# D:A:D CKD risk score (Mocroft) D:A:D CKD Status: LIVE Price: $0.005 USDC `GET /api/calc/dad_ckd` HTML: https://magentlab.com/docs/dad-ckd Markdown: https://magentlab.com/docs/dad-ckd.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the Mocroft 2015 D:A:D Table 2 full integer CKD risk score from injecting drug use, hepatitis C, age, caller-assigned eGFR >60, sex, nadir CD4, hypertension, prior CVD, and diabetes. ## When to use When an agent already has those caller-assigned values and needs the published full-score point total and low/medium/high band. magent does not compute eGFR, diagnose HIV or CKD, or order ART. ## When not to use - Not a medical device. Not a CKD diagnosis and not an antiretroviral (ART) start or switch order. - Mocroft 2015 Table 2 full integer risk score only. This is not the short score, not the Poisson exact-probability model, not number needed to harm (NNTH), and not an ARV-start decision tool. - Derivation required eGFR > 60 mL/min. eGFR ≤60 is invalid (not in that population). - eGFR is caller-assigned. magent does not compute CKD-EPI, MDRD, or Cockcroft–Gault. - Race was not in the published score and is not an input. - Flags are caller-supplied booleans. magent does not diagnose injecting drug use, hepatitis C, hypertension, CVD, or diabetes. ## Formula ``` D:A:D full CKD = ivdu 2 + hepatitis_c 1 + age (≤35 0; >35 and ≤50 4; >50 and ≤60 7; >60 10) + egfr (>90 −6; >70 and ≤90 0; >60 and ≤70 6) + female 1 + nadir_cd4 (>200 −1; ≤200 0) + hypertension 1 + prior_cvd 1 + diabetes 2; Mocroft 2015 Table 2; max 24; bands low <0, medium 0–4, high ≥5 ``` ## Citation [Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study](https://doi.org/10.1371/journal.pmed.1001809) Mocroft A, Lundgren JD, Ross M, Law M, Reiss P, Kirk O, et al. PLoS Med. 2015;12(3):e1001809 DOI: [10.1371/journal.pmed.1001809](https://doi.org/10.1371/journal.pmed.1001809) ## Worked example ### Mocroft 2015 worked example (score 12, high) Given: `age_years=38, diabetes=true, egfr_ml_min=68, hepatitis_c=false, hypertension=false, ivdu=false, nadir_cd4_cells_mm3=250, prior_cvd=false, sex=female` 1. female 1 + no IVDU 0 + no HCV 0 + age 38 → 4 + eGFR 68 → 6 + nadir CD4 250 → −1 + no HTN 0 + no CVD 0 + diabetes 2 2. Score = 12 (max 24); risk_band high ### Young male, eGFR >90, nadir CD4 >200, no flags Given: `age_years=30, diabetes=false, egfr_ml_min=95, hepatitis_c=false, hypertension=false, ivdu=false, nadir_cd4_cells_mm3=300, prior_cvd=false, sex=male` 1. age ≤35 → 0; eGFR >90 → −6; nadir CD4 >200 → −1; remaining factors 0 2. Score = −7 (max 24); risk_band low ## Also searched as - D:A:D CKD score - Mocroft CKD HIV - D:A:D chronic kidney disease - HIV CKD risk score - DAD CKD ## Parameters - `ivdu` (boolean, required): Caller-assigned injecting drug use (Mocroft 2015 Table 2). true scores 2. magent does not diagnose injecting drug use. - `hepatitis_c` (boolean, required): Caller-assigned hepatitis C co-infection (Mocroft 2015 Table 2). true scores 1. magent does not diagnose hepatitis C. - `age_years` (integer, required): Age in years (integer 16-120). Mocroft 2015 Table 2: ≤35 scores 0; >35 and ≤50 scores 4; >50 and ≤60 scores 7; >60 scores 10. - `egfr_ml_min` (number, required): Caller-assigned eGFR in mL/min (0.1-250, must be >60). Mocroft 2015 Table 2: >90 scores −6; >70 and ≤90 scores 0; >60 and ≤70 scores 6. eGFR ≤60 is outside the derivation population. magent does not compute eGFR. - `sex` (string, required): Sex (Mocroft 2015 Table 2). female scores 1; male scores 0. - `nadir_cd4_cells_mm3` (integer, required): Nadir CD4 count in cells/mm³ (integer 0-3000). Mocroft 2015 Table 2: ≤200 scores 0; >200 scores −1. magent does not assay CD4. - `hypertension` (boolean, required): Caller-assigned hypertension (Mocroft 2015 Table 2). true scores 1. magent does not diagnose hypertension. - `prior_cvd` (boolean, required): Caller-assigned prior cardiovascular disease (Mocroft 2015 Table 2). true scores 1. magent does not diagnose CVD. - `diabetes` (boolean, required): Caller-assigned diabetes (Mocroft 2015 Table 2). true scores 2. magent does not diagnose diabetes. ## Bulk (POST) POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/dad_ckd` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "age_years": "38", "diabetes": "true", "egfr_ml_min": "68", "hepatitis_c": "false", "hypertension": "false", "ivdu": "false", "nadir_cd4_cells_mm3": "250", "prior_cvd": "false", "sex": "female" }, { "age_years": "38", "diabetes": "true", "egfr_ml_min": "68", "hepatitis_c": "false", "hypertension": "false", "ivdu": "false", "nadir_cd4_cells_mm3": "250", "prior_cvd": "false", "sex": "female" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/dad-ckd Example 200: ```json { "count": 2, "path": "/api/calc/dad_ckd", "items": [ { "components": [ { "factor": "ivdu", "points": 0, "present": false }, { "factor": "hepatitis_c", "points": 0, "present": false }, { "value": 38, "factor": "age_years", "points": 4, "present": true }, { "value": 68.0, "factor": "egfr_ml_min", "points": 6, "present": true }, { "value": "female", "factor": "sex", "points": 1, "present": true }, { "value": 250, "factor": "nadir_cd4_cells_mm3", "points": -1, "present": true }, { "factor": "hypertension", "points": 0, "present": false }, { "factor": "prior_cvd", "points": 0, "present": false }, { "factor": "diabetes", "points": 2, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "age_years": 38, "citation": { "authors": "Mocroft A, Lundgren JD, Ross M, Law M, Reiss P, Kirk O, et al.", "doi": "10.1371/journal.pmed.1001809", "id": "mocroft-2015", "pmid": "25826420", "source": "PLoS Med. 2015;12(3):e1001809", "title": "Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study" }, "formula": "dad_ckd", "formula_expression": "D:A:D full CKD = ivdu 2 + hepatitis_c 1 + age (≤35 0; >35 and ≤50 4; >50 and ≤60 7; >60 10) + egfr (>90 −6; >70 and ≤90 0; >60 and ≤70 6) + female 1 + nadir_cd4 (>200 −1; ≤200 0) + hypertension 1 + prior_cvd 1 + diabetes 2; Mocroft 2015 Table 2; max 24; bands low <0, medium 0–4, high ≥5", "max_score": 24, "score": 12, "risk_band": "high", "sex": "female", "diabetes": true, "egfr_ml_min": 68.0, "hepatitis_c": false, "hypertension": false, "ivdu": false, "nadir_cd4_cells_mm3": 250, "prior_cvd": false }, { "components": [ { "factor": "ivdu", "points": 0, "present": false }, { "factor": "hepatitis_c", "points": 0, "present": false }, { "value": 38, "factor": "age_years", "points": 4, "present": true }, { "value": 68.0, "factor": "egfr_ml_min", "points": 6, "present": true }, { "value": "female", "factor": "sex", "points": 1, "present": true }, { "value": 250, "factor": "nadir_cd4_cells_mm3", "points": -1, "present": true }, { "factor": "hypertension", "points": 0, "present": false }, { "factor": "prior_cvd", "points": 0, "present": false }, { "factor": "diabetes", "points": 2, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "age_years": 38, "citation": { "authors": "Mocroft A, Lundgren JD, Ross M, Law M, Reiss P, Kirk O, et al.", "doi": "10.1371/journal.pmed.1001809", "id": "mocroft-2015", "pmid": "25826420", "source": "PLoS Med. 2015;12(3):e1001809", "title": "Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study" }, "formula": "dad_ckd", "formula_expression": "D:A:D full CKD = ivdu 2 + hepatitis_c 1 + age (≤35 0; >35 and ≤50 4; >50 and ≤60 7; >60 10) + egfr (>90 −6; >70 and ≤90 0; >60 and ≤70 6) + female 1 + nadir_cd4 (>200 −1; ≤200 0) + hypertension 1 + prior_cvd 1 + diabetes 2; Mocroft 2015 Table 2; max 24; bands low <0, medium 0–4, high ≥5", "max_score": 24, "score": 12, "risk_band": "high", "sex": "female", "diabetes": true, "egfr_ml_min": 68.0, "hepatitis_c": false, "hypertension": false, "ivdu": false, "nadir_cd4_cells_mm3": 250, "prior_cvd": false } ] } ``` ## Response fields - `formula` (string): dad_ckd - `formula_expression` (string): Exact expression used - `score` (integer): Mocroft 2015 Table 2 full-score points - `max_score` (integer): 24 - `risk_band` (string): Mocroft 2015 band: low (score < 0), medium (0–4), or high (≥5). A band, not a CKD diagnosis. - `age_years` (integer): Age in years used for Table 2 age bands - `egfr_ml_min` (number): Caller-assigned eGFR used for Table 2 eGFR bands - `sex` (string): female or male - `nadir_cd4_cells_mm3` (integer): Nadir CD4 cells/mm³ used for Table 2 nadir bands - `ivdu` (boolean): Caller-assigned injecting drug use flag - `hepatitis_c` (boolean): Caller-assigned hepatitis C flag - `hypertension` (boolean): Caller-assigned hypertension flag - `prior_cvd` (boolean): Caller-assigned prior CVD flag - `diabetes` (boolean): Caller-assigned diabetes flag - `components` (array): Per-factor Table 2 points - `citation` (object): Mocroft et al. PLoS Med 2015 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "ivdu", "points": 0, "present": false }, { "factor": "hepatitis_c", "points": 0, "present": false }, { "value": 38, "factor": "age_years", "points": 4, "present": true }, { "value": 68.0, "factor": "egfr_ml_min", "points": 6, "present": true }, { "value": "female", "factor": "sex", "points": 1, "present": true }, { "value": 250, "factor": "nadir_cd4_cells_mm3", "points": -1, "present": true }, { "factor": "hypertension", "points": 0, "present": false }, { "factor": "prior_cvd", "points": 0, "present": false }, { "factor": "diabetes", "points": 2, "present": true } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "age_years": 38, "citation": { "authors": "Mocroft A, Lundgren JD, Ross M, Law M, Reiss P, Kirk O, et al.", "doi": "10.1371/journal.pmed.1001809", "id": "mocroft-2015", "pmid": "25826420", "source": "PLoS Med. 2015;12(3):e1001809", "title": "Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study" }, "formula": "dad_ckd", "formula_expression": "D:A:D full CKD = ivdu 2 + hepatitis_c 1 + age (≤35 0; >35 and ≤50 4; >50 and ≤60 7; >60 10) + egfr (>90 −6; >70 and ≤90 0; >60 and ≤70 6) + female 1 + nadir_cd4 (>200 −1; ≤200 0) + hypertension 1 + prior_cvd 1 + diabetes 2; Mocroft 2015 Table 2; max 24; bands low <0, medium 0–4, high ≥5", "max_score": 24, "score": 12, "risk_band": "high", "sex": "female", "diabetes": true, "egfr_ml_min": 68.0, "hepatitis_c": false, "hypertension": false, "ivdu": false, "nadir_cd4_cells_mm3": 250, "prior_cvd": false } ``` ## Errors - HTTP 400 `invalid_dad_ckd`: D:A:D CKD score inputs must match Mocroft 2015 age, eGFR, CD4 nadir, and flag categories from that paper. Returned before settlement; you are not charged. - HTTP 400 `invalid_sex`: sex must be female or male Returned before settlement; you are not charged. - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [CKD-EPI 2021 eGFR](https://magentlab.com/docs/egfr) — Compute race-free CKD-EPI 2021 creatinine eGFR in mL/min/1.73m2. - [Cockcroft–Gault CrCl](https://magentlab.com/docs/crcl) — Compute Cockcroft–Gault creatinine clearance in mL/min using total body weight. - [Schwartz 2009 eGFR](https://magentlab.com/docs/schwartz-gfr) — Compute the 2009 Schwartz bedside CKiD eGFR in mL/min/1.73m2 from height and serum creatinine. ## Payment Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON. - exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.