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Kidney / Renal

Modern U.S. life / SI / mortgage-protection underwriting knowledge — actuarial decision framing for software.

Knowledge priority 9/10 Not legacy dump tree

Actuarial software-knowledge disclaimer: These pages synthesize typical U.S. life / simplified-issue / final-expense / mortgage-protection underwriting logic used industry-wide (2024–2026 field guides, carrier appetites, reinsurance mortality framing). They are not any single carrier’s filed rates, not advice to applicants, and not the legacy 2022 database dump. Use them to design interview schemas and carrier-ruleset APIs.

Actuarial view

Renal impairment is a powerful mortality marker (eGFR, proteinuria, dialysis, transplant). Dialysis and transplant are near-automatic declines for traditional/SI level.

Primary risk drivers

eGFR / CKD stage
Proteinuria / ACR
Dialysis
Transplant vintage
Diabetes/HTN cause

Life (full / accelerated)

Map drivers → rate class / flat extra / postpone / decline. Labs & Rx history refine.

Mortgage / FE SI

Advanced CKD/dialysis → not level mortgage SI.

Health insurance

eGFR is central to health risk; collect labs when expanding beyond SI.

Recommended interview logic (software schema)

Chronic kidney disease, dialysis, transplant, or significant proteinuria?

Proteinuria / early CKD

Need eGFR

CKD stage 3–4

Usually decline Level SI

Dialysis

Decline traditional/SI Level

Transplant

Decline most; specialty only after long stability

Typical decision patterns

Profile	Traditional / Express-style	FE / Mortgage SI path
Normal renal function	OK	OK
Mild CKD, stable eGFR	Table / postpone	Some FE Graded
Dialysis or awaiting transplant	DECLINE	GI

Software implementation note

ckd_stage, on_dialysis, transplant_bool, egfr_band.