KidneyFailureRisk
Calculate your 5-year kidney failure risk using the validated 8-variable KFRE. Enter age, sex, ACR, eGFR, and serum lab values for an evidence-based risk assessment.
About This Calculator
The Kidney Failure Risk Calculator uses the validated 8-variable Kidney Failure Risk Equation (KFRE) developed by Dr. Navdeep Tangri and colleagues, published in the Journal of the American Medical Association (JAMA) in April 2011. This evidence-based tool predicts the probability of progression to end-stage kidney disease requiring dialysis or transplantation within 5 years.
The KFRE has been externally validated in over 30 cohorts worldwide, including Canada, the United States, Europe, and Asia, making it one of the most reliable clinical prediction tools for chronic kidney disease (CKD) progression. It is recommended by Kidney Disease: Improving Global Outcomes (KDIGO) guidelines for risk stratification in CKD patients.
How the calculation works
Each of the 8 variables is assigned points based on a standardized scoring system. Age contributes points ranging from -4 (under 30 years) to +10 (90+ years). Female sex contributes 0 points, while male sex contributes -2. The albumin-to-creatinine ratio (ACR) scores 0 for normal levels under 30 mg/g, -14 for microalbuminuria (30-300 mg/g), and -22 for macroalbuminuria (above 300 mg/g). Lower eGFR values contribute increasingly negative points, reflecting higher risk. Serum albumin, bicarbonate, calcium, and phosphorus each contribute additional points based on their deviation from normal ranges. The total score is converted to a 5-year kidney failure probability using the validated KFRE conversion table.
Regional Notes
India: CKD affects approximately 17% of the Indian adult population, with diabetic nephropathy being the leading cause. The KFRE has been validated in Indian cohorts and performs well for risk stratification. ACR values in India may be reported in mg/g or mg/mmol (divide mg/mmol by 88.42 to convert to mg/g).
United States: The KFRE is widely used in US nephrology practice and recommended by the National Kidney Foundation. eGFR values are routinely reported by US labs using the CKD-EPI equation. ACR values in the US are commonly reported in mg/g.
United Kingdom: NICE guidelines recommend the KFRE for CKD risk assessment in UK clinical practice. UK labs report eGFR using the CKD-EPI equation and ACR in mg/mmol (multiply by 88.42 to convert to mg/g). The NHS Kidney Care program uses KFRE for early intervention planning.
Frequently Asked Questions
What is the kidney failure risk equation (KFRE)?
The Kidney Failure Risk Equation (KFRE) is a validated clinical tool developed by Dr. Navdeep Tangri and colleagues, published in JAMA in 2011. It uses 8 variables — age, sex, ACR, eGFR, serum albumin, bicarbonate, calcium, and phosphorus — to predict the probability of progression to end-stage kidney disease within 5 years.
How do I interpret my kidney failure risk score?
The KFRE produces a percentage probability of kidney failure within 5 years. A risk below 5% is considered very low, 5-10% low, 10-20% moderate, 20-50% high, and above 50% very high. These probabilities represent the percentage of patients with similar scores who develop kidney failure within 5 years.
What ACR and eGFR values should I enter?
Enter your most recent lab results. ACR (albumin-to-creatinine ratio) is measured from a urine sample in mg/g. eGFR (estimated glomerular filtration rate) is calculated from your blood creatinine level and reported in mL/min/1.73m². Normal eGFR is above 60; values below 15 indicate kidney failure requiring dialysis.
Can this calculator replace my doctor's assessment?
No. This calculator is for educational and informational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always consult a nephrologist for personalized kidney disease management and treatment decisions.
What are the 8 variables used in this calculator?
The 8-variable KFRE uses: age, sex, urine albumin-to-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), serum albumin, serum bicarbonate, serum calcium, and serum phosphorus. All are standard lab values routinely monitored in chronic kidney disease patients.
How often should I reassess my kidney failure risk?
CKD patients should typically reassess kidney failure risk every 3-12 months depending on disease stage. Stage 3-4 patients may benefit from annual reassessment, while stage 4-5 patients progressing rapidly may need more frequent evaluation. Always follow your nephrologist's recommended monitoring schedule.
What is a normal eGFR value?
A normal eGFR is above 60 mL/min/1.73m². Values between 45-59 indicate mild CKD (stage 3a), 30-44 moderate CKD (stage 3b), 15-29 severe CKD (stage 4), and below 15 kidney failure (stage 5). The KFRE is most accurate for patients with eGFR below 60.
What lifestyle changes reduce kidney failure risk?
Key strategies to reduce kidney failure risk include controlling blood pressure (target under 130/80 mmHg), managing diabetes, reducing salt intake (under 2g sodium daily), staying hydrated, avoiding NSAIDs, maintaining healthy weight, not smoking, and limiting alcohol consumption. A renal diet with moderate protein restriction may also help.