The Kidney Failure Risk Equation (KFRE) is a scientific tool that helps doctors predict how likely it is that someone with chronic kidney disease (CKD) will develop kidney failure. By using data from blood and urine tests, this equation can guide treatment choices and encourage patients to take action that may delay the need for dialysis or a transplant. Although the KFRE is mainly used by doctors and researchers, it’s also available to the public and can spark important conversations about kidney health.*

What the KFRE Measures and Why It Matters

There are two versions of the KFRE: one that uses four key health indicators and another that uses eight. These indicators help doctors better understand how fast a person’s kidney disease may be progressing.

• Four-variable KFRE. Looks at age, sex, estimated glomerular filtration rate (eGFR), and the urine albumin-to-creatinine ratio (UACR).
  
• Eight-variable KFRE. Adds blood levels of bicarbonate, albumin, phosphorus, and calcium to the list.
  

These values give a clearer picture of how the kidneys are functioning and how soon they might fail without treatment.

Accuracy, Use, and Limitations

Studies have shown the KFRE is a reliable tool, especially for people with CKD stages 3a through 5. It’s effective at predicting who might develop kidney failure in two to five years, whether using the simpler or more detailed version of the equation.

Still, there are a few things it doesn’t cover:

• It doesn’t include other health problems that might shorten someone’s life.
• It may be less accurate in people with certain rare kidney conditions.
• Some test results used in the equation can be thrown off by infections or unusual body weight.

When and How to Use the KFRE

Doctors can use the KFRE to track CKD progression and adjust treatment plans. Patients with CKD can also access the equation online (with their lab results) to understand their risk and prepare questions for their doctor.

Call a doctor if you notice:

• Swelling, shortness of breath, or fatigue
• Blood in urine or trouble sleeping
  

Rechecking the KFRE at least once a year is recommended for most CKD patients—more often for those in advanced stages.

*Lillis, C. (2025, April 8). What to know about the kidney failure risk equation (KFRE). Medical News Today. https://www.medicalnewstoday.com/articles/kidney-failure-risk-equation 

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