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Kidney Failure Risk Equation (KFRE)

The Kidney Failure Risk Equation (KFRE) is a risk prediction model to measure the 2-year and 5-year risk of end-stage kidney disease in people with chronic kidney disease (CKD) with an estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1.73m2. The model was developed initially in Canada and its accuracy was subsequently validated in over 30 countries.

The Ontario Renal Network has added a KFRE criterion for nephrology referral to the updated KidneyWise Clinical Toolkit, which is also available in a PDF format.

Benefits of Using the KFRE

The 5-year KFRE ≥ 5% criterion captures higher risk patients, some of whom are missed by existing referral criteria:

Earlier identification of patients at risk of progression to end-stage kidney disease leads to improved care:

Using the KFRE in Your Primary Care Practice

  • Obtain your patient’s eGFR and urinary albumin-to-creatinine ratio (ACR)
    • Suggestion: calculate the KFRE if eGFR is less than 60 ml/min/1.73m2
  • To calculate the KFRE, visit the kidney failure risk calculator:
    • Enter your patient’s age, sex, eGFR and ACR
    • Monitor and manage your lower-risk patient with the KidneyWise Clinical Toolkit if the 5-year KFRE is < 5%
    • Consider referring patient to nephrology if the 5-year KFRE result is ≥ 5%
  • KidneyWise Clinical Algorithm – Find information on identification and management of chronic kidney disease patients, as well as additional referral criteria.
  • Outpatient Nephrology Referral Form – Find out what type of information to include in your referral to nephrology.

Sign Up for eConsult

Do you have questions about your patient that you’d like to ask a nephrologist? Sign up for the Ontario eConsult Program and ask one of the 40+ nephrologists registered. Feedback on the program has been very positive from referring healthcare providers, specialists and patients.

Email to learn how to make eConsult a regular part of your practice.