Estimated reading time: 3 minutes
Conceptual Medicine is dedicated to delivering high-quality medical education that empowers physicians with cutting-edge clinical knowledge. Our YouTube videos are just a glimpse of the complete learning experience available on the Conceptual Medicine App. Today, we explore an essential tool for nephrology decision-making—the Kidney Failure Risk Equation (KFRE).
KFRE: What Is It? Why Is It Important?
An equation with just another different set of variables, the KFRE is a more accurate way of understanding chronic kidney disease. Based on evaluated over 700,000 patients, it enables general practitioners and physicians to know when a patient should be referred to a nephrologist or start planning for dialysis. This puts the entire kidney prognosis into the hands of doctors, allowing early action and adequate preparation for timely interventions in the form of necessary dialysis: they won’t just be waiting for the crisis to achieve plans.
How Does KFRE Work?
Four-variable-model/ eight-variable-model for kidney failure risk estimates come into play when the following variables have been informed:
- Age
- Sex
- Estimated Glomerular Filtration Rate (eGFR)
- Urine albumin to creatinine ratio
- Serum albumin
- Serum phosphorus
Fill in these parameters on the free online KFRE calculator, and it will provide a valid percentage risk of undergoing kidney failure within 2 and 5 years.
Making the Case: Why KFRE Is So Important
Let’s take this example: a 50-year-old diabetic and hypertensive male with:
- Creatinine: 1.7 mg/dL (eGFR ~45, CKD Stage 3).
- He is noticed to have proteinuria of 4.5 g/day.
- Serum albumin is reported at 3.4 g/dL.
- Phosphorus is at 4.5 mg/dL.
- Bicarbonate at 20 mEq/L.
When KFRE was used, the risk of kidney failure was seen at 8% within the next 2 years and 31.45% within 5 years—certainly a red flag! The guidelines state:
- Greater than 5% risk over 5 years → Refer to nephrologists.
- Greater than 10% risk within 2 years → Schedule team-based care (nephrologist, dietitian, pharmacist).
- Greater than 20-40% risk within 2 years → Rapid planning for transplant or dialysis access.
- The patient has red flags and, therefore, there is an urgent need to refer to nephrology for discussions on how they can play active roles in dealing with the conditions.
Why Is KFRE Important?
Information about patients scared the nephrologists, it is actually meant for the use of physicians and general practitioners. Early recognition of high-risk patients means:
- Timely referrals to specialists
- Better preparedness for dialysis
- Better outcomes for patients
- Reduced burden of healthcare
For the practitioners handling CKD patients, KFRE is the immediate tool. So the next time luck gives way to evidence, use KFRE as the perfect discussion starter, taking away uncertainties and doing justice to the quality of patient care.
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