biostudies-literatureNaranjo FSNational Institute of Diabetes and Digestive and Kidney DiseasesNIDDK NIH HHSUS National Kidney Foundation415-424https://www.ebi.ac.uk/biostudies/studies/S-EPMC8786004biostudies-literatureUnknown2(3)<h4>Background</h4>The four-variable kidney failure risk equation (KFRE) is a well-validated tool for patients with GFR <60 ml/min per 1.73 m² and incorporates age, sex, GFR, and urine albumin-creatinine ratio (ACR) to forecast individual risk of kidney failure. Implementing the KFRE in electronic medical records is challenging, however, due to low ACR testing in clinical practice. The aim of this study was to determine, when ACR is missing, whether to impute ACR from protein-to-creatinine ratio (PCR) or dipstick protein for use in the four-variable KFRE, or to use the three-variable KFRE, which does not require ACR.<h4>Methods</h4>Using electronic health records from OptumLabs Data Warehouse, patients with eGFR <60 ml/min per 1.73 m² were categorized on the basis of Kidney360Estimating Kidney Failure Risk Using Electronic Medical Records.PMC8786004R01DK115534R01DK100446-01R01 DK115534R01 DK100446Levey ASCoresh JNaranjo FSStempniewicz NGrams MESang YBallew SHDunning SCfalseEstimating Kidney Failure Risk Using Electronic Medical Records.<h4>Background</h4>The four-variable kidney failure risk equation (KFRE) is a well-validated tool for patients with GFR <60 ml/min per 1.73 m² and incorporates age, sex, GFR, and urine albumin-creatinine ratio (ACR) to forecast individual risk of kidney failure. Implementing the KFRE in electronic medical records is challenging, however, due to low ACR testing in clinical practice. The aim of this study was to determine, when ACR is missing, whether to impute ACR from protein-to-creatinine ratio (PCR) or dipstick protein for use in the four-variable KFRE, or to use the three-variable KFRE, which does not require ACR.<h4>Methods</h4>Using electronic health records from OptumLabs Data Warehouse, patients with eGFR <60 ml/min per 1.73 m² were categorized on the basis of 2021-01-01T00:00:00Z2021 Mar2025-04-04T07:47:54.171Z2025-04-04T07:47:54.171ZS-EPMC87860043536901410.34067/kid.000559202010.34067/KID.0005592020