Enter age, sex, eGFR and urine albumin-to-creatinine ratio (ACR) to estimate 2-year and 5-year treated kidney failure risk for an adult with chronic kidneydisease (CKD).
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How to use the calculator
- Use this only for an adult with established CKD G3–G5, before kidney replacement therapy. Enter age and the binary sex value used by the published equation.
- Enter eGFR in mL/min/1.73 m² and the urine ACR with the correct unit (mg/g or mg/mmol). The number fields start blank; Fill example adds demonstration values.
- Calculate, then review both time horizons and the model limitations. Preview the report before printing or saving a PDF.
Worked example
For age 70, male, eGFR 36 and urine ACR 170 mg/g, the non-North American 4-variable equation gives approximately 1.91% at 2 years and 7.18% at 5 years. The sample button fills these values, but they do not describe a patient.
Equation and units
Linear predictor = −0.2201 × (age/10 − 7.036) + 0.2467 × (male indicator − 0.5642) − 0.5567 × (eGFR/5 − 7.222) + 0.4510 × (ln[ACR in mg/g] − 5.137). Risk = 1 − baseline survival raised to exp(linear predictor). The non-North American baseline survival is 0.9832 for 2 years and 0.9365 for 5 years. For mg/mmol, the entered ACR is multiplied by 8.84 to obtain mg/g before the natural logarithm. The equation requires a positive ACR; a reported zero needs clarification of the laboratory detection limit.
What the risk means
The endpoint is treated kidney failure (dialysis or transplantation), rather than a fall in eGFR alone. This is an estimate in people with similar values, not an individual diagnosis, death risk or a date for dialysis. The equation was developed for CKD G3–G5; this implementation accepts eGFR 10 to below 60, age 18–110 and ACR greater than zero. These entry bounds help prevent errors; they do not extend the model’s validation. A single abnormal result does not establish chronicity. Discuss changes, repeat measurements and other clinical factors with a clinician.
KDIGO 2024 suggests considering a 5-year risk of 3–5% for referral, a 2-year risk above 10% for multidisciplinary care and above 40% for kidney replacement preparation, alongside eGFR, ACR and other factors. It recommends disease-specific externally validated equations for IgA nephropathy and autosomal dominant polycystic kidney disease. Regional recalibration improved group calibration in multinational cohorts but may still overpredict or underpredict for a particular health system or person.
Frequently asked questions
Can I use a urine dipstick or protein-to-creatinine ratio instead of ACR?
No. Enter a measured urine albumin-to-creatinine ratio. If only dipstick protein or urine PCR is available, ask about an ACR test.
Does the 5-year percentage include the 2-year percentage?
Yes. They are cumulative horizons measured from the same starting point; do not add them.
Can I use this during acute kidney injury, after transplant or while on dialysis?
No. The CKD prediction is inappropriate in those situations. Seek individual clinical assessment.
Related resources
eGFR calculator · Urine ACR calculator · Reading creatinine and eGFR · Urine protein and ACR guide · Health records
Sources
- Tangri et al., JAMA 2016: Multinational assessment of the KFRE
- Major et al., PLOS Medicine 2019: external validation and non-North American calibration
- KDIGO 2024 CKD guideline
- CDC CKD risk calculators
Sources checked 2026-09-30 · General information, not a substitute for care. No independent clinician review is claimed.