Kidney Failure and the Kidney Failure Risk Equations (KFRE): What You Need to Know

Kidney failure happens when your kidneys stop working. At this point, you need to choose a treatment that replaces lost kidney function, such as dialysis or kidney transplant. Or, you may choose medical care alone, without dialysis or transplant. You may also choose no treatment.

The KFRE are math equations that can predict how high or low your chance (risk) is for reaching kidney failure within the next 2-year and 5-year points in time. Results are given as a percent (%) on a scale of less than 1% to 99.99%. For example, a result of 1% chance of reaching kidney failure within 2 years, with a 5% chance at 5 years, is considered low.

The KFRE use specific information about you and your health called variables. Some variables such as age and gender can't be changed, so they're called non-modifiable variables.

However, other variables such as phosphorus and urine albumin-to-creatinine ratio (UACR) can be improved to lower your chances of reaching kidney failure, or to prolong the time it takes to reach kidney failure. These variables are modifiable because they can improve with the right care.

By studying the health information of more than 700,000 patients with chronic kidney disease (CKD) in 30 countries around the world, experts found which variables increase a person's chances for reaching kidney failure. These variables are listed below. By clicking a variable, you'll be taken to a page with more information about how it fits into the KFRE and how it might be improved to lower your chances of reaching kidney failure, or at least prolong the time it takes to reach kidney failure.

• Age
• Gender
• Estimated glomerular filtration rate (eGFR)
• Urine albumin-to-creatinine ratio (UACR)
• Serum bicarbonate
• Serum albumin
• Serum phosphorus
• Serum calcium

There are 2 KFRE. The 4 variable equation uses the first four variables only, and the 8 variable equation uses all eight. Your doctor and healthcare team use only your personal variables to calculate your individual risk for kidney failure using one of these equations.

Rather than waiting for kidney failure to strike without warning, it's much better for your health if you can predict how great a chance you have for developing it in the future. This knowledge helps you be as well prepared as possible.

On the other hand, this knowledge could put you at ease because your risk for kidney failure is lower than you thought. You may find that even though you have CKD, your risk for reaching kidney failure in your lifetime is very low. In fact, only 3% of patients with CKD reach kidney failure.

But if you are at high risk for reaching kidney failure, then you'll have time to take better care of yourself. This could possibly slow down the progression of your CKD and help you delay the need for dialysis or a transplant.

And finally, if you do need treatment for kidney failure within 2 to 5 years, then you'll have time to consider your treatment options. Predicting when you might be reaching kidney failure allows you and your healthcare team to prepare and make the best decisions possible regarding your care. Treating kidney failure requires adequate time for careful planning based on your personal goals and individual state of health.

For more information:

• Download a printable version of this information
• Speak with your healthcare team
• Visit the National Kidney Foundation at www.kidney.org
• Visit kidneyfailurerisk.com to use the kidney failure risk calculator