The Kidney Failure Risk Equation is a risk prediction tool recommended by NICE for patients with chronic kidney disease (CKD) stages 3a-5 (eGFR <60 ml/min/1.73m2) to assess the risk of an individual needing kidney replacement therapy in the next five years. The five-year predictions may be used in primary care to counsel patients regarding referral to secondary care.
KFRE should be calculated at least on an annual basis in patients with CKD, but more frequently with more advanced disease.
To estimate the risk of kidney replacement therapy, the four-variable KFRE uses age, sex, estimated glomerular filtration rate (eGFR) and urine albumin:creatinine ratio (ACR).
Please refer to NICE NG203 for further information and guidance.
Additional information
Please use the calculator provided to calculated eGFR using CKD-EPI equation, and the kindey failure risk.
Turn around
To be calculated in primary care
Collection Con
Results for serum creatinine (to calculate eGFR) and urine ACR should ideally be collected less than 1 month apart and must be collected within 6 months of each other.
eGFR should be calculated using 2009 CKD-EPI equation (not provided by the lab) – see calculator.
KFRE should only be calculated when eGFR <60 ml/min/1.73m2
Reference Range
Refer adults (M & F) with CKD for specialist assessment if they have >5% 5 year risk of needing kidney replacement therapy (NICE NG203).