ToolsCalculators
Kidney Failure Risk Calculator (KFRE)
Predicts 2- and 5-year risk of treated kidney failure in CKD stage 3-5.
Kidney Failure Risk Calculator (KFRE)
Age
years
Sex
eGFR
Estimated glomerular filtration rate (any standard creatinine-based equation).
mL/min/1.73 m²
Urine albumin-to-creatinine ratio (ACR)
Enter mg/g; multiply mg/mmol by 8.84 to convert.
mg/g
Complete the fields above to see the result.
When to use
- Estimating the probability that an adult with CKD stage 3-5 (eGFR 10-59) will progress to treated kidney failure within 2 or 5 years.
- Informing timing of nephrology referral, vascular access planning, or transplant work-up.
Formula
4-variable KFRE: L = -0.2201x(age/10 - 7.036) + 0.2467x(male - 0.5642) - 0.5567x(eGFR/5 - 7.222) + 0.4510x(ln(ACR mg/g) - 5.137). 2-year risk = 1 - 0.9832^exp(L); 5-year risk = 1 - 0.9365^exp(L).
Pearls and pitfalls
- Derived and validated in patients referred to nephrology with CKD stages 3-5 (eGFR 10-59 mL/min/1.73 m²); accuracy outside this range or in transplant recipients is less established.
- A related 8-variable model adds serum calcium, phosphate, bicarbonate and albumin for marginally better discrimination but requires more inputs.
- Many guidelines suggest nephrology referral once 5-year risk exceeds roughly 3-5%, and multidisciplinary dialysis/transplant planning once it approaches 40%.