Kidney Failure Risk Equation (KFRE)

Predicting the 2-year and 5-year risk of end-stage kidney disease

Last updated on: July 2, 2025

8-Variable KFRE Calculator

mL/min/1.73m²
mg/g
mEq/L

What is the KFRE?

The Kidney Failure Risk Equation (KFRE) is a validated clinical tool that accurately predicts the risk of a patient with Chronic Kidney Disease (CKD) progressing to kidney failure (requiring dialysis or transplant) within a 2-year or 5-year timeframe.

This 8-variable model incorporates age, sex, eGFR, ACR, and four common serum analytes to provide a personalized risk assessment, which is superior to using eGFR or albuminuria alone.

Why is KFRE Important for Patient Care?

  • Facilitates informed discussions with patients about their prognosis.
  • Helps in timely referral to nephrology and planning for renal replacement therapy.
  • Can aid in clinical decision-making, such as the appropriateness of certain interventions or medications.

Interpreting the Risk Percentage

The KFRE result helps tailor the intensity of management. A higher risk percentage necessitates more aggressive strategies to slow CKD progression.

  • Low Risk (<5%): Continue routine monitoring and management of risk factors like blood pressure.
  • Intermediate Risk (5-15%): Consider more frequent monitoring and potential nephrology consultation.
  • High Risk (>15%): Urgent nephrology referral is recommended to discuss management and future options.
  • Always base clinical decisions on the full patient context, not just this score.

This page has been medically reviewed by Dr. Khoulah Attia – PharmD, Immunology Specialist.