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
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.