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Assessing risk of developing chronic kidney disease (CKD)

Klinrisk

Klinrisk is an algorithm based on results from routine blood and urine tests. It generates a score for patients with CKD, to predict the progression of disease before kidney function is lost. The model is built on a foundation of lab data from large national/international population health repositories with published data from health systems.

How is the test performed?

Blood and Urine Samples
Individual tests are performed using patients’ Blood and Urine Samples as per their respective laboratory requirements

FAQs

Chronic Kidney Disease (CKD) is a term used to describe a gradually reduced kidney function lasting for three months or more. It is caused by a number of conditions or diseases that damage kidneys. CKD can range from mild to severe and in some cases can lead to kidney failure which is also called end-stage kidney disease (ESKD). Kidney disease often starts slowly and develops without symptoms over several years. You may not even know you have CKD until your kidney function is quite low. Fortunately, most people do not progress to end-stage kidney disease and when kidney disease is found early, you can take steps to look after your remaining kidney function.

There are two common tests that are used to detect kidney damage and to see how well your kidneys are working.

Blood test: Using a blood sample, a creatinine test measures the level of wastes in your blood, and is used to calculate your estimated glomerular filtration rate (eGFR or just GFR). Your eGFR shows how well your kidneys are working to remove wastes from your body. It is the most common way to measure kidney function. The eGFR number roughly represents the percentage of kidney function remaining.

Urine test: A simple urine test is used to look for protein in your urine. Having protein in urine is usually a sign of kidney disease.
Other blood and urine tests, X-rays, ultrasound or a kidney biopsy may also be needed to diagnose the specific type of kidney disease and to decide the best treatment for you. However, these commonly ordered tests do not always provide sufficient information for adequate prognosis and management of CKD. High risk patients often get treated late and low risk patients get early and inappropriate treatment.
Klinrisk Score*: This score is built for all patients with kidney disease and can help with early identification of patients that are at risk of progressive kidney disease so that kidney disease progression can be prevented for a lifetime. Klinrisk equips health care providers with a powerful tool that assesses the risk of CKD progression so that patients at risk can reduce their chances of developing end-stage kidney disease.
*Please note: Currently, Klinrisk is only available in Ontario

There are different types of kidney diseases and conditions. Some people are born with kidney disease and others develop it as they grow older. Most diseases of the kidney attack the filtering units in the kidney which damages their ability to remove waste and excess fluids. There is no cure for CKD, but it may be possible to prevent it or slow it down. This is especially true in cases of people with diabetes and/or high blood pressure ‒ the leading causes of kidney failure.

You should get tested with Klinrisk if you have:

  • Diabetes
  • High blood pressure
  • Glomerulonephritis (specific diseases causing kidney inflammation)
  • Polycystic kidney disease (a genetic condition)
  • Urinary tract obstruction (blockage of urine from the kidneys)
  • Recurrent kidney stones
  • Drug- and medication-induced kidney problems (illegal drugs and some over-the-counter and prescription medications can damage the kidneys)

Klinrisk is a screening tool for kidney disease in the early stages of disease progression. Your health care provider may order this test if you fall under the high-risk group categories as outlined in the ‘Who should get tested’ section above, or if you begin to develop any of the following symptoms associated with declining kidney function:

  • High blood pressure (hypertension)
  • Puffiness of the eyes, hands and feet
  • Bloody, cloudy or tea-colored urine
  • Excessive foaming of the urine
  • Frequent need to urinate during the night
  • Passing less urine or difficulty urinating
  • Fatigue, difficulty concentrating
  • Loss of appetite or weight
  • Persistent generalized itching

Klinrisk testing is completed by LifeLabs at a Patient Service Centre through collection of routine blood and urine samples. You will require a completed and signed test requisition from your health care provider.

You can download the Klinrisk requisition by clicking here

Please note:

  • The Klinrisk test is currently available at LifeLabs’ locations in Ontario only.
  • The Klinrisk test will be available in BC – in the Spring of 2024

Klinrisk test results will be provided directly to your health care provider for discussion with you. The report will indicate the probability of kidney function loss of up to 40% or kidney failure in the next 5 years. Risk categories and recommendations are also provided to alert patients and health care providers to complications of kidney disease, and associated care pathways recommended by clinical practice guidelines.

The Klinrisk score ranges from 0-100 and is split into the following categories:

  • Low score: 0 to 5% risk over 5 years
  • Medium score: 6 to 24% risk over 5 years
  • High score: 25+% risk over 5 years

Patients with a high Klinrisk score are at increased risk but can work with their health care provider on a care plan focused on improving their kidney health.

FAQs

The Klinrisk algorithm is a machine learning model based on results from routine blood and urine tests. It generates a score for every patient with CKD, helping guide decisions about referrals, treatments, and goals of care, ultimately helping reduce the risk of developing end-stage kidney disease. This algorithm is the next generation solution for prognosis in kidney disease, built on a foundation of lab data from large national and international population health repositories with published complete data from healthcare systems; it predicts the progress of kidney disease before kidney function is lost.

eGFR and albuminuria are essential for diagnosis and staging in CKD, and should be part of screening and ongoing management. Klinrisk score provides prognostic information beyond eGFR and albuminuria, and identifies patients who are at risk of kidney disease progression.

Please note the following important information:

  • Currently, the Klinrisk test is only available in Ontario
  • Klinrisk will be introduced in British Columbia in the second half of 2024
  • The Klinrisk test should not be confused with Kidney Failure Risk Equation (KFRE)
  • KFRE is a freely available equation based on 4 lab tests to determine renal failure risk at later stages of kidney disease progression and will be launched in Ontario in 2024 with the Ontario Renal Network (ORN)
  • Klinrisk is a patient paid test to determine the risk score of kidney failure in the early stages of renal disease, based on the artificial intelligence algorithm that uses the results of 16 lab tests to generate a risk score

To order the Klinrisk test, please download the pre-populated requisition by clicking here

Please note the following:

  • This test is only available for patients who are >/= 18 years of age
  • Please ensure that the information at the top of the requisition is complete including all patient demographics as the Klinrisk test cannot be performed without the patient’s date of birth and sex
  • The following 16 laboratory tests must be ordered to perform the Klinrisk test:
    • Hematology
      • CBC
    • Blood chemistry:
      • Random Glucose
      • Creatinine (eGFR)
      • Urea (BUN)
      • Sodium
      • Potassium
      • ALT
      • Alk. Phosphatase
      • Bilirubin
      • Albumin
      • Calcium
      • Magnesium
      • Chloride
      • Phosphate
      • Carbon Dioxide (Bicarbonate)
    • Urine chemistry:
      • Albumin/Creatinine Ratio
  • Patient should not fast for this test
  • Patient will be required to provide a urine sample
  • Patients can visit any LifeLabs patient service centre to have their blood and urine samples collected

Results are provided within 8 to 10 business days or less once sample is received by the lab.

To download a Klinrisk sample report please click here.

Cost in Ontario
The Klinrisk test is currently an uninsured test in Ontario.
The cost for the Klinrisk test is $65.

Payment may be made by the patient when the blood and urine samples are taken at one of our Patient Service Centres. For convenience, Visa, Mastercard and Debit Cards are accepted.
Patients are encouraged to check with their private healthcare insurer to see if coverage is provided.

Cost in British Columbia
Currently, the Klinrisk test is not available in British Columbia.

We have a wealth of medical experts available to support you in interpreting test results. Consults with our experts are available upon request. Request medical consultation.

Schedule a test
The Klinrisk Score can be scheduled directly by the patient at any of our Patient Service Centres in Ontario.
The patient must have a requisition form completed by a physician or health care provider.

 

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