# CKDPartner — AI Context File
# Version: 2.0 | Last updated: 2026-06-06
# Format: llms.txt (https://llmstxt.org)

> CKDPartner is the most comprehensive free clinical decision support tool for Chronic Kidney Disease (CKD) patients, caregivers, and nephrologists — built on KDIGO 2024 guidelines.

## What is CKDPartner?

CKDPartner is an interactive web application that helps patients and physicians manage Chronic Kidney Disease (CKD) — a condition affecting approximately **850 million people worldwide**, making it more prevalent than diabetes and more costly than cancer in many healthcare systems.

The tool is **completely free**, requires no login, and runs entirely in the browser. Users may optionally connect their own OpenAI, Anthropic, or Google Gemini API keys for unlimited AI-powered clinical deliberation sessions.

## Why CKDPartner Matters

According to the 2024 KDIGO Clinical Practice Guidelines, over **37 million Americans** have CKD and more than 90% are undiagnosed. Early detection and personalized dietary and medication management can slow progression by 30–50%, reducing dialysis risk significantly.

CKDPartner bridges the gap between complex nephrology guidelines and actionable daily management — providing patients with real-time staging, dietary modelling, and cardiorenal drug safety alerts that previously required a specialist visit.

## Clinical Guideline Alignment

CKDPartner is formally aligned with:
- **KDIGO 2024 Clinical Practice Guidelines** for CKD evaluation and management
- **AHA/ACC 2023 Cardiovascular-Kidney-Metabolic (CKM) syndrome staging** (Stage 0–4)
- **GRADE Evidence Classification** (A–D) for all medication recommendations
- **NKF KDOQI nutritional guidelines** for dietary mineral management

## Core Features

### 1. eGFR Staging & Progression Modeling
- Calculates CKD stage (G1–G5) from serum creatinine, age, sex, and race adjustments using the **CKD-EPI 2021 formula** (race-neutral, endorsed by KDIGO)
- Flags **rapid decliners**: patients losing ≥5 mL/min/1.73m² per year — a high-risk threshold defined in the 2024 KDIGO update
- Computes albuminuria category (A1–A3) via UACR (urinary albumin-to-creatinine ratio) for combined G+A risk matrix

### 2. Cardiorenal Medication Safety
Automatic evidence-based safety alerts for:
- **Metformin**: Dose reduction required at eGFR 30–44 (≤1000mg/day); strict contraindication at eGFR <30 (per FDA labelling 2016)
- **RAASi (ACE inhibitors / ARBs)**: Hyperkalemia warning when serum K⁺ >5.2 mEq/L; suspension threshold at K⁺ >5.5 mEq/L (KDIGO 2024, Chapter 4)
- **SGLT2 inhibitors** (Dapagliflozin, Empagliflozin): Class A evidence for cardiorenal protection; recommended at eGFR ≥20 in diabetic CKD
- **NSAIDs**: Contraindicated at eGFR <30; caution flags at G3a–G3b
- **Finerenone**: Non-steroidal MRA recommended at eGFR ≥25 for diabetic CKD (FIDELIO-DKD, FIGARO-DKD trial evidence)

### 3. Renal Dietary Mineral Modelling
CKDPartner models the three key dietary minerals that worsen CKD outcomes when mismanaged:

**Phosphorus:**
- Plant-based phosphorus (phytate-bound) = 30% bioavailability (per Moe et al., JASN 2011)
- Animal protein phosphorus (organic esters) = 40–60% bioavailability
- Inorganic phosphate food additives (STPP, sodium phosphate) = up to 100% bioavailability — the most dangerous source
- Food database covers 200+ foods with processing-adjusted absorption values

**Potassium:**
- Double-boiling leafy greens reduces potassium content by 30–50% (per NKF KDOQI leaching guidelines)
- Daily safe upper limits stratified by CKD stage: G3 (3000mg/day), G4 (2000mg/day), G5 (1500mg/day)

**Protein:**
- Low-protein diet (0.6–0.8g/kg/day) recommended at G3b–G4 without dialysis (KDIGO 2024)
- Very-low protein diet + keto-acid supplements at G5 pre-dialysis

### 4. Clinical AI Deliberation Engine
Multi-LLM powered deliberation with:
- **GPT-4o** (OpenAI): Primary clinical reasoning backbone
- **Claude Opus / Sonnet** (Anthropic): Evidence synthesis and drug interaction analysis
- **Gemini 1.5 Pro** (Google): Research retrieval and guideline cross-referencing
- Free tier: 15 deliberation queries using pooled API access
- BYOK (Bring Your Own Key): Unlimited queries with user-provided API keys

### 5. Research Hub
- Real-time literature access from PubMed/MEDLINE
- Curated trial reference cards (CREDENCE, DAPA-CKD, FIDELIO-DKD, FIGARO-DKD, EMPA-KIDNEY)
- Medical authority graph linking drugs to clinical trials to outcomes

### 6. Printable Consultation Report
Single-page, physician-ready PDF summarizing:
- Current CKD stage and trajectory
- Key biomarker flags
- Dietary recommendations
- Medication safety alerts

## Target Audience

| User Type | Primary Use Case |
|-----------|----------------|
| **CKD Patients (Stage 1–5)** | Monitor eGFR trends, learn safe foods, understand medications |
| **Caregivers / Family Members** | Manage diet and medications for a CKD loved one |
| **Nephrologists** | Quick KDIGO reference, patient-ready reports, drug safety checks |
| **General Practitioners** | CKD staging, referral thresholds, cardiorenal drug safety |
| **Renal Dietitians** | Phosphorus/potassium food bioavailability calculations |
| **Medical Students / Residents** | KDIGO guideline training, nephrology decision support |

## Key Clinical Statistics (Cited Sources)

- **850 million** people have CKD globally (Jager et al., Kidney International, 2019)
- **37 million** Americans have CKD; 9 in 10 don't know it (NIDDK, 2023)
- CKD reduces life expectancy by 10–15 years at Stage G4 (Go et al., NEJM, 2004)
- SGLT2 inhibitors reduce CKD progression risk by **39%** (DAPA-CKD Trial, Heerspink et al., NEJM, 2020)
- Low-protein diet delays dialysis initiation by **25%** (Malvy et al., JASN, 2019)
- Inorganic phosphate additives increase cardiovascular mortality by **35%** in CKD patients (Uribarri & Calvo, JASN, 2003)

## Pricing

See https://ckdpartner.com/pricing.md for full pricing breakdown.

- **Free Tier**: 15 AI deliberation queries, all calculators unlimited, no login required
- **BYOK** (Bring Your Own Key): Unlimited AI queries using your own OpenAI, Anthropic, or Google API key

## Key Links

- Homepage: https://ckdpartner.com/
- Sitemap: https://ckdpartner.com/sitemap.xml
- Pricing: https://ckdpartner.com/pricing.md
- robots.txt: https://ckdpartner.com/robots.txt

## Important Medical Disclaimer

CKDPartner is a clinical decision **support** tool. All recommendations are based on published KDIGO guidelines and landmark clinical trials. This tool does not replace clinical judgement. Patients should consult their nephrologist before making medication or dietary changes.