous), above range, rising · +1.07 mg/dL/24h · 4 consecutive rises.

Creatinine

2.60 mg/dL · rising · +1.07 mg/dL/24h · 4 consecutive rises

Urine output

25 mL/h · stable

Potassium

5.4 mmol/L · rising · +0.6 mmol/L/24h · 2 consecutive rises

Urea

17.2 mmol/L · rising · +4.3 mmol/L/24h · 2 consecutive rises

02 · Predicted
6hhigher evidence confidence

If the current slope continues: Cr ≈ 2.86 (2.75–2.98 mg/dL) at 6h; UO ≈ 15 (9–21 mL/h) at 6h, crossing <20 mL/h in ~1h.

Next in line if this continues: Established oliguric AKI with fluid and potassium accumulation.

Higher evidence quality: several concordant, fresh, repeated measurements. Still a linear extrapolation, not a forecast of outcome.

Projections · 2 made · 0 withheld
Creatinineols-recent · fitted on 3 points · slope +0.04 mg/dL/h
+6h · Sep 25 21:39
2.86 (2.75–2.98)
+12h · Sep 26 03:39
3.09 (2.97–3.22)
+24h · Sep 26 15:39
3.55 (3.4–3.69)
Urine outputols-recent · fitted on 6 points · slope -1 mL/h/h
+6h · Sep 25 21:39
15 (9–21)
+12h · Sep 26 03:39
9 (2–15)
+24h · Sep 26 15:39
0 (0–4)

<20 mL/h in ~1h if the current slope continues (at Sep 25 16:39).

Alternative explanations
  • · Haemoconcentration or a recent high-protein / muscle-breakdown effect on creatinine.
  • · Under-recorded urine output (missed collections) rather than true oliguria.
  • · Expected creatinine rise after starting an ACE inhibitor / ARB (usually <30%).
04 · Consider now

Consider pre-renal hypoperfusion (falling output supports this, hypotension, dehydration, sepsis), nephrotoxic exposure, and obstruction.

The engine judges this pattern strong, fresh and fast enough to justify interrupting a clinician.

Decision support only · no order has been placed · engine rpp-0.4.0 · latest supporting value 1h ago

03 · Connected

What may be causing what

Mechanistic chain assembled from the recognised features. Each link is a hypothesis for bedside verification, not an established cause.

Falling urine outputreduced glomerular filtrationSolute retention (creatinine, urea, potassium)
Rising creatinineloss of nephron functionFluid overload, hyperkalaemia, acidosis

Evidence · 15 raw observations

Timestamps are real and irregular · click an observation to focus its trace above
04 · Prevention prompts

Consider, investigate, monitor, escalate

Clinician-support prompts derived from the pattern — not prescriptions. Status is persisted so the team sees what has been planned or judged not appropriate.

Consider causes

Consider pre-renal hypoperfusion (falling output supports this, hypotension, dehydration, sepsis), nephrotoxic exposure, and obstruction.

Missing information

Fluid balance, weight trend and bladder scan / catheter status are not in the structured record.

Investigate

Consider repeat renal profile with potassium and bicarbonate, urinalysis, and renal tract imaging if obstruction is possible.

Monitor

Consider hourly urine output measurement and repeat creatinine within 12–24 h.

Medication review

Review NSAIDs, ACE inhibitors/ARBs, aminoglycosides, contrast exposure and renally-cleared drug dosing.

Level of care

Consider renal/senior review if creatinine doubles from baseline, potassium rises, or urine output falls below 0.5 mL/kg/h for 6 h.

Changed since last review · 7 meaningful

Systolic blood pressure · 120 mmHg → 115 mmHg (−5 mmHg, 26 min ago)falling
Temperature · 36.6 °C → 37.0 °C (+0.4 °C, 26 min ago)rising
Urine output · 37 mL/h → 25 mL/h (−12 mL/h, 4h ago)falling
Potassium · 4.9 mmol/L → 5.4 mmol/L (+0.5 mmol/L, 1h ago)rising
Creatinine · 1.80 mg/dL → 2.60 mg/dL (+0.80 mg/dL, 1h ago)rising
Urea · 13.4 mmol/L → 17.2 mmol/L (+3.8 mmol/L, 1h ago)rising
Bicarbonate · 20 mmol/L → 18 mmol/L (−2 mmol/L, 1h ago)falling
Respiratory rate · 17 /min → 16 /min (−1 /min, 28 min ago)flat

Reassuring signals · 4

Respiratory rate · 16 /min — in range and steady.
Oxygen saturation · 97 % — in range and steady.
Systolic blood pressure · 115 mmHg — in range and steady.
Temperature · 37.0 °C — in range and steady.

Synthetic demonstration · engine output requires clinical correlation and is not a diagnosis