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The following is a summary of “Analysis of the kidney failure risk equation implementation in routine clinical practice and health inequalities in chronic kidney disease care: a retrospective cohort study,” published in the March 2025 issue of BMC Nephrology by Walker et al. 

NICE recommends using kidney failure risk equation (KFRE) to identify patients with high-risk chronic kidney disease (CKD), requiring albuminuria results. Limited testing hinders its implementation. 

Researchers conducted a retrospective study to assess KFRE implementation in clinical practice and variations in albuminuria testing among patients with CKD. 

They evaluated albuminuria testing rates and KFRE’s predictive performance for 5-year kidney failure risk in patients with CKD. Logistic regression quantified associations between demographic/clinical variables and albuminuria testing. KFRE’s impact on referral timing was retrospectively assessed in patients who developed kidney failure. 

The results showed albuminuria testing in 44.5% of 10,874 adults with CKD. Females (aOR 0.86, 95% CI 0.79–0.93) and those with hypertension (aOR 0.69, 95% CI 0.63–0.77) were less likely to be tested. Testing was higher in those aged 40–50 (aOR 1.83, 95% CI 1.15–2.91), with diabetes (aOR 2.35, 95% CI 2.14–2.58), and in the least deprived areas (aOR 1.11, 95% CI 1.00–1.23). Of 1,352 with incident kidney failure, KFRE use improved early high-risk identification. 

Investigators calculated KFRE for less than half of the people due to insufficient albuminuria testing. They emphasized improving testing and addressing inequities for wider KFRE implementation. 

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-025-04043-0