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R.E.N.A.L. nephrometry

Sum the Kutikov 2009 R.E.N.A.L. nephrometry score for a renal mass from four caller-assigned published item points (radius, exophytic/endophytic, nearness, location) and return the integer total (4–12) plus anterior and hilar descriptors. Does not return complexity bands.

LIVE $0.005 USDC GET /api/calc/renal_nephrometry

Markdown: /docs/renal-nephrometry.md · Canonical: https://magentlab.com/docs/renal-nephrometry

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Sum the Kutikov 2009 R.E.N.A.L. nephrometry score for a renal mass from four caller-assigned published item points (radius, exophytic/endophytic, nearness, location) and return the integer total (4–12) plus anterior and hilar descriptors. Does not return complexity bands.

When to use

When an agent has already assigned Kutikov 2009 radius, exophytic/endophytic properties, nearness to collecting system or sinus, anterior/posterior descriptor, polar-line location, and hilar abutment for a renal mass and needs the published integer sum, not a nephrectomy order, CT read, PADUA, or STONE nephrolithometry.

When not to use

  • Not a medical device. magent does not measure diameter, exophytic fraction, nearness, polar lines, or hilar abutment. Radius, exophytic, nearness, anterior, location, and hilar are caller-assigned.
  • Not a nephrectomy order. The score is not a command to operate, choose partial versus radical nephrectomy, or select a surgical approach.
  • Not PADUA and not Okhunov 2013 STONE nephrolithometry. This tool is Kutikov 2009 R.E.N.A.L. nephrometry for renal masses.
  • Kutikov 2009 Table 1 scores R, E, N, and L (1–3 each). Anterior (a/p/x) and hilar suffix h are descriptors, not points. magent returns score and max_score only; it does not return low/moderate/high complexity bands.

Formula

RENAL = radius (le_4 1, gt_4_lt_7 2, ge_7 3) + exophytic (ge_50 1, lt_50 2, entirely_endophytic 3) + nearness (ge_7 1, gt_4_lt_7 2, le_4 3) + location (entirely_polar 1, crosses_polar 2, gt_50_midline_or_between 3); anterior a|p|x 0 points; hilar suffix h boolean 0 points; Kutikov 2009 R.E.N.A.L. Nephrometry; sum 4-12; no published complexity bands

Citation

Title
The R.E.N.A.L. Nephrometry Score: A Comprehensive Standardized System for Quantitating Renal Tumor Size, Location and Depth
Authors
Kutikov A, Uzzo RG
Source
J Urol. 2009;182(3):844-853
DOI
10.1016/j.juro.2009.05.035

Worked example

All minimum grades

Given: anterior=aexophytic=ge_50hilar=falselocation=entirely_polarnearness=ge_7radius=le_4

  1. le_4 1 + ge_50 1 + ge_7 1 + entirely_polar 1; anterior a; hilar false
  2. Score = 4 (max 12); renal_string 4a. No complexity band. Not a nephrectomy order

All maximum grades

Given: anterior=xexophytic=entirely_endophytichilar=truelocation=gt_50_midline_or_betweennearness=le_4radius=ge_7

  1. ge_7 3 + entirely_endophytic 3 + le_4 3 + gt_50_midline_or_between 3; anterior x; hilar true
  2. Score = 12 (max 12); renal_string 12xh. No complexity band. Not a nephrectomy order

Also searched as

  • RENAL score
  • R.E.N.A.L. nephrometry
  • Kutikov nephrometry
  • renal tumor nephrometry
  • Kutikov 2009
  • RENAL nephrometry score
  • renal mass score
  • nephrometry score

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/renal_nephrometry?radius=le_4&exophytic=ge_50&nearness=ge_7&anterior=a&location=entirely_polar&hilar=false

Full URL: https://api.magentlab.com/api/calc/renal_nephrometry?radius=le_4&exophytic=ge_50&nearness=ge_7&anterior=a&location=entirely_polar&hilar=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge. 

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/renal_nephrometry?radius=le_4&exophytic=ge_50&nearness=ge_7&anterior=a&location=entirely_polar&hilar=false"

Parameters

Name Type Required Description
radius string required · le_4, gt_4_lt_7, ge_7 Caller-assigned maximal diameter in cm (Kutikov 2009 R, radius). le_4 (≤4 cm) scores 1; gt_4_lt_7 (>4 but <7 cm) scores 2; ge_7 (≥7 cm) scores 3. magent does not measure diameter or read CT.
exophytic string required · ge_50, lt_50, entirely_endophytic Caller-assigned exophytic/endophytic properties (Kutikov 2009 E). ge_50 (≥50% exophytic) scores 1; lt_50 (<50% exophytic) scores 2; entirely_endophytic (completely endophytic) scores 3. magent does not read CT.
nearness string required · ge_7, gt_4_lt_7, le_4 Caller-assigned nearness of the deepest portion of the mass to the collecting system or sinus in mm (Kutikov 2009 N). ge_7 (≥7 mm) scores 1; gt_4_lt_7 (>4 but <7 mm) scores 2; le_4 (≤4 mm) scores 3. magent does not measure nearness or read CT.
anterior string required · a, p, x Caller-assigned anterior/posterior descriptor (Kutikov 2009 A). a (anterior), p (posterior), or x (indeterminate). 0 points; echoed as anterior. magent does not read CT.
location string required · entirely_polar, crosses_polar, gt_50_midline_or_between Caller-assigned location relative to polar lines (Kutikov 2009 L). entirely_polar (entirely above the upper polar line or entirely below the lower polar line) scores 1; crosses_polar (mass crosses a polar line) scores 2; gt_50_midline_or_between (>50% of the mass is across a polar line, or the mass crosses the axial renal midline, or the mass is entirely between the polar lines) scores 3. magent does not read CT.
hilar boolean required Caller-assigned hilar suffix (Kutikov 2009). true means the mass abuts the main renal artery or vein (suffix h). Boolean, not points. magent does not read CT.

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.

POST /api/calc/renal_nephrometry Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 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 (fixture)

{
  "items": [
    {
      "anterior": "a",
      "exophytic": "ge_50",
      "hilar": "false",
      "location": "entirely_polar",
      "nearness": "ge_7",
      "radius": "le_4"
    },
    {
      "anterior": "a",
      "exophytic": "ge_50",
      "hilar": "false",
      "location": "entirely_polar",
      "nearness": "ge_7",
      "radius": "le_4"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/renal_nephrometry",
  "items": [
    {
      "location": "entirely_polar",
      "r": 1,
      "l": 1,
      "components": [
        {
          "value": "le_4",
          "factor": "radius",
          "points": 1,
          "present": true
        },
        {
          "value": "ge_50",
          "factor": "exophytic",
          "points": 1,
          "present": true
        },
        {
          "value": "ge_7",
          "factor": "nearness",
          "points": 1,
          "present": true
        },
        {
          "value": "entirely_polar",
          "factor": "location",
          "points": 1,
          "present": true
        }
      ],
      "n": 1,
      "e": 1,
      "radius": "le_4",
      "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.",
      "citation": {
        "authors": "Kutikov A, Uzzo RG",
        "doi": "10.1016/j.juro.2009.05.035",
        "id": "kutikov-2009",
        "pmid": "19616235",
        "source": "J Urol. 2009;182(3):844-853",
        "title": "The R.E.N.A.L. Nephrometry Score: A Comprehensive Standardized System for Quantitating Renal Tumor Size, Location and Depth"
      },
      "formula": "renal_nephrometry",
      "formula_expression": "RENAL = radius (le_4 1, gt_4_lt_7 2, ge_7 3) + exophytic (ge_50 1, lt_50 2, entirely_endophytic 3) + nearness (ge_7 1, gt_4_lt_7 2, le_4 3) + location (entirely_polar 1, crosses_polar 2, gt_50_midline_or_between 3); anterior a|p|x 0 points; hilar suffix h boolean 0 points; Kutikov 2009 R.E.N.A.L. Nephrometry; sum 4-12; no published complexity bands",
      "max_score": 12,
      "score": 4,
      "anterior": "a",
      "exophytic": "ge_50",
      "hilar": false,
      "nearness": "ge_7",
      "renal_string": "4a"
    },
    {
      "location": "entirely_polar",
      "r": 1,
      "l": 1,
      "components": [
        {
          "value": "le_4",
          "factor": "radius",
          "points": 1,
          "present": true
        },
        {
          "value": "ge_50",
          "factor": "exophytic",
          "points": 1,
          "present": true
        },
        {
          "value": "ge_7",
          "factor": "nearness",
          "points": 1,
          "present": true
        },
        {
          "value": "entirely_polar",
          "factor": "location",
          "points": 1,
          "present": true
        }
      ],
      "n": 1,
      "e": 1,
      "radius": "le_4",
      "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.",
      "citation": {
        "authors": "Kutikov A, Uzzo RG",
        "doi": "10.1016/j.juro.2009.05.035",
        "id": "kutikov-2009",
        "pmid": "19616235",
        "source": "J Urol. 2009;182(3):844-853",
        "title": "The R.E.N.A.L. Nephrometry Score: A Comprehensive Standardized System for Quantitating Renal Tumor Size, Location and Depth"
      },
      "formula": "renal_nephrometry",
      "formula_expression": "RENAL = radius (le_4 1, gt_4_lt_7 2, ge_7 3) + exophytic (ge_50 1, lt_50 2, entirely_endophytic 3) + nearness (ge_7 1, gt_4_lt_7 2, le_4 3) + location (entirely_polar 1, crosses_polar 2, gt_50_midline_or_between 3); anterior a|p|x 0 points; hilar suffix h boolean 0 points; Kutikov 2009 R.E.N.A.L. Nephrometry; sum 4-12; no published complexity bands",
      "max_score": 12,
      "score": 4,
      "anterior": "a",
      "exophytic": "ge_50",
      "hilar": false,
      "nearness": "ge_7",
      "renal_string": "4a"
    }
  ]
}

Response

Field Type Description
formula string renal_nephrometry
formula_expression string Exact expression used
score integer Kutikov 2009 R.E.N.A.L. nephrometry integer sum 4-12 (R+E+N+L). Anterior and hilar are not added. Not a nephrectomy order. No published complexity band.
max_score integer 12
r integer Radius points 1-3 (Kutikov 2009 R)
e integer Exophytic/endophytic points 1-3 (Kutikov 2009 E)
n integer Nearness points 1-3 (Kutikov 2009 N)
l integer Location points 1-3 (Kutikov 2009 L)
radius string Caller-assigned radius used (le_4, gt_4_lt_7, or ge_7)
exophytic string Caller-assigned exophytic used (ge_50, lt_50, or entirely_endophytic)
nearness string Caller-assigned nearness used (ge_7, gt_4_lt_7, or le_4)
anterior string Caller-assigned anterior descriptor used (a, p, or x). 0 points.
location string Caller-assigned location used (entirely_polar, crosses_polar, or gt_50_midline_or_between)
hilar boolean true when the mass abuts the main renal artery or vein (suffix h). Not scored.
renal_string string Kutikov 2009 notation: {score}{anterior} plus h if hilar (for example 4a or 12xh)
components array Per-item Kutikov 2009 R, E, N, L points
citation object Kutikov and Uzzo J Urol 2009 citation
disclaimer string Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup. 

{
  "location": "entirely_polar",
  "r": 1,
  "l": 1,
  "components": [
    {
      "value": "le_4",
      "factor": "radius",
      "points": 1,
      "present": true
    },
    {
      "value": "ge_50",
      "factor": "exophytic",
      "points": 1,
      "present": true
    },
    {
      "value": "ge_7",
      "factor": "nearness",
      "points": 1,
      "present": true
    },
    {
      "value": "entirely_polar",
      "factor": "location",
      "points": 1,
      "present": true
    }
  ],
  "n": 1,
  "e": 1,
  "radius": "le_4",
  "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.",
  "citation": {
    "authors": "Kutikov A, Uzzo RG",
    "doi": "10.1016/j.juro.2009.05.035",
    "id": "kutikov-2009",
    "pmid": "19616235",
    "source": "J Urol. 2009;182(3):844-853",
    "title": "The R.E.N.A.L. Nephrometry Score: A Comprehensive Standardized System for Quantitating Renal Tumor Size, Location and Depth"
  },
  "formula": "renal_nephrometry",
  "formula_expression": "RENAL = radius (le_4 1, gt_4_lt_7 2, ge_7 3) + exophytic (ge_50 1, lt_50 2, entirely_endophytic 3) + nearness (ge_7 1, gt_4_lt_7 2, le_4 3) + location (entirely_polar 1, crosses_polar 2, gt_50_midline_or_between 3); anterior a|p|x 0 points; hilar suffix h boolean 0 points; Kutikov 2009 R.E.N.A.L. Nephrometry; sum 4-12; no published complexity bands",
  "max_score": 12,
  "score": 4,
  "anterior": "a",
  "exophytic": "ge_50",
  "hilar": false,
  "nearness": "ge_7",
  "renal_string": "4a"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP Code When
400 invalid_renal_nephrometry radius must be le_4, gt_4_lt_7, or ge_7; exophytic must be ge_50, lt_50, or entirely_endophytic; nearness must be ge_7, gt_4_lt_7, or le_4; anterior must be a, p, or x; location must be entirely_polar, crosses_polar, or gt_50_midline_or_between (Kutikov 2009 R.E.N.A.L.). Returned before settlement; you are not charged.
400 invalid_flag boolean clinical flags must be true or false Returned before settlement; you are not charged.
400 invalid_items POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400 invalid_item_count items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400 invalid_item each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

  • STONE nephrolithometry — Sum the Okhunov 2013 STONE nephrolithometry score for kidney calculi (PCNL) from five caller-assigned published item points and return the integer total (5–13). Does not return stone-free-rate bands.

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. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /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.