What the Klinrisk requisition is for
Klinrisk is a machine learning model that turns routine blood and urine results into a 0 to 100 score for the risk of chronic kidney disease progression. The report gives the probability of losing up to 40% of kidney function, or of kidney failure, over the next five years, with risk categories and suggested care pathways. LifeLabs suggests it for patients with diabetes, high blood pressure, glomerulonephritis, polycystic kidney disease, urinary obstruction, recurrent stones, or drug-related kidney injury.
The form is the standard Ontario laboratory requisition, 4422-84, with the Klinrisk panel written into Other Tests.
Who completes it
The ordering clinician completes and signs it. Some patients print a copy from LifeLabs’ site and bring it to you to sign. The patient doesn’t complete any part.
How to fill in the requisition
Clinician and patient details
Enter your name, address, CPSO or registration number, and a contact number for urgent results. For the patient, give the health number and version, sex, date of birth, phone, address, and names as on the OHIP card. LifeLabs says the score can’t be produced without the date of birth and sex.
Payer
Check one of OHIP/Insured, Third Party/Uninsured, or WSIB. The Klinrisk score itself is uninsured.
Klinrisk panel
The panel is entered in Other Tests, and the form says to enter only the panel test code. It includes CBC, random glucose, creatinine (eGFR), urea, sodium, potassium, ALT, alkaline phosphatase, bilirubin, albumin, calcium, magnesium, chloride, phosphate, bicarbonate, and urine albumin to creatinine ratio. Don’t check those tests again in their own sections.
Signature
Sign and date the form. LifeLabs requires a completed and signed requisition for the collection.
Common reasons it’s delayed
- Date of birth or sex missing, so the score can’t be calculated.
- Panel tests checked individually as well as the panel.
- Unsigned requisition.
- Ordered for a patient who will be tested outside Ontario, where LifeLabs doesn’t offer it.
Submitting and who pays
The patient books or walks in at a LifeLabs patient service centre in Ontario for the blood and urine collection. The patient pays $90 for the Klinrisk score. Results go to you to discuss with the patient.