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Renalytix AI plc

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FY2023 Annual Report · Renalytix AI plc
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2023 ANNUAL REPORT

Life-changing
innovations in early-stage
kidney care prognosis.

FDA De Novo Marketing Authorization. 
Real World Evidence.
Increasing Reimbursement.

                                     
                                                                                             
 
       Index

  STRATEGIC REPORT

Chairman & CEO’s Joint Statement

Company Overview

Operational and Financial Highlights

Product Overview and Strategy

Financial Review

Risk Management Approach

Section 172 Statement

Corporate Social Responsibility Review

 3-26

3

9

10

12

18

20

24

26

 CORPORATE GOVERNANCE 

 27-62

Board of Directors

Directors’ Report

Corporate Governance Statement

Directors’ Remuneration Report and Policy

Audit Committee Report

Independent Auditors’ Report

27

31

35

38

55

57

 FINANCIAL STATEMENTS

 63-94

Consolidated Income Statement

Consolidated Statement of Comprehensive Income

Consolidated and Company’s Statements of Financial Position

Consolidated and Company’s Statements of Cash Flows

Consolidated Statement of Changes in Equity

Company’s Statement of Changes in Equity

Notes to the Financial Statements

Additional Financial Information

63

64

65

67

68

69

70

93

 | Renalytix plc Annual Report and Financial Statements

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STRATEGIC REPORT
Chairman & CEO’s Joint Statement

TO THE MEMBERS OF RENALYTIX PLC

We are pleased to present our annual report for the twelve months ended 30 June 2023 for Renalytix plc (“Renalytix” 
or the “Company”).

This has been a highly productive year for Renalytix.  We have crossed major thresholds in reimbursement, outcomes 
and utility data and received FDA De Novo marketing authorization for kidneyintelX.dkd.  Our progress was further 
amplified by inclusion of KidneyIntelX in the draft of the leading kidney clinical guidelines, KDIGO, for 2023.  It is 
rare to see all of these milestones pass in a short period of time and we believe they are significant for broader adoption 
and clinical acceptance of KidneyIntelX testing for risk assessment of patients with type 2 diabetes and early-stage 
kidney disease in the United States and abroad.

Kidney disease remains one of the costliest and most widespread unmet medical needs of our time.  In the United States 
alone, there are approximately 14 million adults with diabetic kidney disease, which is the intended use population 
authorized by FDA for kidneyintelX.dkd.  Our goal is to make the benefits of early prognosis from KidneyIntelX 
technology accessible to as many of these individuals as possible at an early stage when the benefits of treatment 
strategies and new drug therapies have the greatest chance of success, before the disease irreversibly damages the 
kidneys. 

Importantly, post FDA authorization, we have reviewed our operating cost basis with a view to meaningfully reduce 
our quarterly cash burn rate.   This reduction in cash burn should become apparent in the remainder of our 2024 
financial year and is being undertaken without compromising our sales efforts focused on growing testing volume and 
revenue.  These reductions are on top of our recent year over year operating expense reduction of $11 million.    Post 
FDA authorization, we will also evaluate potential international licensing opportunities and strategic partnerships, both 
of which could provide sources of non-dilutive capital and expanded revenue opportunities for Renalytix. 

KidneyintelX.dkd is now the only prognostic in vitro diagnostic test for assessment of chronic kidney disease 
progression with FDA authorization, with claims reimbursed by a broad array of insurance companies including Blue 
Cross Blue Shield groups, Medicare, and Medicaid, and real-world evidence demonstrating improved outcomes in both 
diabetes and kidney health in the short-term. 

Repeated publication of both outcomes and utility data underpin successful diagnostic launches and the establishment 
of new standards of care. At Renalytix, we have invested heavily in and emphasized real-world evidence since we 
began full operations in late 2018. We were excited to present KidneyIntelX outcomes data that has exceeded our 
expectations by showing that use of KidneyIntelX was associated with clinical actions that in less than 12 months led to 
observed changes in the core measure for diabetes health, as measured by A1C reductions, and kidney health, as 
measured by eGFR slope improvement. We expect more data from our real-world evidence studies over coming 
months.   

Raising funds to fuel these clear commercial opportunities is essential, particularly now that we have reduced risks 
associated with a successful service product launch and adoption.  Toward that end, to maximize our flexibility to fund 
the business growth, we filed an S-3 shelf registration statement to give us the ability to source capital at the right time.  
We will continue to explore less dilutive and non-dilutive capital funding sources, particularly now that we have a 
unique product proposition post-FDA authorization. 

On behalf of everyone at Renalytix, we would like to thank you for your continued support.

Christopher Mills                                              James R. McCullough
Chairman                                                                            Chief Executive Officer

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       3

   
                                      
  INTRODUCTORY NOTE

In this Annual Report, we use the terms “KidneyIntelX”, “KidneyIntelX Technology”, “KidneyIntelX Technology 
Platform” and “kidneyintelX.dkd.” When we refer to KidneyIntelX, we are referring to our diagnostic platform and any 
products developed based on this platform including our KidneyIntelX laboratory developed test currently offered as a 
testing service across the United States from our CLIA certified laboratories. When we refer to kidneyintelX.dkd, we 
are referring to the specific testing service from our KidneyIntelX technology platform or KidneyIntelX technology that 
has received De Novo marketing authorization from the U.S. Food and Drug Administration (FDA) to assess risk of 
progressive kidney function decline in adults with diabetes and early-stage kidney disease.  KidneyintelX.dkd received 
FDA De Novo marketing authorization on June 29, 2023. 

OVERVIEW AND RECENT DEVELOPMENTS

Renalytix is focused on providing doctors around the world with a safe, reliable and effective tool to identify which 
patients are or are not in danger of losing significant kidney function and falling into kidney failure and may require 
long-term dialysis or kidney transplant.  Chronic kidney disease is one of the largest urgent medical needs, globally 
affecting an estimated 850 million people, and is responsible for an unsustainable and growing societal cost burden.  

We believe an important part of the answer is preventative medicine and the ability to identify individuals with 
advancing chronic kidney disease early, where new drug therapies and clinical strategies have the optimal chance to 
stop uncontrolled disease progression.   

At Renalytix, we developed kidneyintelX.dkd, the first U.S. Food and Drug Administration ("FDA"), authorized in 
vitro prognostic test that uses an artificial intelligence-enabled algorithm to aid in assessment of the risk of progressive 
decline in kidney function.  The test is designed to predict early in the progression of kidney disease who is at risk for 
significant sustained decline in kidney function.  Prognostic tests, such as kidneyintelX.dkd, are not intended for 
diagnosing any disease or for monitoring disease progression or the effect of any therapeutic product.  Rather, 
prognostic tests are intended to be used in conjunction with other clinical and diagnostic findings and consistent with 
professional standards of practice, including information obtained by alternative methods, and clinical evaluation, as 
appropriate.  When used as intended, potential interventions can be considered early, ideally before major damage is 
done and when treatments can be most effective. KidneyintelX.dkd is part of a family of clinical tests being developed 
from the KidneyIntelX technology platform developed using technology licensed from the Icahn School of Medicine at 
Mount Sinai in New York, the Joslin Diabetes Center in Boston and under development through U.S. and international 
collaborations. 

This past year has seen the achievement of milestones necessary to begin broad commercial expansion of the use of the 
KidneyIntelX technology in select regions of the United States with high rates of diabetes and kidney disease. Key 
milestones include achieving FDA De Novo marketing authorization, a significant expansion of commercial insurance 
coverage at the Medicare national payment rate of $950 per test, publication of real world outcomes data and real world 
utility data, training and deployment of a core sales force, and inclusion in the draft of the leading kidney clinical 
guidelines.

On June 29, 2023, the first FDA positive decision on a KidneyIntelX technology platform clinical test was achieved 
with De Novo marketing authorization issued to kidneyintelX.dkd for the assessment of risk of progressive kidney 
function decline in adults with diabetes and early-stage kidney disease (also referred to as diabetic kidney disease 
("DKD").  An estimated 14 million Americans adults currently fall within the FDA authorized indicated use population 
for kidneyintelX.dkd.  

Renalytix believes that with FDA marketing authorization, kidneyintelX.dkd has achieved a number of industry firsts 
that may have significant implications for current clinical use and development of new applications to provide advanced 
prognostic tests and monitoring in widespread or highly prevalent chronic diseases such as kidney disease and diabetes. 
Among the core kidneyintelX.dkd innovations that support our ability to provide safe, regulated and insurance 
reimbursable tests are 1) use of a non-linear or machine learning algorithm, 2) validation of an endpoint of progressive 
and sustained decline in estimated Glomerular Filtration Rate (eGFR), 3) use of novel disease blood biomarkers with 
demonstrated prognostic performance in multiple studies, and 4) incorporation of electronic health record (EHR) 
features, specifically laboratory measurements that are not measured in Renalytix laboratories.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       4

We believe that collectively these innovations, which have undergone FDA regulatory review and which have now 
been contracted for payment by multiple major insurance companies in the United States including Medicaid, Medicare 
and Blue Cross Blue Shield entities, provide kidneyintelX.dkd with the foundation to establish a broadly used standard 
for early prognosis to help clinicians address the threat posed by uncontrolled diabetic kidney disease.  We have 
established coverage pricing for KidneyIntelX technology at or above $950 per reportable result for base-line 
prognosis. To date we have executed over 40 commercial payor contracts at or above this price and enrolled as a 
provider in 35 state Medicaid programs.   

Further, KidneyIntelX has been included in the draft Kidney Disease Improving Global Outcomes (KDIGO) 2023 
Clinical Practice Guideline for Evaluation and Management of Chronic Kidney Disease.  KDIGO guideline 
development follows an explicit process to translate global scientific evidence review and appraisal into practical 
recommendations for clinicians and patients. The final version of these kidney disease guidelines is expected to be 
released in the fourth calendar quarter of 2023.  

Most importantly, these significant milestones in the diagnostic product lifecycle would not be achievable without 
establishing a comprehensive, peer reviewed portfolio of data publications covering four key areas: 1) clinical 
outcomes, 2) clinical utility, 3) economics, and 4) performance validations.  Since Renalytix achieved its first large 
capital infusion from listing on the London Stock Exchange nearly five years ago, we have invested heavily in these 
core categories of proof in support of the KidneyIntelX technology and believe we have exceeded standards for 
delivering a validated data portfolio necessary to support broad-scale clinical use and insurance reimbursement.  Most 
recently, a late-breaking clinical data release at the 83rd American Diabetes Association Scientific Sessions in July 
2023 demonstrated that KidneyIntelX in vitro prognostic use was associated with clinical actions that in less than 12 
months led to improvements in both diabetes health, as measured by hemoglobin A1C reductions, and kidney health, as 
measured by eGFR slope improvement in patients with diabetic kidney disease. We believe that these observed 
improvements in both diabetes and kidney outcomes will continue to have a positive impact on the commercial 
prospects of KidneyIntelX technology.   

Our commercial model is now focused on expanding clinical use in a limited group of regions in the United States with 
high rates of adult diabetes, where we have established comprehensive insurance coverage - ideally with greater than 
90% of our indicated use population with insurance coverage, and where there are hospital system partners available to 
enable outreach to large groups of treating primary care physician practices.  Into these limited regions, we are 
deploying a direct-to-physician sales force.  As we continue to demonstrate  revenue growth and adoption, we will 
continue to add regions where the kidneyintelX.dkd service provision can demonstrate specific return-on-investment 
targets and revenue growth.   

We believe our model of deploying KidneyIntelX technology directly into the electronic medical record systems in 
partnership with large integrated disease network hospital systems, such as our announced partners Mount Sinai Health 
System in New York and Atrium Wake Forest in North Carolina, has demonstrated significant advantages in 
simplifying test ordering and score reporting, driving awareness and use, and unleashing the full capabilities of the 
clinical care pathway to help slow or stop kidney disease progression and mitigate long-term cost of care.  We and our 
third-party hospital partners have continued to publish on the evidence of real-world benefits of this coordinated 
approach to enabling advanced prognosis and care management across broad primary care practices and diverse patient 
populations.  These real-world evidence results continue to consistently validate the use of KidneyIntelX technology to 
combat this large unmet medical need.  We also believe coordinated partnerships with hospital systems are key to 
leveraging the high fixed cost associated with effective sales force build and management that can potentially lead to 
significantly higher investment yield, ultimately increasing patient access to the benefits of innovative technology such 
as the FDA authorized kidneyintelX.dkd. 

Kidney disease is a worldwide public health crisis, resulting in more deaths per year than breast or prostate cancer. The 
National Kidney Foundation (the "NKF"), estimates that one-third of adults in the United States are at risk of 
developing kidney disease. Advanced kidney disease is generally not reversible and, once the disease progresses to 
kidney failure, the only available treatments are long-term dialysis or kidney transplant. In 2019, more than 809,000 
patients had end-stage kidney disease ("ESKD"), with more than 566,000 requiring dialysis at least three times a week. 
More than 131,000 patients begin dialysis each year to treat ESKD. Once on dialysis, patients typically experience a 
five-year mortality rate of up to 65%, about the equivalent rate for brain cancer. Furthermore, transplants are expensive 
and uncertain. As of 2022, about 92,000 Americans were on the waiting list to receive a kidney transplant and six 
patients die in the United States while waiting for a kidney transplant every day. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       5

Moreover, the kidney disease crisis is continuing to grow along with the increased prevalence of contributing risk 
factors. One of the most significant risk factors for developing CKD is diabetes. It is estimated that there are 
approximately 14 million adults with DKD in the United States, and DKD is the most common cause of ESKD in most 
developed countries. Obesity is believed to account for 80% to 85% of the risk of developing type 2 diabetes. The 
worldwide prevalence of obesity nearly tripled between 1975 and 2016. Further, according to a 2019 study from the 
Harvard T.H. Chan School of Public Health, by 2030, it is estimated that about half of the U.S. adult population will be 
classified as obese and about a quarter as severely obese. This significant projected increase in the prevalence of obesity 
is expected to continue to drive an increase in diabetes, CKD, DKD and ESKD. 

Managing a CKD population of this scale and the associated healthcare spending presents a unique healthcare system 
challenge, requiring a solution that provides a clearer understanding of clinical risk which can inform specific 
guideline-driven clinical actions. The ability to predict which patients will experience progressive and sustained kidney 
function decline or kidney failure (requiring initiation of long-term dialysis or kidney transplant), is critical to changing 
patient outcomes and health economics. Other methods for risk stratification of patients with CKD lack sufficient 
precision in predicting progressive kidney function decline, especially at earlier stages of the disease. This can 
exacerbate the occurrence of unexpected and expensive clinical events. In fact, up to 38% of patients with CKD initiate 
dialysis with little or no prior clinical specialist consultation, and up to 63% of patients with CKD initiate dialysis in an 
unplanned fashion with a central venous catheter and/or during emergency hospitalization, which we refer to as 
“dialysis crash.” This highlights the need for a mechanism to identify potential instances of rapidly progressing CKD 
before it becomes critical to the patient’s health and costly to healthcare providers.

KidneyIntelX technology addresses this challenge as a first-in-class, artificial intelligence-enabled prognostic testing 
platform to help guide care management for adults with DKD. KidneyintelX.dkd  provides prognostic risk stratification 
using three discrete risk levels (low, moderate, and high). This result provides timely information on patient risk for 
progressive decline in kidney function within five years, providing independent information from the current standard 
of care measures and can be readily deployed at the primary care level where the vast majority of patients with early-
stage disease are being treated. 

Early detection and intervention can result in health economic benefits in three key areas: (1) slowing progression to the 
next stage of DKD, (2) delaying or preventing progression to ESKD and the need for dialysis or kidney transplant and 
(3) avoiding dialysis crashes. According to an independent review commissioned by Boston Healthcare Associates, 
based on the Medicare established price of $950 per reportable test, successful incorporation of the KidneyIntelX 
technology could generate a positive return for health insurers in 12-24 months and deliver cost savings of up to $1.1 
billion over five years per 100,000 patients with DKD, when considering these key areas of benefit. 

Our executive team has an average of 25 years’ experience in different professional disciplines including 
bioinformatics, digital health, data security, market access, commercial operations, medical affairs, insurance 
reimbursement, FDA regulation and International Organization for Standardization ("ISO"), quality management 
systems, population health, clinical medicine, finance and health economics. We believe the integration of such diverse 
experience is essential to understanding the complex dynamics of deploying a new technology into the highly regulated 
world of patient clinical care, and we have assembled our team specifically with this multi-disciplinary approach in 
mind. 

We also benefit from the extensive experience of our board of directors, our clinical investigators and medical advisory 
board of world-leading experts in kidney disease. 

Financing

On February 9, 2023, the Company entered into security purchase agreements to sell an aggregate of 3,699,910 
Ordinary Shares, and 7,511,525  ADS, at a price of $2.17 per ADS and £0.90 per Ordinary Share. The private placement 
generated gross cash proceeds of $20.3 million, the net proceeds of which will be used for sales and marketing, clinical 
product development, and corporate support and financing costs. Certain related parties, directors of the company and 
executive officers participated in the private placement.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       6

Clinical Evidence 

Clinical outcomes, clinical utility, validations, and health economics data were published and/or presented in multiple 
scientific venues including the American Society of Nephrology Kidney Week 2022, the National Kidney Foundation 
Spring Clinical Meeting 2023, American Diabetes Association 83rd Scientific Session in June 2023, and American 
Association of Nurse Practitioners Annual Meeting in June 2023. Study conclusions presented included data from the 
Wake Forest Real World Evidence cohort, The Mount Sinai Health System Real Evidence World cohort, the Mount 
Sinai BioMe Biobank program, the UPenn Medicine Biobank program, the Janssen CANVAS SGLT2i clinical trial 
cohort, and the Veterans Affairs Department Database. Published and/or presented data included detail on the 
KidneyIntelX technology platform, the KidneyIntelX laboratory developed test, and the FDA De Novo authorized 
kidneyintelX.dkd test. Presentations during the financial year included:

▪

American Society of Nephrology Kidney Week 2022





A Markov model that estimated the incremental cost-effectiveness of KidneyIntelX compared to risk 
stratification using eGFR and UACR, with a lifetime horizon from both a public and private payer 
perspective, demonstrated that population-based KidneyIntelX testing for the prognosis of progression in a 
DKD G1-G3b population is a cost-effective strategy for both Medicare and commercial populations in 
comparison to prognosis relying on eGFR and UACR alone. The analyses projected that the average 
Medicare and Commercial patient population would experience fewer dialysis starts and kidney transplants 
while experiencing an increased life span and quality-adjusted life span by using KidneyIntelX compared to 
the standard of care. 

The clinical impact of the KidneyIntelX risk score was assessed in patients with T2D and early-stage CKD 
in the Wake Forest Health System. Initial results suggested that despite similar median eGFR and median 
UACR levels, African American patients tested with KidneyIntelX were three times more likely to be 
scored as high risk. KidneyIntelX may allow PCPs and healthcare systems to optimize the allocation of 
treatments and clinical resources to those at highest risk, beyond traditional clinical metrics and potentially 
improve equity in outcomes.

▪

National Kidney Foundation Spring Clinical Meeting 2023





In an expanded analysis of clinical utility and impact study from Wake Forest Health System, KidneyIntelX 
classified more Black vs non-Black patients as high risk for progression of diabetic kidney disease, and this 
was associated with in increased prescription of SGLT2-inhibitor drug therapy post-testing, contributing to 
elimination of disparity in SGLT2i usage in Blacks vs. non-Blacks.

In a retrospective cohort study of all U.S. veterans with DKD (n>685,000) treated in the VHA between 
01/2016 and 03/2022, analyses demonstrated that the majority of veterans with DKD were only first 
diagnosed once they had stages G3a or G3b CKD, which implies that clinical practice and lab test intervals 
predating VHA’s Directive 1053 may not optimally identify DKD patients (nearly half of DKD should be 
represented by G1-G2/A2-A3 staging according to the National Health and Nutrition Examination Survey 
("NHANES"). 

▪

American Diabetes Association 83rd Annual Meeting

o

o

In analyses from the Mount Sinai Health System, real world data on 2,317 patients that had KidneyIntelX 
test results with at least 12 months of post-test follow-up data demonstrated that deployment and risk 
stratification by KidneyIntelX was associated with escalation in actions taken to optimize cardio-metabolic-
kidney health including medications and referrals. Moreover, glycemic control and eGFR slopes improved 
post-KidneyIntelX testing, with the largest improvements observed in those scored as high-risk.

In the presentation entitled “Derivation and Independent Validation of kidneyintelX.dkd”, the FDA 
authorized kidneyintelX.dkd was trained in the UPenn Biobank cohort and validated in an external cohort 
(BioMe), with excellent performance characteristics, and was robustly prognostic after adjustment for key 
demographics and clinical variables (adjusted HR for high vs. low 7.7 and 3.7 for intermediate vs. low 
risk), with consistent performance across diverse subgroups of the intended use population. The cumulative 
incidence of accelerated progression of kidney function decline was approximately 2/3rds of the high-risk 
group (67%, 95% CI 49% - 84%), and the rates of eGFR decline in the low risk group were comparable to 
that of normal physiologic aging.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       7

▪

American Association of Nurse Practitioners Annual Meeting

o

In a subset of patients tested with KidneyIntelX in the Mount Sinai Health System, 988 were successfully 
contacted by the Nurse Practitioners on the DKD Care Navigation Team at Mount Sinai and completed a 
post-test survey which demonstrated enhanced patient understanding about kidney disease, and revealed 
substantial motivation to take appropriate actions and receive further education for their kidney health, 
including consultations with dietitians. 

 Peer-reviewed publications during the year: 

▪

▪

▪

The Journal of Primary Care and Community Health.  Publication of real-world evidence in Journal of Primary 
Care and Community Health in which KidneyIntelX resulted in a 4.5-fold increase in new drug prescriptions (for 
SGLT2 inhibitors) for high-risk compared to low-risk patients; early evidence suggested that the introduction of 
SGLT2i contributed to an observed reduction in HbA1c levels most notably in high-risk patients, and a more than 
a 20% change in dose or type of antihypertensive therapeutic prescriptions in high vs. low-risk patients.

Diabetic Nephropathy.  Publication of new patient case studies in the journal Diabetic Nephropathy demonstrated 
how KidneyIntelX can optimize clinical management in early-stage kidney disease across multiple physician 
specialties. 

Diabetes, Obesity, and Metabolism.   Acceptance and online publication of the new validation data for 
kidneyintelX.dkd in the journal Diabetes, Obesity, and Metabolism in Sept 2023. Using data from two 
independent cohorts and a clinical trial population, it was demonstrated kidneyintelX.dkd significantly enhanced 
risk stratification for progressive decline in kidney function, independent from known risk factors for progression.  

  Current Trading and Outlook

We believe FDA authorization, positive utility and outcomes data, our physician and patient education programs, and 
comprehensive reimbursement puts us on a path towards kidneyintelX.dkd becoming broadly used across the United 
States among the 14 million Americans with diabetic kidney disease, and ultimately within the global market of 850 
million people with chronic kidney disease.  We are proud of the rapid pace of these achievements just five years 
from our company’s inception.  

Our real-world evidence data is comprehensive and shows clear benefit.  With FDA De Novo marketing authorization 
in June, kidneyintelX.dkd will become available commercially later in this financial year and we expect to see growth 
in adoption. The social need could not be higher to establish the innovative preventative medicine strategies that 
KidneyIntelX technology enables at the front-end of diabetes and kidney disease. 

During fiscal 2023 over 5,000 KidneyIntelX tests were performed, which was up 55% from the prior year. We expect 
a meaningful increase in total tests during the remainder of fiscal 2024, building on quarterly test volumes of about 
1,200 during fiscal 2023 and through first quarter of 2024.  More than half of these during the first quarter of 2024 
thus far are revenue generating, with a set of the Mount Sinai clinical trial tests no longer billable following last 
spring’s transition to full commercial payment at the hospital system. We are encouraged by the continued adoption 
by physicians beyond Mount Sinai.  With the launch of the FDA-authorized kidneyintelX.dkd expected later this 
fiscal year, the enhancement of our direct to physician sales force, and new hospital partners such as Atrium / Wake 
Forest commencing commercial testing before year-end, we expect to see accelerating billable testing volume growth.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       8

 
                                             
 
Company Overview

PIONEERING NEXT-GENERATION TECHNOLOGY SOLUTIONS FOR KIDNEY 
HEALTH

Renalytix is the global founder and leader in the new field of bioprognosisTM  for kidney health. The Company has 
engineered a new solution that enables early-stage chronic kidney disease progression risk assessment.  The Company’s 
lead product, KidneyIntelX, has been granted Breakthrough Designation by the U.S. Food and Drug Administration 
(FDA) and is designed to help make significant improvements in kidney disease prognosis, transplant management, 
clinical care, patient stratification for drug clinical trials, and drug target discovery.

Renalytix is focused on optimizing clinical management of kidney disease to drive improved patient outcomes and 
lower healthcare costs. KidneyIntelX, our first-in-class in vitro diagnostic platform, employs a proprietary algorithm 
that combines diverse data inputs, including validated blood-based biomarkers, inherited genetics and personalized 
patient data from electronic health record, or EHR, systems, to generate a unique patient risk score. This patient risk 
score enables prediction of rapid progressive kidney function decline in chronic kidney disease, or CKD, allowing 
physicians and healthcare systems to optimize the allocation of treatments and clinical resources to patients at highest 
risk.

ON A MISSION TO COMBAT A DEVASTATING AND COSTLY DISEASE

Kidney disease is a public health epidemic affecting over 850 million people globally. Managing a CKD population 
of this scale and the associated healthcare spending presents a unique healthcare system challenge, requiring a 
solution that provides a clearer understanding of clinical risk tied to specific guideline-driven clinical 
recommendations. The ability to predict which patients will experience progressive kidney function decline, which 
includes rapid kidney function decline, or RKFD, sustained significant decline in kidney function, kidney failure, 
initiation of long-term dialysis or kidney transplant, is critical to changing patient outcomes and health economics. 
Current methods for risk stratification of patients with CKD lack sufficient precision in predicting progressive 
kidney function decline, especially at earlier stages of the disease. This can exacerbate the occurrence of unexpected 
and expensive clinical events. In fact, up to 38% of patients with CKD initiate dialysis with little or no prior clinical 
specialist consultation, and up to 63% of patients with CKD initiate dialysis in an unplanned fashion with a central 
venous catheter and/or during emergency hospitalization, which we refer to as “dialysis crash.”  This highlights the 
need for an early mechanism to identify potential instances of rapidly progressing CKD before it becomes critical to 
the patient’s health and costly to healthcare providers. 

We have now validated KidneyIntelX in multiple distinct studies, involving specimens from thousands of patients with 
DKD.  In all studies, KidneyIntelX has demonstrated the ability to more accurately identify which patients would 
experience rapid progressive kidney function decline over current clinical practice.  We believe early risk stratification, 
using advanced technology implemented in partnership with healthcare systems and insurance payors, can help support 
a fundamental shift towards optimal treatment for the over 850 million people suffering from kidney disease 
worldwide.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       9

 
Operational and Financial Highlights
Including post-period events

REGULATORY & REIMBURSEMENT 

▪

▪

▪

▪

▪

▪

▪

▪

Achieved FDA De Novo marketing authorization for kidneyintelX.dkd to assess risk of progressive kidney 
function decline in adults with diabetes and early-stage kidney disease.

Secured additional key insurance coverage contracts for KidneyIntelX including:







EmblemHealth, covering over three million lives in New York Tri-state region

CareFirst BlueCross BlueShield, the largest health care plan in the U.S. Mid-Atlantic region         

Texas Blue Cross Blue Shield and Parkland Community Health Plan covering over seven million lives 

Since announcement of FDA authorization in June 2023, engagement with various parties regarding benefits of 
KidneyIntelX technology has expanded

Inclusion of KidneyIntelX in draft Kidney Disease Improving Global Outcomes (KDIGO) 2023 Clinical Practice 
Guideline for Evaluation and Management of Chronic Kidney Disease (KDIGO 2023 Guideline) 

Continuing to maintain contracted pricing at or over the Medicare Clinical Laboratory Fee Schedule (CLFS) of 
$950 per reportable test result

Initial Medicare payments for KidneyIntelX received





Certain claims submitted through the individual claims review (ICR) process paid effective July 1, 2022

Local Coverage Determination (LCD) evaluation underway with two Medicare Administrative Contractors 
supported by new published real-world utility evidence

Executed over 40 commercial payor contracts and enrolled as a provider in 35 state Medicaid programs to date

Milestone achievement converting payment to full, long-term commercial insurance billing model at Mount Sinai 
Health System





Insurance payment now available for over 90% of KidneyIntelX eligible Mount Sinai patients 

Although Mount Sinai test volumes declined during the transition to commercial insurance billing in the 
second half of fiscal 2023, order mechanisms are now restored and commercial testing has resumed

COMMERCIAL & PARTNERSHIPS 

▪

▪

▪

▪

▪

▪

Appointed senior diagnostics executive Howard Doran to lead global commercial sales beginning with direct to 
physician salesforce in New York, Illinois, North Carolina, Florida and Texas 

Full Epic electronic health record system integration with Atrium / Wake Forest proceeding with launch expected 
before end of calendar 2023

Selected EVERSANA® to supplement identification and training of sales personnel in select U.S. regions



Accelerates deployment of KidneyIntelX across key U.S. regions with high rates of diabetic kidney disease 
and established insurance coverage

Agreement with Veterans Affairs (VA) to integrate KidneyIntelX testing with Veterans Health Administration 
electronic health record system

Core participant in consortium granted $10 million by Horizon Europe Grant to advance personalized medicine in 
treating chronic kidney disease

Increasing diversity of commercially billable testing volume, particularly among primary care physician practices 
ordering through the MyIntelX portal

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       10

CLINICAL & VALIDATION 

▪

Studies regarding KidneyIntelX clinical utility and health economics presented in multiple scientific venues:









American Society of Nephrology Kidney Week 2022

National Kidney Foundation Spring Clinical Meeting 2023

American Diabetes Association 83rd Scientific Session in June 2023

American Association of Nurse Practitioners Annual Meeting in June 2023

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Key takeaways:

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A model that estimated the incremental cost-effectiveness of KidneyIntelX compared to risk stratification 
using eGFR and UACR, with a lifetime horizon from both a public and private payer perspective, predicted 
that the average Medicare and commercial patient would experience fewer dialysis starts and kidney 
transplants while experiencing an increased life span and quality-adjusted life span by using KidneyIntelX 
compared to the standard of care.

Deployment and risk stratification by KidneyIntelX was associated with escalation in clinical actions taken 
to optimize cardio-metabolic-kidney health including medications and referrals.

KidneyIntelX classified more Black vs. non-Black patients as high risk for progression of diabetic kidney 
disease, and this was associated with increased prescription of SGLT2-inhibitor drug therapy post-testing, 
contributing to elimination of racial disparity in SGLT2i usage.

Data includes studies from Wake Forest real world cohort, Mount Sinai real world cohort, Mount Sinai BioMe 
Biobank, UPenn Medicine Biobank, the CANVAS clinical trial cohort, and the Veterans Affairs Database

Publications:

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Real-world evidence in Journal of Primary Care and Community Health in which KidneyIntelX resulted in 
a 4.5-fold increase in new drug prescriptions (for SGLT2 inhibitors) for high-risk compared to low-risk 
patients; early evidence suggested that the introduction of SGLT2i contributed to an observed reduction in 
HbA1c levels most notably in high-risk patients, and a more than a 20% change in dose or type of 
antihypertensive therapeutic prescriptions in high vs. low-risk patients

Patient case studies in the journal Diabetic Nephropathy demonstrated how KidneyIntelX can optimize 
clinical management in early-stage kidney disease across multiple physician specialties 

New validation data for kidneyintelX.dkd, the FDA approved version of KidneyIntelX, in the journal 
Diabetes, Obesity, and Metabolism. Using data from two independent cohorts and a clinical trial 
population, it was demonstrated that the updated KidneyIntelX test significantly enhanced risk stratification 
for progressive decline in kidney function, independent from known risk factors for progression.  

FINANCE & OPERATIONS 

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Completed $20.3 million equity financing led by new institutional investors in February 2023

Reduced annual operating expenses by over $11 million versus the prior year with additional cost reduction 
initiatives underway to extend cash runway while preserving revenue generating activity

Over 5,000 KidneyIntelX tests performed in financial year 2023, up 55% from the prior year

Expanded board of directors with addition of financial executive Catherine Coste

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       11

 
Product Overview and Strategy

THE KIDNEYINTELX MODEL

At the core of our approach is an artificial intelligence-enabled algorithm capable of synthesizing a set of current and 
diverse data inputs, such as biomarkers, EHR data, genomics, patient-generated digital data, environmental information, 
clinical utility, and actuarial and clinical compliance information. 

Proprietary blood-based biomarkers 

Blood-based biomarkers are typically genes or proteins that indicate the existence and severity of certain conditions 
(such as kidney disease) and can be measured from a simple blood sample. KidneyIntelX includes inputs from three 
specific blood-based biomarkers that have previously been examined in several academic and clinical study settings as 
reported in scientific publications. These publications support consistent associations of soluble Tumor Necrosis Factor 
Receptor (sTNFR) 1 and 2 and plasma Kidney Injury Molecule-1 ("KIM-1"), with reliable independent predictive signals 
for kidney disease progression in DKD patients. We licensed the patented sTNFR1 and sTNFR2 biomarkers from the 
Joslin Diabetes Center of Harvard University because of this evidence of their predictive capabilities. KidneyintelX.dkd 
measures these biomarkers using a proprietary, analytically validated multiplex format with reliable inter- and intra-assay 
results. We are exploring additional biomarkers, including both proteomic and genomic based, from blood, urine and 
other biological samples for subsequent KidneyIntelX technology platform service offerings that could support enhanced 
predictive performance and expand indicated uses. 

Electronic health records data harmonization, adjudication and machine learning 

The use of EHRs has been adopted broadly by hospital systems in the United States, the United Kingdom, the European 
Union and other developed countries. EHR data are generally collected during routine clinical encounters and contain 
detailed information on disease and treatment patterns. When assessed in the aggregate, EHR data can provide insights 
into disease progression and clinical management strategies across diverse populations. EHR factors may include items 
such as current or past therapeutic regimes, diagnostic results, weight, age, geographic location, physician visiting habits 
and physician annotations. Additional data factors can be added to the KidneyIntelX technology algorithms to address 
different target populations. 

Through experience with our clinical study work, we have developed proprietary data processing methods that enables us 
to analyze patient data collected during clinical encounters by a diverse set of physicians in different clinical 
environments and still ensure that the data used by the KidneyIntelX technology platform to support product 
development and clinical testing is consistent and falls within specific quality control metrics. We have tested this 
capability in our clinical validation studies involving stored specimens from over 2000 patients with DKD from the 
Mount Sinai Health System and University of Pennsylvania Health System biobanks. 

▪

▪

▪

EHR Data Harmonization. EHR data from different institutions can be entered and stored in different formats. To 
overcome this significant limitation, we have developed proprietary algorithms to convert the diverse data 
(specifically laboratory values and medication names) and map to a standardized template. 

Clinical Adjudication. Kidney function can fluctuate over time and can vary in different clinical scenarios. In the 
clinical validation studies, to ensure that the kidney disease outcomes for kidneyintelX.dkd and future service 
offerings were accurately classified and did not represent random non-disease variation, all kidney function 
changes over time and all clinical outcomes were adjudicated by examining the trajectory of kidney function over 
their longitudinal course of treatment to the outcome. This adjudication and knowledge base has been codified 
into the overall workflow for KidneyIntelX technology versioning and validation. 

Machine Learning. We use a proprietary machine learning-enabled algorithm to integrate the diverse inputs from 
biomarker data and harmonized EHR data to achieve increased predictive performance over the current metrics 
for prediction of kidney disease progression. 

In addition, the KidneyIntelX technology risk score may, at the sole discretion of the clinical user, be tied to specific clinical 
guideline recommendations developed by the healthcare system, health insurance providers or practice groups. This care 
pathway is expected to include elements such as targets for clinician visits and referrals, blood pressure control, diabetes 
control and prescription of specific medications, as well as patient behavior, such as appropriate diet, exercise, weight loss, 
medication adherence, to provide immediate and actionable steps related to kidney health. We also plan to link reportable 
results to educational modules on kidney disease for patients to improve awareness and influence lifestyle practices. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       12

Seamless integration with electronic health record systems for test ordering and reporting results 

KidneyIntelX is designed to interface with EHR systems in order to securely access the information required for each ordered 
test, which is then combined with biomarker data to generate the risk score and test report. The test result is reported directly 
to the ordering physician through the EHR system. 

In this way, the treating physician can have all of the relevant information pertinent to the patient’s care delivered to them at 
the time of the clinical encounter and can trigger care pathways directly from the EHR interface, with the goal of driving a 
virtuous cycle in which patients and clinicians have increased visibility and awareness changes in care management and 
patient behavior on kidney health. 

All personal health information captured by the kidneyintelX.dkd application is at all times stored in secure Microsoft Azure-
supported cloud infrastructure and is encrypted using Advanced Encryption Standard. All transfers of data and reports 
through firewalls of the health system are executed using secure transfer protocols in accordance with internationally accepted 
Transport Layer Security versions 1.2 and 1.3. Security components also include rigid authentication and authorization of all 
users, a continuous monitoring tool, intrusion detection system and periodic penetration testing to mitigate risks of cyber-
attacks. 

At the core of our approach is an artificial intelligence-enabled algorithm capable of synthesizing a set of current and 
diverse data inputs, such as biomarkers, EHR data, genomics, patient-generated digital data, environmental information, 
clinical utility, and actuarial and clinical compliance information. 

Proprietary blood-based biomarkers 

Blood-based biomarkers are typically genes or proteins that indicate the existence and severity of certain conditions (such 
as kidney disease) and can be measured from a simple blood sample. KidneyIntelX includes inputs from three specific 
blood-based biomarkers that have previously been examined in several academic and clinical study settings as reported in 
scientific publications. These publications support consistent associations of soluble Tumor Necrosis Factor Receptor 
(sTNFR) 1 and 2 and plasma Kidney Injury Molecule-1 ("KIM-1"), with reliable independent predictive signals for kidney 
disease progression in DKD patients. We licensed the patented sTNFR1 and sTNFR2 biomarkers from the Joslin Diabetes 
Center of Harvard University because of this evidence of their predictive capabilities. KidneyintelX.dkd measures these 
biomarkers using a proprietary, analytically validated multiplex format with reliable inter- and intra-assay results. We are 
exploring additional biomarkers, including both proteomic and genomic based, from blood, urine and other biological 
samples for subsequent KidneyIntelX technology platform service offerings that could support enhanced predictive 
performance and expand indicated uses. 

Electronic health records data harmonization, adjudication and machine learning 

The use of EHRs has been adopted broadly by hospital systems in the United States, the United Kingdom, the European 
Union and other developed countries. EHR data are generally collected during routine clinical encounters and contain 
detailed information on disease and treatment patterns. When assessed in the aggregate, EHR data can provide insights 
into disease progression and clinical management strategies across diverse populations. EHR factors may include items 
such as current or past therapeutic regimes, diagnostic results, weight, age, geographic location, physician visiting habits 
and physician annotations. Additional data factors can be added to the KidneyIntelX technology algorithms to address 
different target populations. 

Through experience with our clinical study work, we have developed proprietary data processing methods that enables us 
to analyze patient data collected during clinical encounters by a diverse set of physicians in different clinical environments 
and still ensure that the data used by the KidneyIntelX technology platform to support product development and clinical 
testing is consistent and falls within specific quality control metrics. We have tested this capability in our clinical 
validation studies involving stored specimens from over 2000 patients with DKD from the Mount Sinai Health System 
and University of Pennsylvania Health System biobanks. 

▪

▪

EHR Data Harmonization. EHR data from different institutions can be entered and stored in different formats. 
To overcome this significant limitation, we have developed proprietary algorithms to convert the diverse data 
(specifically laboratory values and medication names) and map to a standardized template. 

Clinical Adjudication. Kidney function can fluctuate over time and can vary in different clinical scenarios. In 
the clinical validation studies, to ensure that the kidney disease outcomes for kidneyintelX.dkd and future 
service offerings were accurately classified and did not represent random non-disease variation, all kidney 
function changes over time and all clinical outcomes were adjudicated by examining the trajectory of kidney 
function over their longitudinal course of treatment to the outcome. This adjudication and knowledge base has 
been codified into the overall workflow for KidneyIntelX technology versioning and validation. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       13

▪

Machine Learning. We use a proprietary machine learning-enabled algorithm to integrate the diverse inputs 
from biomarker data and harmonized EHR data to achieve increased predictive performance over the current 
metrics for prediction of kidney disease progression. 

In addition, the KidneyIntelX technology risk score may, at the sole discretion of the clinical user, be tied to specific 
clinical guideline recommendations developed by the healthcare system, health insurance providers or practice groups. 
This care pathway is expected to include elements such as targets for clinician visits and referrals, blood pressure control, 
diabetes control and prescription of specific medications, as well as patient behavior, such as appropriate diet, exercise, 
weight loss, medication adherence, to provide immediate and actionable steps related to kidney health. We also plan to 
link reportable results to educational modules on kidney disease for patients to improve awareness and influence lifestyle 
practices.

Seamless integration with electronic health record systems for test ordering and reporting results 

KidneyIntelX is designed to interface with EHR systems in order to securely access the information required for each 
ordered test, which is then combined with biomarker data to generate the risk score and test report. The test result is 
reported directly to the ordering physician through the EHR system.  

In this way, the treating physician can have all of the relevant information pertinent to the patient’s care delivered to them 
at the time of the clinical encounter and can trigger care pathways directly from the EHR interface, with the goal of 
driving a virtuous cycle in which patients and clinicians have increased visibility and awareness changes in care 
management and patient behavior on kidney health. 

All personal health information captured by the kidneyintelX.dkd application is at all times stored in secure Microsoft 
Azure-supported cloud infrastructure and is encrypted using Advanced Encryption Standard. All transfers of data and 
reports through firewalls of the health system are executed using secure transfer protocols in accordance with 
internationally accepted Transport Layer Security versions 1.2 and 1.3. Security components also include rigid 
authentication and authorization of all users, a continuous monitoring tool, intrusion detection system and periodic 
penetration testing to mitigate risks of cyber-attacks. 

OUR STRATEGY

Our goal is to lower healthcare costs and improve patient quality of life by transforming the paradigm for kidney disease 
risk assessment and clinical management through our KidneyIntelX platform technology and the now FDA authorized 
kidneyintelX.dkd. Core strategy elements to achieve this goal include the following: 

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Continue to Build Integrated Partnerships with Healthcare Systems on a Population Health Basis. We are 
focused on building partnerships with healthcare systems and the engagement and support of their clinical 
leadership teams, which will enable us to efficiently initiate and deploy our solution to patient populations with 
DKD. A key aspect of this is technical integration of the KidneyIntelX technology software platform with 
healthcare systems’ EHR systems and clinical workflow. In September 2020, we announced the initiation of 
patient testing with Mount Sinai Health System. Integrated partnerships such as this is designed to allow 
KidneyIntelX technology to be deployed directly to patient populations and their treating clinicians in a cost-
efficient and timely manner. We are engaging with multiple healthcare institutions and national payors regarding 
additional partnership opportunities. 

Further Expand Insurance Payor Coverage. We continue to successfully build pathways for payment for 
KidneyIntelX technology across a range of insurance payors in multiple states including from Blue Cross Blue 
Shield, Medicaid, Medicare, Medicare Advantage and other private insurance companies.  We believe we are 
reaching critical scale of insurance payment in several key markets including in Illinois, New York, Texas, 
Florida and North Carolina. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       14

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Continue to Pursue Permanent Medicare Coverage Through a Local Coverage Determination (LCD) and a 
National Coverage Determination (NCD). We achieved our first payments from National Government Services 
(NGS), a Medicare Administrative Contractor ("MAC"), in October 2022.  Following FDA De Novo marketing 
authorization, NGS convened a Contractor Advisory Committee ("CAC") meeting as part of the LCD process.  
As part of the 21st Century Cures Act, Medicare Administrative Contractors are mandated to base an LCD on a 
review of the published clinical evidence and consensus guidelines.  Part of the process is to convene a group of 
healthcare professionals to review the clinical literature and provide input to help inform the potential coverage 
decision.  During the CAC meeting on August 24, 2023, the members of the panel discussed the literature and 
their confidence in the effectiveness and utility of the KidneyIntelX technology.  While there are no guarantees, 
we believe KidneyIntelX has sufficient peer review literature on effectiveness to support a Local Coverage 
Decision from NGS, and we are pursuing additional coverage from other MACs in other jurisdictions. We are 
also simultaneously pursuing a National coverage determination directly from the Centers for Medicare & 
Medicaid Services ("CMS").  FDA and CMS have proposed a new Transitional Coverage for Emerging 
Technologies (TCET) program to support Medicare coverage on the national level for innovative diagnostic 
devices that service an urgent clinical need.

Build Substantial Repository of Kidney Disease-Related Data. We are building a repository of kidney disease-
related data for the development of progressive KidneyIntelX product versions and additional artificial 
intelligence-powered clinical applications. We are designing applications to examine disease patterns in large 
patient populations and to optimize clinical care navigation and management effectiveness. These developments 
are underpinned by the goals of driving patient and physician behavior changes and ultimately improving patient 
outcomes. Access to current and historical patient data, combined with the ability to analytically and clinically 
validate study results in a quality-controlled framework, provides us with a powerful product development 
platform. Moreover, the depth, specificity and quality of data is of paramount importance to developing solutions 
with demonstrated clinical utility across a range of practice specialties and patient demographics, and securing 
access to this data is central to our strategy of demonstrating both short- and long-term impact on patient 
outcomes and health economics. 

Expand Our Product Portfolio. We believe there are significant opportunities to expand our platform through 
incremental version releases of KidneyIntelX technology as well as through extending the KidneyIntelX platform 
into new applications for CKD patients beyond those with diabetes, including repeat testing to monitor changes in 
risk and therapeutic response and other CKD subtypes. We also intend to develop solutions for use in other large 
chronic disease patient populations, like CKD associated cardiovascular disease. KidneyIntelX technology has 
been designed within a quality controlled environment with regulatory approval process to allow us to take 
advantage of the dynamic nature of machine learning to improve product performance through a sequence of 
controlled version releases. We believe that our product development approach, which is based on a quality 
systems framework following FDA’s Quality System Regulations and the ISO guidelines applicable to medical 
devices, will enable our KidneyIntelX platform to take advantage of exponential data growth and new clinical use 
cases, with a clearer path to achieving additional products and services. 

Real World Evidence Program.  We have invested heavily over the past several years in developing a 
comprehensive portfolio of both real-world evidence outcomes and utility data.  We have published and presented 
this data in various formats including in peer-reviewed publications and at major medical conferences.   We 
believe the data released to date has largely satisfied the primary objective of demonstrating the clinical and 
economic impact of KidneyIntelX technology informed care management in large populations as has been 
evidenced by our regulatory, reimbursement and adoption achievements. We expect to continue to pursue real-
world evidence generation in the future for KidneyIntelX platform products over time.   

Launch in Major International Markets. With FDA De Novo authorization for kidneyintelX.dkd, we have seen 
an increase in in-bound inquiries for international licensing and distribution opportunities.  Kidney disease poses 
an increasing threat globally and we believe there will be a number of opportunities to partner with third-party 
entities to carry KidneyIntelX technology internationally through license.  

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       15

We believe KidneyIntelX technology produces early, actionable prognosis that can support clinical pathways to slow the 
progression of kidney disease and potentially prevent the occurrence of progressive kidney function decline such as kidney 
failure and the need for long-term dialysis or kidney transplant. We have built a comprehensive body of published evidence 
through clinical validation studies and patient data generation to demonstrate that accurate and early identification of high-risk 
patients, coupled with guidelines-driven clinical recommendations designed to maximize patient treatment and compliance, 
can have a measurable positive impact on patient quality of life and significantly lower healthcare costs. By involving a broad 
range of expert clinical opinions, testing a growing number of patient samples, consulting closely with clinical society and 
patient advocacy organizations, partnering with healthcare systems and payors and developing a detailed understanding of the 
clinical practice environment, we believe successful use of KidneyIntelX technology will help ease suffering and improve 
outcomes for patients living with DKD. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       16

OUR COMPETITIVE STRENGTHS

The KidneyIntelX platform has the following key strengths: 

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Novel Bioprognostic™ Platform Incorporating Biomarkers and Health Record Features Analyzed with a 
Machine Learning Enabled Algorithm to Assess the Risk for Kidney Disease Progression. KidneyIntelX 
technology has produced the first machine learning enabled in vitro prognostic device with the ability to identify 
patients at risk of progressive kidney function decline while in the earlier stages of DKD, when costs and 
outcomes can be better controlled. 

Large and Growing Addressable Market. CKD affects over 850 million people worldwide, including 
approximately 35.5 million people in the United States. The NKF estimates that one third of adults in the United 
States are at risk of developing kidney disease. Type 2 diabetes is one of the most significant risk factors for 
developing CKD and obesity is believed to account for 80% to 85% of the risk of developing type 2 diabetes. It is 
estimated that there are approximately 14 million adults with DKD in the United States. Published data suggests 
that the DKD population will continue to grow along with the anticipated increase in the occurrence of type 2 
diabetes and obesity. One study estimates that by 2060, the number of adults in the United States diagnosed with 
diabetes will reach 60 million. Further, according to a 2019 study from the Harvard T.H. Chan School of Public 
Health, by 2030, about half of the adult U.S. population will be obese and about a quarter will be severely obese.

Achievements in Reimbursement and Coverage. We have received Medicare payment, Medicare national 
payment rate and multiple private insurance coverage determinations to date. We believe these positive outcomes 
are the result of several factors: (1) our rigorous approach to a product development and the market access 
process, (2) significant changes in U.S. reimbursement law with the full implementation of the Protecting Access 
to Medicare Act, and (3) global improvements in kidney disease policy management, including the U.S. 
Presidential Executive Order on Advancing American Kidney Health issued in July 2019. 

Economic Health Benefits.  KidneyIntelX technology was designed to provide accurate, real-time, actionable 
results for patients and physicians while reducing costs and promoting improved health economics for patients, 
physicians, healthcare systems and payors. Health economic benefits are projected to be derived from three key 
areas: (1) slowing progression to the next stage of CKD, (2) delaying or preventing progression to ESKD and the 
need for dialysis or kidney transplant and (3) avoiding dialysis crashes. By deploying our proprietary artificial 
intelligence-enabled algorithm in a regulated, clinically validated, in vitro diagnostic test, kidneyintelX.dkd is 
able to help predict which patients will experience progressive kidney function decline from early stage disease 
(Stage 1-3b) within a five-year timeframe, equipping physicians with the information they need to understand risk 
in their patients. According to a study conducted by BHA, based on the Medicare price of $950 per reportable 
test, KidneyIntelX technology would generate a positive return for health insurers in 12-24 months and deliver a 
cost savings of up to $1.3 billion over five years per 100,000 patients with DKD.  We believe successive and 
broad insurance coverage decisions have validated this health economics value proposition.  

Partnered Business Model at Population Health Level. We have begun to deploy KidneyIntelX technology in 
the form of the KidneyIntelX laboratory developed service through partnerships with healthcare systems 
(including Mount Sinai Health System, and Atrium Health/Wake Forest Baptist Health) and insurance payors that 
provide coverage to certain healthcare systems’ patients. We expect to transition these deployments and new 
deployments to our now FDA authorized kidneyintelX.dkd beginning early in calendar 2024.  As we have 
demonstrated with the KidneyIntelX laboratory developed service, we believe an EHR integrated 
kidneyintelX.dkd with population health support will be able to potentially benefit significant patient populations 
without employing a large, traditional sales force on a provider-level basis at those health systems. In addition, 
integration of the kidneyintelX.dkd software platform with healthcare providers’ EHR systems enables seamless 
electronic test ordering and score reporting.  

Kidney Disease Data Repository. As a result of our partnered business model at a population health level, we 
anticipate that we will have the opportunity to build the most comprehensive de-identified kidney disease data 
repository geared toward early identification of high-risk patients and optimization of care pathways. Further, our 
partnerships with relevant insurance payors increases the visibility and the potential cost/benefit economics of 
KidneyIntelX technology. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       17

 
Financial Review

The results presented cover FY23. The presentational currency for Renalytix plc and its subsidiaries (together, the 
“Group”) is the United States Dollar.

INCOME STATEMENT

Revenue

The Group recognized a total of $3.4 million in revenue in the financial year ended 30 June 2023 (“FY23”) (financial year 
ended 30 June 2022 (“FY22”): $2.9 million) which was comprised of $3.1 million in revenue related to testing services  
(FY22: $2.7 million) as well as $0.3 million related to pharmaceutical services revenue  (FY22: $0.2 million). 

Cost of Sales

The cost of sales associated with the services performed and commercial testing revenue was $2.7 million for FY23 (FY22: 
$2.1 million).

Administrative Costs

During FY23, administrative expenses totaled $43.1 million (FY22): $58.3 million). The major items of expenditure were 
general and administrative costs of which included $21.0million in employee- related costs (FY22: $27.6 million), $5.9 
million in subcontractors, legal, accounting, and other professional fees (FY22: $12.9 million), $8.0 million in external R&D 
Services, lab supplies and lab services(FY22: $6.4 million), $2.7 million in insurance (FY22: $4.6 million), $2.1 million in 
depreciation and amortisation (FY22: $2.1 million), $1.3 million in marketing and public relations (FY22: $1.9 million), 
$1.3 million in IT related costs (FY22: $1.7million), $0.4 million in office related expenses including rent (FY22: $0.5 
million), $0.1 million in stock exchange listing and filing fees (FY22: $0.3 million) and $0.3 million in other expenses 
(FY22: $0.3 million). 

Gain (Loss) On Financial Assets At Fair Value Through Profit Or Loss

The Company accounts for the investment in VericiDx equity securities at fair value, with changes in fair value recognized 
in the income statement. During the year ended 30 June 2023, we recorded a loss of $1.3 million to adjust the VericiDx 
investment to fair value. During the year ended 30 June 2022, we recorded a loss of $5.9 million to adjust the VericiDx 
investment to fair value.

Fair Value Adjustment Of Convertible Debt

We elected to account for the convertible notes at fair value with qualifying changes in fair value recognized through the 
income statement until the notes are settled. This excludes fair value adjustments related to instrument-specific credit risk, 
which are recognized in OCI. For the year ended 30 June 2023, we recorded a loss of $3.1 million to adjust the convertible 
notes to fair value.  For the year ended 30 June 2022, we recorded a gain of $4.0 million to adjust the convertible notes to 
fair value. 

Finance Income (Expense)

During the year ended 30 June 2023, we recognized a gain of $0.5 million, which was comprised of $0.2 million of income 
related to the dissolution of Kantaro, $0.3 million of income for refunds from Citibank, $0.1 million interest income earned 
on our cash deposits, and offset by $0.1 million of foreign exchange losses. During the year ended 30 June 2022, we 
recognized a foreign currency gain of $9.6 million due to exchange rate fluctuations on transactions denominated in a 
currency other than our functional currency.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       18

BALANCE SHEET

Inventory

Inventory consists of consumable materials used by the labs to carry out KidneyIntelX tests. Inventory on hand at 30 June 
2023 totaled $0.7 million (FY22: $1.2 million). During FY22, inventory levels increased due to purchases as the company 
prepares for increased KidneyIntelX testing volumes. 

Fixed Assets

Property, plant, and equipment consists of laboratory equipment being used to support testing and product development 
activities. At 30 June 2023, the company held $1.0 million in net property, plant, and equipment (FY22: $1.4 million).

Intangible Assets

The Group held $12.5 million net book value of intangible assets at 30 June 2023 (FY22: $14.0 million) which includes 
payments made primarily to Mount Sinai for license and patent costs for the intellectual property underlying KidneyIntelX, 
as well as amounts capitalized as development costs. Intangible assets also include the value of the biomarker business 
purchased (in exchange for ordinary shares in the Company) from EKF. Intangible assets decreased period over period due 
to amortisation and the impact of foreign exchange translation at period end.

Investment in Verici

At the end of FY23 the group held 9,831,681 shares in Verici Dx, the fair value of the investment in Verici Dx was $1.5 
million at 30 June 2023 (FY22: $2.7 million).

Convertible Note

In April 2022, the Company issued amortising senior convertible bonds with a principal amount of $21.2 million due in 
April 2027 (the "Bonds"). The Bonds were issued at 85% par value with total net proceeds of $18.0 million. The Company 
elected to account for the Bonds at fair value. At 30 June 2023, the Bonds had a fair value of $11.9 million.  At 30 June 
2022, the Bonds had a fair value of $12.3 million.

Cash

The Group had cash on hand of $24.7 million (FY22: $41.3 million). Cash and equivalents are held in several deposit 
accounts in the US ($14.9 million), UK ($8.6 million) and IRE ($1.2 million). 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       19

 
Risk Management Approach

We recognize that effective risk management is essential to the successful delivery of the Group’s strategy. As we grow our 
business, we believe it is important to develop and enhance our risk management processes and control environment on an 
ongoing basis and ensure it is fit for purpose by identifying and managing risks across the Group in a consistent and robust 
manner.

Below we describe our risk management approach, the principal risks and uncertainties faced by the Group and the controls 
in place to manage them.

OVERVIEW OF RISK MANAGEMENT APPROACH

The key principles that guide the Group’s risk management approach are outlined below:

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▪

It is the employees’ responsibility to ensure they understand and comply with the Risk Management Policy and 
their defined risk management roles and responsibilities.

There is a defined risk management governance structure with clear accountabilities.

A consistent risk management approach is used throughout the Group to identify and manage risks posed in the 
AI and life sciences industries.

Risk management is embedded in all key processes and decision-making within the Group (including strategy 
setting, budgeting, planning and day-to-day operations and activities).

A risk register is maintained and updated periodically. The register includes the risk description, risk owner, 
mitigation/control description and risk profile.

PRINCIPAL RISKS AND UNCERTAINTIES

Set out below are the principal risks which we believe could materially affect the Group’s ability to achieve its financial and 
operating objectives and control or mitigating activities adopted to manage them. The risks are not listed in order of 
significance.

THE GROUP IS DEPENDENT UPON ITS STRATEGIC COLLABORATION WITH 
THIRD PARTY PARTNERS

The Group is working to develop and commercialize its products in close collaboration with strategic partners. The Group is 
dependent upon third parties for resources and revenue. Failure by these strategic partners to meet its key contractual 
obligations or to purchase KidneyIntelX tests, for whatever reason, would likely have a material adverse effect on the Group 
and its ability to achieve its commercial objectives, potentially including the attainment of sales volumes leading to 
profitability, and may ultimately result in the Group becoming unviable.

REGULATORY RISK

There can be no guarantee that any of the Group’s products will be able to obtain or maintain the necessary regulatory 
approvals in any or all of the territories in respect of which applications for such approvals are made. Where regulatory 
approvals are obtained, there can be no guarantee that the conditions attached to such approvals will not be considered too 
onerous by the Group or its partners in order to be able to market its products effectively.

The Group seeks to reduce this risk by seeking advice from regulatory advisers, consultations with regulatory approval 
bodies and by working with experienced partners.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       20

REIMBURSEMENT LEVELS

There is no guarantee that the Company will be able to continue to sell its products or services profitably if the 
reimbursement level from third party payers, including government and private health insurers, is limited or subsequently 
withdrawn. Third party payers are increasingly attempting to contain health care costs through measures that could impact 
the Company including challenging the prices charged for health care products and services, limiting both coverage and the 
amount of reimbursement for new diagnostics products and services, and denying or limiting coverage for products that are 
approved by the regulatory agencies but are considered experimental by third party payers.

The Company understands that due to third party dependency it is extremely difficult to eradicate this risk. However, the 
Company manages this risk with constant dialogue and educating the third-party payers on the Group’s products and also 
developing new technologies in order to seek additional reimbursements.

KEY EMPLOYEES

The Company’s future development and prospects depend to a significant degree on the continuing contribution of key 
members of its Board, Senior Management and Scientific Advisory Board. As a small organization, the Company relies on a 
core team of staff and is therefore exposed to any significant departures of key personnel. In particular, the Company’s 
performance depends significantly on the continuing contribution of its CEO, James McCullough, its President, Thomas 
McLain, its CTO, Fergus Fleming, its CFO, O. James Sterling and its CMO, Michael Donovan.

The Group operates in a highly competitive field and the expertise and skills of key individuals are also applicable in a 
number of other fields and industries. The high level of demand for such expertise and skills means that there is increasingly 
intense competition for talent. The departure of any of the key members to pursue other opportunities or because they are no 
longer able to continue to perform their roles (for whatever reason) could have a negative impact on its operations and could 
affect the Group’s ability to execute the Group’s business strategy.

To seek to mitigate the potential risk of departures, the Company has adopted a competitive remuneration structure, which 
includes share-based incentives. The Company has also taken out key- man insurance on James McCullough. However, 
there can be no assurance that this insurance will be adequate or continue to be available on appropriate terms or at all.

OBSOLESCENCE OF GROUP’S PRODUCTS

Demand for the Group’s products could be adversely impacted by the development of alternative technology and alternative 
medicines specifically intended for the identification, stratification and/ or treatment of CKD patients. There can be no 
assurance that the technology and products currently being developed by the Group will not be rendered obsolete. New AI 
technology may continue to emerge and develop. As a result, there is the possibility that new technology may be superior to, 
or render obsolete, the technology that the Group currently is developing. Any failure of the Company to ensure that its 
technology platform and products remain up to date with the latest technology may have a material adverse impact on the 
Company’s competitiveness and financial performance. The Group’s success will depend, in part, on its or its partners’ 
ability to develop and adapt to these technological changes and industry trends.

THE GROUP IS SUBJECT TO INCREASINGLY STRINGENT PRIVACY AND DATA 
SECURITY LEGISLATION

Regulatory, legislative or self-regulatory/standard developments regarding privacy and data security matters could adversely 
affect the Group’s ability to conduct the Group’s business. The Group is subject to laws, rules, regulations and industry 
standards related to data privacy and cyber security, and restrictions or technological requirements regarding the collection, 
use, storage, protection, retention or transfer of data.

For the foreseeable future, the Group will only process data relating to patients in the US and will therefore be subject to 
various rules and regulations, including those promulgated under the authority of the US Department of Health and Human 
Services, the Federal Trade Commission, and state cybersecurity and breach notification laws, as well as regulator 
enforcement positions and expectations.

If the Company begins processing personal data in the context of an establishment in a country that is subject to the GDPR 
or if it offers products or services to residents of an EU country, it will have to comply with various robust obligations.

Globally, governments and agencies have adopted and could in the future adopt, modify, apply or enforce laws, policies, 
regulations, and standards covering user privacy, data security, technologies that are used to collect, store and/or process 
data, marketing online, the use of data to inform marketing, the taxation of products and services, unfair and deceptive 

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                                                                                                                       21

practices, and the collection (including the collection of information), use, processing, transfer, storage and/or disclosure of 
data associated with unique individual internet users. New regulation or legislative actions regarding data privacy and 
security (together with applicable industry standards) may increase the costs of doing business and could have a material 
adverse impact on the Group’s operations and cash flows.

Despite the Group’s ongoing efforts to ensure practices are compliant, the Group may not be successful either due to various 
factors within the Group’s control, such as limited financial or human resources, or other factors outside the Group’s control. 
It is also possible that local data protection authorities may have different interpretations of the GDPR, leading to potential 
inconsistencies amongst various EU member states.

COMPETITION

The markets in which the Group operates, which include the markets for laboratory developed tests, clinical diagnostic 
support tools and clinical AI solutions, are potentially highly competitive and rapidly changing.

Competitors may have access to considerably greater financial, technical and marketing resources. The availability and price 
of the Group’s competitors’ clinical AI development services could limit the demand, and the price the Group is able to 
charge, for its services. New competing products may enter the market and make the Group’s discoveries and the products 
developed from those discoveries obsolete.

Alternatively, a competitor’s products may be more effective, cheaper or more effectively marketed than the products 
developed by the Group, which could have a material adverse effect on the Group’s profitability and/or financial condition.

Technological competition from medical device companies, life science companies, universities and academic medical 
centres is intense and can be expected to increase. Many competitors and potential competitors of the Group have 
substantially greater product development capabilities and financial, scientific, marketing and human resources than the 
Group. The future success of the Group depends, in part, on its ability to maintain a competitive position, including an 
ability to further progress through the necessary preclinical and clinical trials to support commercialization, marketing 
authorization where necessary, and coverage and reimbursement. Other companies may succeed in commercializing 
products earlier than the Group or in developing products that are more effective than those which may be produced by the 
Group. While the Group will seek to develop its capabilities in order to remain competitive, there can be no assurance that 
research and development by others will not render the Group’s products obsolete or uncompetitive.

RESEARCH AND DEVELOPMENT RISK

The Group operates in the life sciences sector and will look to exploit opportunities within that sector. The Group is 
involved in complex clinical development processes and industry experience indicates that there may be a very high 
incidence of delay or failure to produce the desired results. The Group may not be able to develop new products or to 
identify specific market needs that can be addressed by technology solutions developed by the Group. The ability of the 
Group to develop new technology relies, in part, on the recruitment of appropriately qualified staff as the Group grows. The 
Group may be unable to find a sufficient number of appropriately highly trained individuals to satisfy its growth rate which 
could affect its ability to develop as planned.

Product development timelines are at risk of delay, particularly since it is not always possible to predict the rate of patient 
recruitment into clinical trials. There is a risk therefore that product development could take longer than presently expected 
by the Board. If such delays occur, the Group may require further working capital. The Board shall seek to minimize the risk 
of delays by careful management of projects.

In addition, research and development may be subject to various requirements, such as research subject protection for 
individuals participating in clinical evaluations of new laboratory developed tests and products, institutional review board 
oversight, regulatory authorizations, and design control requirements for FDA and EU-regulated products. Failure to comply 
with requirements could result in penalties, delay, or prevent commercialisation of products.

FINANCIAL REPORTING AND DISCLOSURE

Due to the nature of the Group there is a requirement to report accurate financial information in compliance with accounting 
standards and applicable legislation.

This risk is mitigated through the Group’s internal controls over the financial information and reporting, overseen by the 
local financial heads and then reviewed by the central finance team, including the Chief Financial Officer. The annual 
financial statements are also subject to audit by the Group’s external auditors.

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CYBER SECURITY RISK

The Group uses computers extensively in its operations and has an online presence but does not trade online. It is at risk of 
attack through hacking or other methods. This risk is mitigated by the use of robust security measures, staff training, and 
back-up systems.

INTELLECTUAL PROPERTY RISK

The commercial success of the Group and its ability to compete effectively with other companies depends, amongst other 
things, on its ability to obtain and maintain patents sufficiently broad in scope to provide protection for the Group’s 
intellectual property rights against third parties and to exploit its products. The absence of any such patents may have a 
material adverse effect on the Group’s ability to develop its business.

The Group mitigates this risk by developing products where legal advice indicates patent protection would be available, 
seeking patent protection for the Group’s products, maintaining confidentiality agreements regarding Group know-how and 
technology and monitoring technological developments and the registration of patents by other parties. The commercial 
success of the Group also depends upon not infringing patents granted, now or in the future, to third parties who may have 
filed applications or who have obtained, or may obtain, patents relating to business processes which might inhibit the 
Group’s ability to develop and exploit its own products.

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Section 172 Statement

The Directors are required by law to act in good faith to promote the success of the Company for the benefit of the 
shareholders as a whole and are also required to have regard to the following:

▪

▪

▪

▪

▪

▪

the likely long-term consequences of any decision;

the interests of the Company’s employees;

the need to foster the Company’s business relationships with suppliers, customers and others;

the impact of the Company’s operations on the community and the environment;

the desirability of the Company maintaining a reputation for high standards of business conduct; and

the need to act fairly as between shareholders of the Company.

Please see the Corporate Governance Statement in the Directors’ Report for an overview of the Company’s corporate 
governance arrangements.

The Chairman and Chief Executive Officer’s joint statement and the section headed “Product Overview and Strategy” in this 
Strategic Report describes the Group’s activities, strategies and future prospects, including the considerations for long-term 
decision making. In particular, the Group has made significant progress towards its operational, regulatory and 
reimbursement goals and is now engaged in commercial roll-out of its lead product, KidneyIntelX in the United States. In 
addition, the Group is seeing an increase in strategic partnering activities which will continue to build on the validation and 
commercial use cases for KidneyIntelX.

The Board has a good relationship with the Group’s employees. The Board maintains constructive dialogue with employees 
through the Chief Executive Officer and other members of the executive team. Appropriate remuneration and incentive 
schemes are maintained to align employees’ objectives with those of the Group. See further under Employees in the section 
headed “Corporate Social Responsibility” below.

The Group endeavors to maintain good relationships with its suppliers by contracting on fair business terms, paying within 
agreed timeframes, and responding promptly to inquiries.

The Group’s operations have minimal environmental impact. Please see Environment in the section headed “Corporate 
Social Responsibility” below for more details.

The Board recognizes the Group’s duty to be a good corporate citizen. See Social, community and human rights in the 
section headed “Corporate Social Responsibility” below for more details.

The Board recognizes the importance of maintaining high standards of business conduct. The Group operates a Code of 
Business Conduct and Ethics applicable to its employees, independent contractors, executive officers and directors. A 
current copy of the Code of Business Conduct and Ethics is available on our website, which is located at 
www.renalytix.com.

The Board endeavors to maintain good relationships with its shareholders and treat them equally. This is described in more 
detail in the Corporate Governance Statement under the heading “Relations with Shareholders.”

There were a number of initiatives and strategic actions undertaken during FY23 which the Directors believe were in the 
best interests of the Company and all its stakeholders as follows:

▪

▪

▪

▪

▪

Achieved FDA De Novo marketing authorization for kidneyintelX.dkd to assess risk of progressive kidney 
function decline in adults with diabetes and early-stage kidney disease.

Secured additional key insurance coverage contracts for KidneyIntelX 

Inclusion of KidneyIntelX in draft Kidney Disease Improving Global Outcomes (KDIGO) 2023 Clinical Practice 
Guideline for Evaluation and Management of Chronic Kidney Disease (KDIGO 2023 Guideline) 

Continuing to maintain contracted pricing at or over the Medicare Clinical Laboratory Fee Schedule (CLFS) of 
$950 per reportable test result

Received Medicare payments for KidneyIntelX

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                                                                                                                       24

▪

▪

▪

▪

▪

▪

▪

▪

▪

▪

▪

Executed over 40 commercial payor contracts and enrolled as a provider in 35 state Medicaid programs to date

Milestone achievement converting payment to full, long-term commercial insurance billing model at Mount Sinai 
Health System

Appointed senior diagnostics executive Howard Doran to lead global commercial sales beginning with direct to 
physician salesforce in New York, Illinois, North Carolina, Florida and Texas 

Full Epic electronic health record system integration with Atrium / Wake Forest proceeding with launch expected 
before end of calendar 2023

Selected EVERSANA® to supplement identification and training of sales personnel in select U.S. regions

Core participant in consortium granted $10 million by Horizon Europe Grant to advance personalized medicine in 
treating chronic kidney disease

Increasing diversity of commercially billable testing volume, particularly among primary care physician practices 
ordering through the MyIntelX portal

Continued data generation and analysis presented in multiple scientific venues and publications reinforcing the 
benefits of KidneyIntelX 

Completed $20.3 million equity financing led by new institutional investors in February 2023

Reduced annual operating expenses by over $11 million versus the prior year with additional cost reduction 
initiatives underway to extend cash runway while preserving revenue generating activity

Expanded board of directors with the addition of financial executive Catherine Coste 

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Corporate Social Responsibility

ENVIRONMENT

The Directors consider that the nature of the Group’s activities is not inherently detrimental to the environment. The Group 
is committed to identifying and minimizing any effect on the environment caused by its operations. As a minimum standard, 
we will fully comply with all relevant legislation and, wherever possible, look for opportunities to make a positive 
contribution to the environments in which we operate.

EMPLOYEES

The Group places great value on the involvement of its employees and they are regularly briefed on the Group’s activities. 
The Group closely monitors staff attrition rates which it seeks to keep at low levels and aims to structure staff compensation 
levels at competitive rates in order to attract and retain high calibre personnel.

DISABLED EMPLOYEES

Applications for employment by disabled persons are always fully considered, bearing in mind the specific aptitudes of the 
applicant involved. It is the policy of the Group that the training, career development and promotion of disabled persons, as 
far as possible, be identical to that of other employees.

SOCIAL, COMMUNITY AND HUMAN RIGHTS

The Board recognizes that the Group has a duty to be a good corporate citizen and to respect and comply with laws, 
regulations, and where appropriate the customs and culture of the territories in which it operates. The Group encourages 
employees to take part in charitable activities which are related to our business areas or customers. It contributes as far as is 
practicable to the local communities in which it operates and takes a responsible and positive approach to employment 
practices.

GENDER DIVERSITY INFORMATION

Directors of the Company
Employees in other senior executive positions
Senior managers other than directors and senior executives of the company
Other employees of the group

Male
7
5
5
33

Female
1
1
2
34

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CORPORATE GOVERNANCE 

Board of Directors

Christopher Mills

Non-Executive Chairman (Aged 70)

Christopher Mills has served as a member of the Renalytix Board since its 
inception. Christopher founded Harwood Capital Management in 2011, a 
successor to its former parent company, J.O. Hambro Capital Management, 
which he co-founded in 1993. He is Chief Executive and Investment 
Manager of North Atlantic Smaller Companies Investment Trust plc and 
Chief Investment Officer of Harwood Capital LLP. He is a Non-executive 
Director of a number of companies, including EKF Diagnostics.

James McCullough

Chief Executive Officer and Director (Aged 55)

James McCullough has served as Renalytix’s co-founder and Chief 
Executive Officer since its inception. James has leadership experience 
building emerging technology companies in both the public and private 
sectors with specific expertise in the life-sciences industry. James was most 
recently Chief Executive Officer of Exosome Diagnostics, a venture-backed 
personalized medicine company developing non-invasive liquid biopsy 
diagnostics in cancer, which was recently acquired by Bio-Techne 
Corporation. James is also a managing partner of Renwick Capital, LLC, a 
management consulting firm specializing in assisting emerging healthcare 
technology companies with strategic planning and business execution, and 
was a co-founder of PAIGE.AI, a computational pathology spin-out from 
the Memorial Sloan Kettering Cancer Center. James received his B.A. from 
Boston University and an M.B.A. from Columbia Business School. James is 
currently Chairman of BalletNext, a performing arts company in park city 
Utah.

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Fergus Fleming

Chief Technical Officer and Director (Aged 56)

Fergus Fleming has served as Renalytix’s Chief Technical Officer since its 
inception. Fergus has over 25 years’ experience in the life sciences sector, 
including leadership positions with Baxter Healthcare, Boston Scientific, 
Trinity Biotech plc, and EKF Diagnostics. Fergus has extensive experience 
in the design and manufacture of interventional medical devices, digital 
health solutions, in vitro diagnostics instruments and reagents, and 
electromechanical devices. He has extensive experience managing global 
projects, including clinical research collaborations, product development, 
acquisitions, and manufacturing site transfers.

Erik Lium Ph.D.

Non-Executive Director (Aged 55)

Erik Lium, Ph.D., has served as a member of the Renalytix Board since 
November 2018. Dr. Lium is the executive vice president of Mount Sinai 
Innovation Partners and is responsible for advancing Mount Sinai’s 
research, instruction, and public service missions through strategic research 
partnerships with industry, the management, transfer and commercialisation 
of technologies, and fostering the development of start- ups and joint 
ventures to advance promising early-stage technologies. Dr. Lium also 
serves as a director of Amathus Therapeutics and as a member of the 
Investment Review Committee for the Accelerate NY Seed Fund.

Prior to joining Mount Sinai, Dr. Lium served as the assistant vice 
chancellor of Innovation, Technology & Alliances at the University of 
California, San Francisco (UCSF), and the UCSF Principal Investigator for 
the Bay area National Science Foundation I-Corps node. He held previous 
positions at UCSF, including assistant vice chancellor of Research and 
director of Industry Contracts, and director of Business Development for the 
Diabetes Center & Immune Tolerance Network. Dr. Lium served as 
president of LabVelocity Inc., an Information Services Company focused 
on accelerating research and development in the life sciences prior to its 
acquisition in 2004. He pursued post-doctoral research at UCSF, and earned 
a PhD with honours from the Integrated Program in Cellular, Molecular and 
Biophysical Studies at Columbia University. Dr. Lium holds a BS in 
Biology from Gonzaga University.

Chirag R. Parikh, Ph.D., M.D.

Non-Executive Director (Aged 50)

Chirag R. Parikh, Ph.D., M.D., has served as a member of the Board since 
October 2019. Since July 2018, Dr. Parikh has served as a Professor of 
Medicine and the Division Director of Nephrology at Johns Hopkins 
University. Dr. Parikh also served as a faculty member at Yale University 
where he directed the Program of Applied Translational Research. Dr. 
Parikh’s research focuses on the translation and validation of novel 
biomarkers for the diagnosis and prognosis of kidney diseases. He has 
assembled multi-centre longitudinal prospective cohorts for translational 
research studies across several clinical settings of acute kidney injury and 
chronic kidney disease for the efficient translation of novel biomarkers. Dr. 
Parikh received his medical degree from Seth G.S. Medical College and 
KEM Hospital in Mumbai, India, and subsequently completed his 
Nephrology fellowship and a Ph.D. in Clinical Investigation at the 

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                                                                                                                       28

University of Colorado Health Sciences Center.

Daniel J. Levangie

Non-Executive Director (Aged 73)

Daniel J. Levangie was appointed to the Company’s board of directors in 
August 2021. He is an experienced executive and long-serving board 
director in the diagnostics and medical devices industry. Mr. Levangie is 
co-founder and manager of ATON Partners, a private investment firm, and 
president and CEO of CereVasc, LLC, a medical device company. He has 
also served on the board of directors of Exact Sciences Corporation since 
2010. From 2013 through January 2017, Mr. Levangie served as president 
of Insulet Drug Delivery Systems and served as a lead director of Insulet 
Corporation. From 2011 through 2013, Mr. Levangie was chief executive 
officer of Dune Medical Devices, Inc., and co-founder and managing 
partner of Constitution Medical Investors, Inc., a Boston-based private 
investment and product development firm acquired by Roche Diagnostics 
Corporation in 2013. Previously, he held executive management positions 
with Cytyc Corporation including executive vice president and chief 
operating officer, chief executive officer and president until the acquisition 
of Cytyc by Hologic, in 2007. He served on the board of Hologic from 2007 
to 2009. Mr. Levangie holds a B.S. in Pharmacy from Northeastern 
University.

Timothy J. Scannell

Non-Executive Director (Aged 59) - resigned 18 October 2023

Timothy J. Scannell was appointed to the Company’s board of directors in 
March 2022. He also serves on the boards of publicly held Insulet 
Corporation, Novocure, and Molekule.  Additionally, Mr. Scannell serves 
on the boards of privately held Collagen Matrix, Synaptive Medical, and 
Cerebral Therapeutics. Mr. Scannell also serves as an Executive Advisor at 
Stryker, one of the world’s leading medical technology companies. His 
career at Stryker spans 32 years, during which he held several leadership 
roles, including President and Chief Operating Officer, Group President of 
MedSurg & Neurotechnology, President of Spine, and Vice President & 
General Manager of Stryker Biotech.

Mr. Scannell brings extensive strategic, sales and marketing, and 
operational skills and experience, with a track record for delivering top tier 
results. He holds Bachelor of Business Administration and Master of 
Business Administration degrees from the University of Notre Dame.

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Catherine Coste

Non-Executive Director (Aged 57)

Catherine Coste was appointed to the Company’s Board of Directors in 
June 2023. Ms. Coste retired from Deloitte and Touche LLP (“Deloitte”) in 
2020, where she was a Senior Partner, and served as one of Deloitte’s Life 
Sciences industry executive leaders. She spent 32 years in both corporate 
and professional services positions leading global finance, internal audit, 
and operations teams. During her career at Deloitte, Ms. Coste was directly 
involved with over 30 life science corporations, the majority of which were 
large-cap and medium-cap public corporations. She also serves as a 
Director at both Minerva Surgical, Inc., where she is Chair of the Audit 
Committee and a Member of the Compensation Committee, and Biomerica, 
Inc., where she is Chair of the Audit Committee, and serves on both the 
Compensation Committee and the Nominating and Corporate Governance 
Committee. Ms. Coste’s experience includes, but is not limited to, 
Sarbanes-Oxley compliance, corporate risk analysis and management, cyber 
risk assessment, fraud prevention, IT systems analysis and upgrades, 
internal controls, and corporate governance. She is a Certified Public 
Accountant, who earned her B.A. in business administration, accounting, 
from California State University, Hayward.

Ann Berman

Non-Executive Director – resigned 19 September 2022 

This report was approved by the Board on 27 October 2023 and signed on behalf of the Board by:

Christopher Mills

Chairman

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Directors’ Report

The Directors present their annual report on the affairs of the Group and Parent Company, together with the consolidated 
financial statements and auditor’s report for the year ended 30 June 2023. The Corporate Governance Statement set out on 
pages 35 to 37 forms part of this report.

CORPORATE DETAILS

Renalytix plc is a public limited company incorporated in the under the laws of England & Wales (Registration Number 
11257655). The address of the registered office is Finsgate, 5-7 Cranwood Street, London EC1V 9EE. 

DIRECTORS

The Directors, who served in office during the year and as at the date of signing these financial statements were as follows:

▪

▪

▪

▪

▪

▪

▪

▪

▪

Christopher Mills

James McCullough

Erik Lium

Fergus Fleming

Chirag Parikh

Daniel Levangie 

Timothy Scannell (resigned 18 October 2023)

Ann Berman (resigned 19 September 2022)

Catherine Coste (appointed on 30 June 2023)

Details of the Directors’ membership of committees is shown on page 36. The Company Secretary is Salim Hamir.

PRINCIPAL ACTIVITIES

The principal activity of the Group is the development of artificial intelligence-enabled clinical diagnostic solutions for 
kidney disease.

GOING CONCERN

The Group and Company meet their day-to-day working capital requirements through the use of cash reserves.

The Directors have considered the applicability of the going concern basis in the preparation of these financial statements. 

The Group and Company have incurred recurring losses and negative cash flows from operations since inception. The 
Company anticipates incurring additional losses until such time, if ever, that it can generate significant sales of 
KidneyIntelX or any future products currently in development. 

As a result of our losses and our projected cash needs, the Directors have concluded that substantial doubt exists about the 
Group and Company’s ability to continue as a going concern. Substantial additional capital will be necessary to fund the 
Group and Company's operations, expand its commercial activities and develop other potential diagnostic related products. 
The Company plans to seek additional funding through public or private equity offerings, debt financings, other 
collaborations, strategic alliances and licensing arrangements. The Group and Company may not be able to obtain financing 
on acceptable terms, or at all, and the Group and Company may not be able to enter into strategic alliances or other 
arrangements on favorable terms, or at all. The terms of any financing may adversely affect the holdings or the rights of the 
Group and Company’s shareholders. If the Group and Company is unable to obtain funding, the Group and Company could 
be required to delay, curtail or discontinue research and development programs, product portfolio expansion or future 
commercialization efforts, which could adversely affect its business prospect. 

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                                                                                                                       31

The Group and Company’s ability to continue as a going concern is contingent upon successful execution of management’s 
intended plan over the next twelve months to improve the Group and Company’s liquidity and profitability, which includes, 
without limitation:

▪

▪

▪

Seeking additional capital through public or private equity offerings, debt financings, other collaborations, 
strategic alliances and licensing arrangements

Implementation of various additional operating cost reduction options that are available to the Group and 
Company 

The achievement of a certain volume of assumed revenue

GREENHOUSE GAS EMISSIONS, ENERGY CONSUMPTION AND ENERGY 
EFFICIENCY ACTION

The majority of the Group's employees are considered remote and primarily work from home offices therefore the Group 
has determined that it is not practical to calculate the annual quantity of greenhouse gas emissions resulting from activities 
for which the company is responsible in tonnes of carbon dioxide equivalent, the annual quantity of energy consumed from 
activities for which the company is responsible in kWh or what proportion of that figure relates to energy consumed in the 
UK and offshore area.

FUTURE DEVELOPMENTS AND RESEARCH AND DEVELOPMENT ACTIVITIES

Future developments and research and development activities are discussed in the Strategic Report on pages 3 to 26.

RESULTS AND DIVIDENDS

The Group recorded a loss for the year of $46.2 million (FY22: loss of $56.7 million). When it is commercially prudent to 
do so and subject to the availability of distributable reserves, the Board may approve the payment of dividends. However, at 
present, the Directors consider that it is more prudent to retain cash to fund the development of the Group and, as a result, 
feel it is inappropriate to give an indication of the likely level or timing of any future dividend payment. The Directors do 
not recommend payment of a dividend in respect of FY23 (FY22: nil).

FINANCIAL RISK MANAGEMENT

Financial risk management is discussed in Note 4 of the financial statements.

BRANCHES OUTSIDE OF THE UK

The company has two overseas branches, Renalytix AI Inc. (United States) and Renalytix AI Limited (Ireland).

EMPLOYEE POLICIES

Employee policies are discussed in the Strategic Report on page 26.

POLITICAL CONTRIBUTIONS AND CHARITABLE CONTRIBUTIONS

Neither the Company nor any of its subsidiaries made any political donations or incurred any political expenditure during 
the year ended 30 June 2023 (FY22: nil).

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                                                                                                                       32

DIRECTORS’ INTERESTS

The interests in the share capital of the Company of those Directors serving at 30 June 2023 and as at the date of signing of 
these financial statements, all of which are beneficial, were as follows:

Christopher Mills
James McCullough
Erik Lium
Fergus Fleming
Chirag Parikh
Daniel Levangie
Timothy Scannell
Catherine Coste

On 30 June 2023 
Ordinary Shares 
of 0.25p each

On 30 June 2022 
Ordinary Shares 
of 0.25p each

10,072,500
2,746,386
—
569,481
—
—
68,964
—

9,726,125
2,746,386
—
569,481
—
—
68,964
—

Christopher Mills’ shareholding includes shares held through North Atlantic Smaller Companies Investment Trust plc and 
Oryx International Growth Fund Limited. Christopher Mills is a partner and Chief Investment Officer of Harwood Capital 
LLP. Harwood Capital LLP is investment manager to North Atlantic Smaller Companies Investment Trust plc and 
investment adviser to Oryx International Growth Fund Limited.

SUBSTANTIAL SHAREHOLDINGS

As at 30 September 2023, the following interests in 4% or more of the issued Ordinary Share capital had been notified to the 
Company:

Shareholder

Number of Shares

Percentage of Issued 
Share Capital

Icahn School of Medicine at Mount Sinai
Christopher Mills
Jefferson River Capital LLC
Polar Capital

14,619,352
10,072,500
8,294,932
4,000,355

15.5%
10.6%
8.7%
4.2%

STATEMENT OF DIRECTORS’ RESPONSIBILITIES IN RESPECT OF THE FINANCIAL 
STATEMENTS

The Directors are responsible for preparing the Annual Report and the financial statements in accordance with applicable 
law and regulations. 

Company law requires the Directors to prepare financial statements for each financial year. Under that law the Directors 
have elected to prepare the Group and Company financial statements in accordance with UK-adopted international 
accounting standards and the parts of the Companies Act 2006 that applies to companies applying UK-adopted international 
accounting standards. Under company law, the Directors must not approve the financial statements unless they are satisfied 
that they give a true and fair view of the state of affairs and profit or loss of the Company and Group for that period. In 
preparing these financial statements, the Directors are required to:

▪

▪

▪

▪

select suitable accounting policies and then apply them consistently; 

make judgements and accounting estimates that are reasonable and prudent; 

for the Group and Company financial statements, state whether applicable UK-adopted international accounting 
standards and the parts of the Companies Act 2006 that applies to companies applying UK-adopted international 
accounting standards have been followed, subject to any material departures disclosed and explained in the 
financial statements; and 

prepare the financial statements on the going concern basis unless it is inappropriate to presume that the Company 
and Group will continue in business.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       33

The Directors are responsible for keeping adequate accounting records that are sufficient to show and explain the Group and 
Company’s transactions and disclose with reasonable accuracy at any time the financial position of the Group and Company 
and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for 
safeguarding the assets of the Group and Company and hence for taking reasonable steps for the prevention and detection of 
fraud and other irregularities. 

The Directors confirm that: 

▪

▪

▪

so far as each Director is aware, there is no relevant audit information of which the Company’s auditor is 
unaware; and 

the Directors have taken all the steps that they ought to have taken as Directors in order to make themselves 
aware of any relevant audit information and to establish that the Company’s auditor is aware of that information; 
and 

the Directors are responsible for preparing the Annual Report in accordance with applicable law and regulations. 
The Directors consider the Annual Report and the financial statements, taken as a whole, provides the information 
necessary to assess the Company’s performance, business model and strategy and is fair, balanced and 
understandable. 

The Directors are responsible for the maintenance and integrity of the corporate and financial information included on the 
Company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements 
may differ from legislation in other jurisdictions.

DIRECTORS’ INDEMNITIES

The Company has entered into deeds of indemnity for the benefit of each Director of the Company in respect of liabilities to 
which they may become liable in their capacity as Director of the Company and of any Company in the Group. Those 
indemnities are qualifying third party indemnity provisions for the purposes of section 234 of the Companies Act 2006 and 
have been in force during the whole of the financial period and up to the date of approval of the financial statements.

INDEPENDENT AUDITORS

PKF Littlejohn LLP has expressed their willingness to continue in office as auditors and a resolution to reappoint them will 
be proposed at the forthcoming Annual General Meeting.

CORPORATE GOVERNANCE

The Company’s statement of corporate governance can be found in the Corporate Governance Statement on pages 35 to 37 
of these financial statements. The Corporate Governance Statement forms part of this Report of the Directors and is 
incorporated into it by cross-reference.

ANNUAL GENERAL MEETING

The resolutions to be proposed at the forthcoming Annual General Meeting are set out in a separate notice sent to the 
shareholders.

RECOMMENDATION

The Board considers that the resolutions to be proposed at the Annual General Meeting are in the best interests of the 
Company and it is unanimously recommended that shareholders support these proposals as the Board intends to do in 
respect of their own holdings.

This report was approved by the Board on 27 October 2023 and signed on behalf of the Board by:

Christopher Mills

Chairman

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       34

   
Corporate Governance Statement

COMPLIANCE

The Company recognizes the value of good corporate governance in every part of its business. The Board has adopted the 
corporate governance principles of the 2018 Quoted Companies Governance Code (the “QCA Code”) and the Company has 
continued to comply with the QCA Code throughout the reporting period. The Board believes that this corporate governance 
framework is appropriate for the Company, having regard to its size and nature. Details of the QCA Code can be obtained 
from the Quoted Companies Alliance’s website (www.theqca.com).

Details of how the Group seeks to address the principles underlying the QCA Code and how it leverages its principles to 
support the long-term success of the Group can be found on the Company’s website.

BOARD COMPOSITION AND RESPONSIBILITY

The Board currently comprises two Executive Directors and six Non-Executive Directors.

It is the Board’s opinion that the Chirag Parikh, Dan Levangie, Cathy Coste and Tim Scannell are independent and have 
been independent in character and judgement and that there were no relationships or circumstances which could materially 
affect or interfere with the exercise of her independent judgement during the course of FY23. 

All Directors are subject to election by Shareholders at the first Annual General Meeting after their appointment, and are 
subject to re-election at least every three years. Non-Executive Directors are appointed for a specific term of office which 
provides for their removal in certain circumstances, including under section 168 of the Companies Act 2006. The Board 
does not automatically re-nominate Non-Executive Directors for election by Shareholders. The terms of appointment of the 
Non- Executive Directors can be obtained by request to the Company Secretary.

The Board’s primary objective is to generate value for the Group by identifying and assessing business opportunities and 
ensuring that potential risks are identified, monitored and controlled. Matters reserved for Board decisions include strategic 
long-term objectives and the capital structure of major transactions. The implementation of Board decisions and day to day 
operations of the Group are delegated to senior management.

There is a division of responsibilities between the Non-Executive Chairman, who is responsible for the overall strategy of 
the Group and running the Board, and the Chief Executive Officer, who is responsible for implementing the strategy and day 
to day running of the Group. He is assisted by the Chief Technical Officer, who is a Board member, and Chief Financial 
Officer who is not a Board member.

BOARD MEETINGS

Eighteen full Board meetings were held during the year, as well as four additional meetings with select executive directors 
and non-executive directors to approve certain matters. The Directors’ attendance record during their period of office is as 
follows:

Christopher Mills (Non-Executive Chairman)
James McCullough (Chief Executive Officer)
Erik Lium (Non-Executive Director)
Fergus Fleming (Chief Technology Officer)
Chirag Parikh (Non-Executive Director)
Dan Levangie (Non-Executive Director)
Timothy Scannell (Non-Executive Director)
Catherine Coste (Non-Executive Director) - appointed 30 June 2023
Ann Berman (Non-Executive Chairman)

13/13
13/13
13/13
12/13
10/13
11/13
13/13
1/1
5/5

During the year, the Board conducted an evaluation of the performance of the Board and that of the Chairman, as well as the 
effectiveness of the Board Committees. The Board intends to develop further its evaluation of the performance of the Board 
and Committees on an annual basis. The evaluation will include Board composition, experience, dynamics and the Board’s 
role and responsibilities for strategy, risk review and succession planning. The evaluations will involve a detailed 
questionnaire and individual discussions between the Non-Executive Chairman and the Directors.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       35

AUDIT COMMITTEE

The Audit Committee comprises now of Catherine Coste, who acts as chair, Daniel Levangie and Erik Lium. The Audit 
Committee, among other things, determines and examines matters relating to the financial affairs of the Company including 
the terms of the engagement of the Company’s auditors and, in consultation with the auditors, the scope of the audit. It 
receives and reviews the reports from management and the Company’s auditors relating to the half yearly and annual 
forward statements and the accounting and the internal control systems in use throughout the Company.

The committee has met formally three times during the year ended 30 June 2023. There have been no significant matters 
communicated to the Committee by the auditors and no interaction with the Financial Reporting Council.

Since Ann Berman resignation in September 2022, Dan Levangie acted as chair before Catherine Coste taking over as chair 
since her appointment as Non-Executive Director of the Company.  

REMUNERATION COMMITTEE

The Remuneration Committee comprised Daniel Levangie, who acted as chair, and Erik Lium and Catherine Coste. The 
Remuneration Committee reviews and makes recommendations in respect of the Executive Directors’ remuneration and 
benefits packages, including share options and the terms of their appointment. The Remuneration Committee also make 
recommendations to the Board concerning the allocation of share options to employees under the intended share option 
schemes.

The Committee has met twice during the year ended 30 June 2023.

NOMINATION COMMITTEE

For the financial year ended 30 June 2023, the Nomination Committee comprised Timothy Scannell, who acted as chair, and 
Chirag Parikh. Timothy Scannell replaced Ann Berman since her resignation as Non-Executive Director of the company in 
September 2022. The Nomination Committee reviews and recommends nominees as new Directors to the Board.

INTERNAL CONTROL

The Directors are responsible for ensuring that the Group maintains a system of internal control to provide them with 
reasonable assurance regarding the reliability of financial information used within the business and for publication and that 
the assets are safeguarded. There are inherent limitations in any system of internal control and accordingly even the most 
effective system can provide only reasonable, but not absolute, assurance with respect to the preparation of financial 
reporting and the safeguarding of assets.

The Group, in administering its business, has put in place strict authorization, approval and control levels within which 
senior management operates. These controls reflect the Group’s organizational structure and business objectives. The control 
system includes clear lines of accountability and covers all areas of the organization. The Board operates procedures which 
include an appropriate control environment through the definition of the above organization structure and authority levels 
and the identification of the major business risks.

INTERNAL FINANCIAL REPORTING

The Directors are responsible for establishing and maintaining the Group’s system of internal reporting and as such have put 
in place a framework of controls to ensure that on-going financial performance is measured in a timely and correct manner 
and that risks are identified as early as is practicably possible. There is a comprehensive budgeting system and monthly 
management accounts are prepared which compare actual results against both the budget and the previous year. They are 
reviewed and approved by the Board and revised forecasts are prepared on a regular basis.

RELATIONS WITH SHAREHOLDERS

The Company reports to Shareholders twice a year. The Company dispatches the notice of its Annual General Meeting, 
together with a description of the items of special business, at least 21 clear days before the meeting. Each substantially 
separate issue is the subject of a separate resolution and all Shareholders have the opportunity to put questions to the Board 
at the Annual General Meeting.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       36

The Chair(s) of the Audit and Remuneration Committees normally attend the Annual General Meeting and will answer 
questions which may be relevant to their work. However, due to the ongoing COVID-19 pandemic, the Committee Chairs 
will not be in attendance at this year’s Annual General Meeting. The Chairman advises the meeting of the details of proxy 
votes cast on each of the individual resolutions after they have been voted on in the meeting. The Chairman and the Non- 
Executive Directors intend to maintain a good and continuing understanding of the objectives and views of the Shareholders.

DIVERSITY POLICY

The Company has not adopted a formal diversity policy however the employee handbook includes a policy against 
harassment, discrimination and retaliation of any kind.

Shareholders May Contact the Company as Follows:

Tel: +44 (0)20 7933 8790 (from USA: +1-646-217-4999) Email: investors@renalytix.com

CORPORATE SOCIAL RESPONSIBILITY

The Board recognizes that the Group has a duty to be a good corporate citizen and is conscious that its business processes 
minimize harm to the environment, that it contributes as far as is practicable to the local communities in which it operates 
and takes a responsible and positive approach to employment practices. The Group is subject to the requirements of the 
Modern Slavery Act 2015 and published the required statement on its website. The directors consider that the nature of the 
Group’s activities is not inherently detrimental to the environment. The Group is committed to minimizing any effect on the 
environment caused by its operations.

The Corporate Governance Statement was approved by the Board on 27 October 2023 and signed on its behalf by:

Salim Hamir

Company Secretary

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       37

 
Director’s Remuneration Report   
and Policy

RENALYTIX PLC

REMUNERATION COMMITTEE REPORT 

FOR THE YEAR ENDED 30 JUNE 2023

Dear shareholder,

As the Chair of the Remuneration Committee (the “Committee”), I am pleased to present, on behalf of the board of directors 
(the “Board”) of Renalytix PLC (the “Company” or “Renalytix”), the Directors’ remuneration report for the year ended 30 
June 2023 (the “Directors’ Remuneration Report”).

The Company’s Annual Report and Accounts, along with the Directors’ Remuneration Report, will be subject to an advisory 
vote at the forthcoming Annual General Meeting on 15 December 2023 (the “AGM”). There are no other matters that the 
Company requires approval for under Chapter 4A of Part 10 of the Companies Act 2006. The Directors’ Remuneration 
Policy (the “Remuneration Policy”) was approved by the shareholders at the Company’s AGM on 19 December 2021. We 
have included a copy of our current Remuneration Policy, which will remain in effect for the 2024 financial year.

Introduction

During the period covered by this Directors’ Remuneration Report, we maintained the remuneration programs and policies 
that the Committee established during the financial year 2023 and implemented strategic compensation initiatives designed 
to incentivise and retain key employees in the Company.

As we move into financial year 2024 and beyond, the Committee’s role will be to ensure that Directors and senior 
executives at Renalytix are appropriately compensated and incentivised to deliver growth to shareholders in a long-term and 
sustainable manner. The Committee seeks to accomplish this by establishing remuneration programs that are grounded in 
market practice, are effective at driving proper management behaviors, clearly link pay and performance and are cost 
efficient overall.

Corporate Governance Standards

As a public company, we are subject to corporate governance standards and regulations applicable in the United States and 
the United Kingdom.

The Global Marketplace for Talent

Renalytix is a biopharmaceutical company with operations in Europe and the United States. The Company plans to expand 
its operations in both geographic regions in line with the growth of its clinical and manufacturing activities and its plans to 
commercialize its products in these geographies. Given that the market for experienced directors and biopharmaceutical 
executive management talent, particularly in the United States, is very competitive, the Committee references the US market 
as the leading indicator for remuneration levels and practices. This will help attract and retain directors and motivate the 
superior executive management talent needed to successfully manage the Company’s complex global operations. Being 
consistent in this market view of the United States as the primary benchmark for remuneration practices for directors and 
executive directors (CEO and CTO) is key for the Company as it builds its global operations in a manner designed to deliver 
sustainable long-term growth and shareholder value.

Committee decisions have been taken in light of the extensive benchmarking for director and executive director 
compensation conducted in 2023, which included a review of compensation practices of comparable companies to Renalytix 
in the US and Europe. In taking any actions, the Committee is mindful of the general UK compensation framework, 
including investor bodies’ guidance, and the UK Corporate Governance Code, and has incorporated these into its 
remuneration programs, policies and decisions where it believes they best serve the long-term interests of shareholders.

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                                                                                                                       38

Remuneration Program Highlights

While I recommend that you carefully read the disclosure on our programs and policies that follows this letter to help with 
the understanding of our approach to director compensation, I want to highlight the following aspects of our program below:

▪

▪

▪

▪

Pay for Performance - We believe that a significant portion of remuneration of our directors and our 
executive directors (CEO & CTO) should be based on achieving objectives designed to create inherent 
value in the Company, and ultimately on achieving value creation for our shareholders. In line with this 
belief, the compensation of our CEO includes a significant performance-based cash bonus opportunity and 
a large equity incentive component. Further, our directors receive equity incentives designed to reward 
long-term value creation for our shareholders.

Shareholding requirements for Executive Directors - We believe having these requirements encourages 
executive directors to build meaningful shareholding positions and furthers alignment of their interests with 
those of shareholders.

2023 Remuneration Outcome - As outlined above, a core principle in Renalytix’s remuneration program 
is the linkage between pay and performance. In financial year 2023, the annual bonuses of James 
McCullough our CEO and Fergus Fleming our CTO, our executive directors were based on a combination 
of corporate and personal objectives. The Committee determined that while Management made progress in 
key areas in financial year 2023 growing the business, the Company did not achieve 100% of its annual 
corporate objectives, and therefore bonuses for company executives will be paid out at 75% of the target. 
This outcome was based on achievements versus goals in the following key areas: overachievement in the 
area of Technology/Innovation, partial achievement in Executive team performance, Insurance 
reimbursement and Governance, Inclusion, Operations and underachievement of the Revenue Target. 

Major Decisions and Substantial Changes regarding Directors’ Remuneration - During financial year 
2023, there were no major decisions or substantial changes on our directors’ remuneration scheme however 
the company did engage remuneration consultants in the financial year to advise the Committee on all 
aspects of senior executive and director remuneration. The remuneration consultant’s findings were relied 
upon when approving compensation for financial year 2023.

Conclusion

On behalf of the Committee, I hope you will agree that our judgements set out in this report are a sensible approach to 
reward and motivate our directors and our CEO to deliver sustainable growth and shareholder value over the long term and 
do so in a responsible and cost efficient manner. 

I hope that you find the information in this report helpful and responsive to shareholders' and other stakeholders' 
expectations, and look forward to the AGM, where we hope to have your support.

Daniel J. Levangie

Chair of the Remuneration Committee

27 October 2023

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                                                                                                                       39

  DIRECTORS’ REMUNERATION POLICY

This part of the Directors’ remuneration report sets out the Directors’ remuneration policy for the Company’s directors and 
executive directors and has been prepared in accordance with the Large and Medium-sized Companies and Groups 
(Accounts and Reports) (Amendment) Regulations 2013.

The remuneration policy was approved by shareholders in a binding vote at our AGM on 19 December 2021 and took effect 
from the date of approval.

The policy applies for a maximum period of three years (or until a revised policy is approved by shareholders) and will 
therefore next need to be approved in a binding vote at the AGM in 2024.

The scenario charts have been updated to reflect the intended application of the policy for the financial year 2024 and 
references to prior financial years have been updated where appropriate to aid understanding. A copy of the as approved 
policy (including the scenario charts set out in that Policy) is in the Annual Report and Financial Statements for the financial 
year 2021 which is available at:  https://investors.renalytixai.com/financials-and-filings/annual-and-half-year-reports. The 
policy is unchanged this year, and as such is not subject to a shareholder vote.

Renalytix’s remuneration policy has been designed to:

▪

▪

▪

▪

align to the Company’s strategy and business model;

attract, retain and motivate high calibre individuals who have the potential to support the growth of the Company;

be competitive against appropriate market benchmarks, focusing particularly on the US bio-technology sector; 
and

take account of good governance and promote the long-term success of the Company.

EXECUTIVE DIRECTOR REMUNERATION POLICY TABLE

The table below sets out, for each element of pay, a summary of how remuneration of executive directors is structured and 
how it supports the Company’s strategy.

        Purpose and Link to 

Strategy

To attract, retain and motivate 
executive directors of the 
highest calibre who are 
capable of delivering the 
Company’s strategic 
objectives, reflecting the 
individual’s experience and 
role within the Company.
Base salary is designed to 
provide an appropriate level of 
fixed income to avoid an over- 
reliance on variable pay 
elements that could encourage 
excessive risk taking.

Executive Directors

Operation

Maximum Opportunity

Performance Metrics

No formal metrics, although 
any increases take account of 
Company performance and the 
individual performance of the 
Executive Director.

BASE SALARY

Salaries are normally 
reviewed annually, and 
changes are generally 
effective from 1 October.
The annual salary review of 
the Executive Directors 
takes
into consideration a number of 
factors, including:
• scope of the 
individual’s 
responsibilities;
• abilities, experience 

and performance of the 
individual;

• business performance;
• salary increases 

awarded to the overall 
employee population;
• market competitiveness 
and US and UK market 
practice; and

• the underlying rate of 

inflation.

Executive Director level salaries 
are determined considering 
industry benchmarking data. 
There is no prescribed 
maximum annual salary or 
salary increase.
Base salary increases are 
awarded at the discretion of 
the Committee; however, the 
Committee is guided by the 
general increase for the 
broader employee population 
but may decide to award a 
lower increase for Executive 
Directors or exceed this to 
recognize, for example, an 
increase in the scale, scope or 
responsibility of the role 
and/or take account relevant 
market movements.
Executive Director level salary 
increases are approved by the 
Board in line with corporate 
performance and are consistent 
with positions held.

Benefits in kind offered to 
Executive Directors are 
provided on a market- 

The Company aims to offer 
benefits that are in line with 
the Executive Directors’ local 

There is no defined maximum 
value for benefits, but the 
Committee will consider the 

Not performance related.

BENEFITS

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                                                                                                                       40

competitive basis, to assist with 
their recruitment and retention.

market and those offered to the 
wider workforce.

aggregate value of any such 
benefits when determining 
what should be offered.

Executive Directors

Operation

Maximum Opportunity

Performance Metrics

   Purpose and Link 

to Strategy

The Company aims to provide 
a contribution towards life in 
retirement.

An annual bonus rewards the 
achievement of objectives that 
support the Company’s
corporate goals and delivery 
of the business strategy.

PENSION

Depending on their location 
and comparable benefits 
offered to local employees, 
Executive Directors may be 
eligible to receive employer 
contributions to a defined 
contribution pension scheme 
or a cash supplement in lieu of 
such contributions, or a 
mixture of both.

The maximum employer 
pension contribution or cash 
in lieu amount will be a 
percentage of annual base 
salary aligned with that 
provided to other senior 
executives in the Executive 
Director’s location.

ANNUAL BONUS

Executive Director level 
bonuses are approved by the 
Board in line with corporate 
performance and are 
consistent with positions held.

Bonuses are determined based 
on objectives that are agreed 
with the Committee, and the 
Board, at the start of each 
financial year although the 
Committee retains the
discretion to amend objectives 
during the year if it considers 
that objectives are no longer 
appropriate.
Different performance 
measures and weightings may 
be used each year, as agreed 
with the Committee, to take 
into account changes in the 
business strategy.
Bonuses are normally paid in 
cash (but may be paid in the 
form of an equity award, at 
the discretion of the 
Committee).

To attract, motivate, retain 
and reward for long-term, 
sustainable performance 
linked to corporate strategy 
and provide alignment with 
shareholders’ interests.

EQUITY INCENTIVE PLAN (‘EIP’)

There is no maximum 
opportunity for equity 
incentives. However, the 
Committee will generally assess 
the position at similar sized 
comparative companies prior to 
making any award to ensure that 
any awards are aligned to the 
market.

Equity awards granted to 
Executive Directors may take 
the form of options, restricted 
shares, performance share 
units, restricted share units, or 
other forms of awards granted 
in accordance with the 
discretionary EIP that may be 
in place from time to time.
The Executive Directors 
received a grant under the 
EIP’s predecessor plan upon 
listing on AIM and it is 
intended that top- up awards 
shall be issued under the EIP 
from time to time in the 
discretion of the Committee.

Not performance related.

Performance measures are 
determined by the Committee 
each year and may vary to 
ensure that they promote the 
Company’s business strategy 
and shareholder value. The 
annual bonus will be based on 
corporate measures, including, 
but not limited to, financial
and/or strategic measures. 
Bonus measures are reviewed 
at least annually and the 
Committee has the discretion 
to change the measures or to 
introduce new measures when 
it deems appropriate.

Vesting of equity awards is 
generally subject to continued 
employment and may also be 
subject to the achievement of 
performance conditions 
aligned with the Company’s 
strategic plan. Measures, their 
weightings and the period 
over which performance is 
tested will be determined by 
the Committee.
The Committee will select the 
most appropriate form of EIP 
for awards each year and/or 
each individual grant.
Vesting of equity awards may 
be accelerated in part or in 
full in connection with certain 
corporate events such as a 
change of control.

ALL EMPLOYEE EQUITY PLANS

Encourages employee share 
ownership and therefore 
increases alignment of 
interests with shareholders.

The Company may, from time 
to time, operate tax-advantaged 
share plans for which 
Executive Directors would be 
eligible on the same basis as all 
other eligible employees.

Within the limits of the relevant 
legislation.

Not performance related.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       41

 
Notes to the Executive Director Remuneration Policy Table

Legacy Arrangements

For the duration of this Remuneration Policy, the Company will honour any commitments made in respect of current or 
former Directors before the date on which either: (i) the Remuneration Policy becomes effective; or (ii) an individual 
becomes a Director, even where not consistent with the Remuneration Policy set out in this report or prevailing at the time 
such commitment is fulfilled. For the avoidance of doubt, all outstanding historic awards that were granted in connection 
with, or prior to, our IPO on NASDAQ remain eligible to vest based on their original or modified terms.

Clawback Provisions

The Company does not currently have a policy on recoupment and clawback, but the Committee will keep this under review.

Shareholding Requirements

Executive directors are not currently required to build and retain a shareholding, but the Committee will keep this under 
review.

NON-EXECUTIVE DIRECTOR REMUNERATION POLICY TABLE

The table below sets out, for each element of pay, a summary of how remuneration of non-executive directors is structured 
and how it supports the Company’s strategy.

Purpose and Link 

to Strategy

Set at a level that is sufficient 
to attract and retain high 
calibre non- executives who 
contribute to the business.

Chair and Non-Executive Directors

Operation

Maximum Opportunity

Performance Metrics

CASH FEES AND BENEFITS

Not performance related.

When reviewing fee levels 
and benefits, account is taken 
of market movements in the 
fees and benefits of Non-
Executive Directors, Board 
Committee responsibilities 
and ongoing time 
commitments.
Actual fee levels are 
disclosed in the annual 
Directors’ Remuneration 
Report for the relevant 
financial year.

The Chair and the Non- 
Executive Directors receive 
fees paid in cash.
Fees are paid and 
reviewed annually.
Non-Executive Directors 
ordinarily do not participate 
in any pension, bonus or 
performance-based share 
incentive plans. Travel, 
accommodation and other 
business-related expenses 
incurred in carrying out the 
role as well as fees for tax 
advice associated with 
completion of  international 
tax returns will be paid by 
the Company including, if 
relevant, any gross- up for 
tax and/or social security 
contributions.
Tax equalization and/or 
relocation benefits may be 
provided to Non-Executive 
Directors who are required to 
relocate or become tax 
resident in a new 
jurisdiction.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       42

 
Purpose and Link to 
Strategy

To facilitate share 
ownership and provide 
alignment with 
shareholders.

Chair and Non-Executive Directors

Operation

Maximum Opportunity

Performance Metrics

EQUITY-BASED AWARDS

Non-executive directors do not 
participate in performance-based 
equity incentives.

There is no maximum number 
of equity incentive awards that 
may be awarded to individuals 
each year. However, when 
reviewing award levels, account 
is taken of market movements in 
equity incentive awards, Board 
committee responsibilities, 
ongoing time commitments
and the general economic 
environment.

Non-Executive Directors may 
receive equity awards under 
any equity incentive plan 
operated by the Company from 
time
to time which permits their 
participation with careful 
consideration being given to 
ensuring their independence.
Non-Executive Directors 
may receive an initial equity 
award upon appointment or 
election. Initial equity 
awards will normally vest 
over a
specified period of time, 
subject generally to continued 
service. Vesting of equity 
awards may be accelerated in 
part or in
full in connection with certain 
corporate events such as a 
change of control.
In addition, Non-Executive 
Directors may be granted an 
equity award each year which 
may vest in full upon grant or 
over time subject to continued 
service. If a new Non-Executive 
Director joins the Board 
following the date of grant of 
this annual grant in any calendar 
year, such Non-Executive 
Director may be granted a pro 
rata portion of the next annual 
grant to reflect his or her service 
during the relevant part of the 
relevant year.

REMUNERATION FOR NEW APPOINTMENTS

Where it is necessary to appoint or replace an Executive Director, the Committee has determined that the new Executive 
Director will receive a compensation package in accordance with the provisions of the approved remuneration policy in 
force at the time of appointment but focusing on the objective of appointing the most appropriate person in the right 
geography.

In setting base salaries for new Executive Directors, the Committee will consider the existing salary package of the new 
Director, the individual’s skills, level of experience and the market rate for the role.

In setting the annual performance bonus, the Committee may wish to set different performance metrics (to those of other 
Executive Directors) in the first year of appointment. Where it is appropriate to offer a below-median salary on initial 
appointment, the Committee will have the discretion to allow phased salary increases over a period of time for a newly 
appointed Director as the Executive gains experience in their new role, even though this may involve increases in excess of 
inflation and the increases awarded to the wider workforce.

Benefits and pensions will be in line with those offered to other executive directors, taking account of local market practice 
with relocation expenses provided at the discretion of the Committee if necessary. Tax equalization may also be considered 
if an executive is adversely affected by taxation due to their employment with the Group. Legal fees and other costs incurred 
by the individual may also be met by the Company.

The ongoing incentive opportunity offered to new recruits will be in line with that offered to existing Directors. Different 
measures and targets under the bonus plan or the Company’s equity incentive arrangements may be set initially taking 
account of the responsibilities of the individual and the point in the financial year at which they join. A new employee may 
be granted normal annual equity awards in the first year of employment in addition to any awards made with respect to prior 
employment being forfeited, which shall be excluded from any annual maximum on the size of awards.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       43

To enable the recruitment of exceptional talent, the Committee may determine that the buy-out of remuneration forfeit from 
a prior employer is necessary. Where possible, any replacement remuneration will be offered on a like-for-like basis with the 
forfeited awards and may be in the form of cash or shares and depending whether the award forgone has similar performance 
conditions, may or may not be subject to performance conditions. The value of any buy-out will be limited to the value of 
remuneration forfeit. Where appropriate, such awards will be granted under existing share plans, however, the Committee 
will have discretion to make standalone awards where appropriate.

In respect of internal appointments, any commitments entered into in respect of a prior role, including variable pay elements, 
may be allowed to pay out according to their prior term, adjusted as relevant to take into account the appointment.

The terms of appointment for a new Non-Executive Director would be in accordance with the remuneration policy for Non- 
Executive Directors in force at that time.

EXECUTIVE DIRECTORS’ SERVICE CONTRACTS

James McCullough (Chief Executive Officer) is currently employed at-will pursuant to an employment agreement entered 
into with Renalytix AI, Inc, dated 2 November 2018 but effective on 1 November 2018. His employment may be terminated 
by either party at any time for any or no reason, with or without notice. Severance payments no more generous than those 
described in this policy will be payable to him on termination. Upon termination of his employment agreement, our Chief 
Executive Officer is required to resign from all other positions within the Company’s group. Following termination of his 
employment, our Chief Executive Officer will be bound by certain post-termination covenants.

As is customary for US executives, our Chief Executive Officer’s remuneration is subject to a “best-after-tax” cutback for 
excise tax calculations under section 280G of the US Internal Revenue Code of 1986, with no tax gross-up.

Fergus Fleming (Chief Technology Officer) is currently employed on an indefinite term pursuant to an employment 
agreement entered into with the Company dated 1 November 2018. His employment may be terminated by either party on 
12 months written notice.

At its discretion, upon receipt of his written notice, or as an alternative to providing notice, terminate the employment with 
immediate effect and make a payment in lieu of notice, comprising base salary only, for the notice period (or remainder 
thereof, should notice have been given). In the event of a breach of service agreement or other summary termination of 
employment, no such payments will be made.

A copy of these contracts may be viewed at the Company’s head office or may be requested from the Company Secretary at 
the annual general meeting.

NON-EXECUTIVE DIRECTORS’ TERMS OF ENGAGEMENT

All Non-Executive Directors, including the Chair, have specific terms of engagement which may be terminated on not less 
than six months’ notice by either party.

The remuneration of Non-Executive Directors is determined by the Board within the limits set by the Company’s articles of 
association and based on a review of fees and equity-based remuneration paid to Non-Executive Directors of similar 
companies.

A Board evaluation has been performed and the results of this exercise confirmed that all Non-Executive Directors were 
independent.

TERMINATION AND LOSS OF OFFICE PAYMENTS

Depending on market practice in the jurisdiction in which an Executive Director is employed, exit payments shall depend on 
the circumstances of termination and may be made by reference to a notice period (including a payment in lieu of notice) or 
employment “at-will” together with a severance payment. Where a notice period applies, this will not exceed 12 months but 
may be accompanied by additional severance entitlements where applicable.

The Company’s policy on remuneration for Executive Directors who leave the Company is set out below. The Committee 
will exercise its discretion when determining amounts that should be paid to leavers, taking into account the facts and 
circumstances of each case.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       44

 
US-BASED EXECUTIVES

Termination without 
cause or with Good 
Reason1
Subject to the 
executive executing a 
release: a payment of 
up to 12 months’ 
salary and benefits 
including COBRA or 
other applicable 
healthcare coverage 
payable in equal 
monthly instalments
or as a lump sum, at 
the discretion of the
Committee.
Any earned but unpaid 
bonus, a pro-rata 
portion of the bonus 
that would have been 
due for any part year 
worked, plus up to one 
year’s target bonus, or 
a higher bonus at the 
discretion of the 
Committee, payable
as a lump sum or on a
monthly basis.
The Company may 
accelerate the vesting 
of the portion of equity
held on the termination 
date that would have 
vested over the following
one year period.

Salary and benefits

Annual bonus

Equity incentive 
awards

Termination for cause

No payment.

No payment.

Termination without cause or 
with Good Reason1 in connection 
with change in control

Subject to the executive 
executing a release: a payment of 
up to 18 months’ salary and 
benefits and benefits payable in 
equal monthly instalments or as a 
lump sum, at the discretion of the 
Committee.

Any earned but unpaid bonus, a 
pro-rata portion of the bonus that 
would have been due for any part 
year worked, plus up to 1.5 year’s 
target bonus, or a higher bonus at 
the discretion of the Committee, 
payable as a lump sum or on a 
monthly basis.

Unvested awards lapse in full.

Full vesting on termination.

1: Includes, among others, a material diminution in role, a material reduction in base salary or mandated relocation, as 
defined by contract.

NON-US BASED EXECUTIVES

When calculating termination payments for Non-US based Executives, the Committee will consider a variety of factors, 
including individual and Company performance, the length of service of the Executive Directors in question and, where 
appropriate, the obligation for the Executive Directors to mitigate loss. In the event of a change of control and ownership, 
the Committee may exercise its discretion to provide for additional remuneration and/or benefits for Executive Directors 
who leave the Company in connection with such change of control, and will take into account all relevant circumstances 
when making any such determination.

In the case of a ‘good leaver’ (to be determined at the discretion of the Committee) the following policy will normally apply, 
although the Committee retains the discretion to make payments which are no more generous than those applicable to a US 
based Executive Director (as described above), when viewed in the round with notice / payment in lieu of notice 
entitlements:

▪

▪

▪

▪

notice period of twelve months or payment in lieu of notice;

statutory redundancy payments will be made, as appropriate;

Executive Directors have no entitlement to a bonus payment in the event that they cease to be employed by the 
Company, however, they may be considered for a pro-rated award by the Committee in good leaver 
circumstances; and

any share-based entitlements granted to an Executive Director under the Company’s share and individual share 
contracts or share option plans will be determined based upon the relevant individual share option contracts or 
plan rules, and performance conditions or hurdles and vesting may be accelerated in the discretion of the 
Committee.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       45

ADDITIONAL PAYMENTS

The Committee will make payment of any statutory entitlements as necessary. In addition, the Committee will retain the 
discretion to make additional payments in settlement of, or to compromise, an actual or potential claim in connection with a 
termination of any Executive Director as necessary.

The Committee reserves the right to make reasonable legal, relocation and outplacement costs, if deemed necessary.

ILLUSTRATION OF APPLICATION OF THE POLICY

Pay-For-Performance Scenario Analysis

The charts below have been updated to reflect the intended application of the policy for the 2024 financial year. A copy of 
the shareholder approved policy (including the scenario charts for the 2023 financial year) is in the Annual Report for the 
year ended 30 June 2022, which is available on the Company’s website. The charts below provide an estimate of the 
potential future reward opportunities for the Executive Directors, and the potential split between different elements of 
remuneration under different performance scenarios:

▪

▪

▪

Minimum - fixed pay only.

Target (performance in line with expectations) - fixed pay, plus bonus and equity payouts at threshold level (50% 
of maximum).

Maximum (performance meets or exceeds maximum) - fixed pay, plus the maximum bonus payout and full 
vesting of any equity awards, based on grant-date face value of awards to be granted in financial year 2024.

Fixed Pay Comprises:

▪

▪

▪

Salaries - salary effective at 1 July 2023.

Benefits - an estimated value of all benefits receivable in the 2024 financial year.

Pension - 5% of salary for the CEO and CTO.

Amounts are shown in thousands (USD).

Values do not include the impact of any share price appreciation over the vesting period. The reporting regulations require 
the disclosure of maximum total pay including the impact of a 50% increase in share price over the vesting period for equity 
awards subject to multi-year performance measures which is not applicable to any of our current equity awards. The equity 
award amounts shown above relate to share options vesting during the year using the Company’s AIM closing price at the 
end of the quarter in which the award vested less associated exercise price.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       46

 
Statement Of Consideration Of Employees’ Pay and Remuneration Conditions Elsewhere In The 
Group

The Company does not formally consult with employees on the matters of Executive Director remuneration. However, 
the Committee is made aware of employment conditions in the wider Group. The same broad principles apply to the 
remuneration policy for both Executive Directors and the wider employee population. However, the remuneration for 
Executive Directors has a stronger emphasis on performance-related pay than for other employees. Salaries, benefits 
and pensions are compared to appropriate market rates in the jurisdiction in which the Executive Director is employed 
and is set at an appropriate level with allowance for role, responsibilities and experience.

Statement Of Consideration Of Shareholders’ Views

The Committee will consider any Shareholder feedback received at the Annual General Meeting and at meetings 
throughout the year, when reviewing the overall remuneration policy each year. The guidance from relevant 
shareholder representative bodies is also considered on an ongoing basis.

More specifically the Committee will consult with major Shareholders when proposing any significant changes to the 
policy in the future.

ANNUAL REPORT ON REMUNERATION

This report constitutes a Directors’ Remuneration Report in accordance with the Large and Medium-sized Companies and 
Groups (Accounts and Reports) (Amendment) Regulations 2013, the Companies (Miscellaneous Reporting) Regulations 
2018, and the Companies (Directors’ Remuneration Policy and Directors’ Remuneration Report) Regulations 2019 and 
section 420 of the Companies Act 2006. This report sets out the Group policy on Directors’ remuneration, including 
emoluments, benefits and other share-based awards made to each Director.

This section of the remuneration report provides details of how our remuneration policy was implemented during the 
financial year ended 30 June 2023, and how it will be implemented during the year ending 30 June 2024.

This report splits certain information into that for Executive Directors and that for Non-Executive Directors.

REMUNERATION COMMITTEE (THE “COMMITTEE”)

Governance

In its decision-making process, the Committee takes account of information from both internal and independent sources and 
Aon surveys. Aon was appointed as remuneration consultants by the Committee based on their expertise in the field via a 
competitive tender process. Aon advises the Committee on all aspects of senior executive remuneration. Aon has kept the 
Committee up to date on remuneration trends and corporate governance best practice. Aon does not have any other 
connection with the Company and is considered to be independent and objective by the Committee. During the year ended 
30 June 2023, fees charged by Aon amounted to approximately USD 19,500 and this was charged on a time spent basis.

The current members of the Committee are Daniel J. Levangie (Chair), Timothy Scannell and Catherine Coste.

Remuneration Committee report

The Company’s Chief Human Resources Officer provides updates to the Committee, as required, to ensure that the 
Committee is fully informed about pay and performance issues throughout the Company. The Committee takes these factors 
into account when determining the remuneration of the Executive Directors and senior executives.

No Executive Director or employee can participate in any discussion directly relating to their own personal conditions of 
service or remuneration.

No conflicts of interest have arisen during the year and none of the members of the Committee has any personal financial 
interest in the matters discussed, other than as option holders. The fees of the Non-Executive Directors are approved by the 
Board on the joint recommendation of the Committee and the Chief Executive Officer.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       47

Director
Daniel J. Levangie
Timothy Scannell
Catherine Coste

Meetings Attended
3/3
3/3
1/1

The Committee met three times in the year to 30 June 2023. Catherine Coste was only a member of the committee for one 
meeting.

Discretions Retained By The Committee

The Committee operates under the powers it has been delegated by the Board. In addition, it complies with rules that require 
certain matters to be put to either shareholder or Board approval. These rules provide the Committee with certain discretions 
which serve to ensure that the implementation of the Remuneration Policy is fair, both to the individual director and to the 
shareholders. The Committee operates the Company’s remuneration plans in accordance with their rules from time to time. 
To maintain an efficient administrative process, the Committee retains the following discretions to apply its judgement in 
setting remuneration:

▪

▪

▪

▪

▪

▪

▪

▪

the eligibility to participate in the plans;

the timing of grant of awards and any payments;

the size of awards and payments (subject to any maximum limits set out in the policy table above and the 
respective plan rules);

the determination of whether the performance conditions have been met;

determining a good or bad leaver under the terms of the plan and the treatment of such leaver’s cash and equity 
remuneration;

dealing with a change of control or restructuring of the Group;

adjustments required in certain capital events such as rights issues, corporate restructuring, events and special 
dividends and certain other out-of-the-ordinary events;

the annual review of performance and other vesting conditions for the annual bonus plan and equity awards.

In certain circumstances, such as a material acquisition/divestment of a Group business, which mean the original 
performance conditions are no longer appropriate, the Committee may adjust the targets, alter weightings or set different 
measures as necessary, to ensure the conditions achieve their original purpose and are not materially less difficult to satisfy.

The Committee may make minor amendments to the Remuneration Policy (for regulatory, exchange control, tax or 
administrative purposes or to take account of a change in legislation) without obtaining shareholder approval for that 
amendment.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       48

Directors’ Remuneration – financial year ended 30 June 2023

The total remuneration of the individual Directors who served during the period is shown below. Total remuneration is 
the sum of emoluments for the period in service as a director plus Company pension contributions, and the value of 
long-term incentive awards vesting by reference to performance in the twelve months to 30 June 2023.

Directors’ Remuneration – financial year ended 30 June 2023

Year

Base Salary 
($000s)a

Benefits 
($000s)b

Bonus 
($000s)c

EIPd

Pension 
($000s)e

Total 
Remuneration 
($000s)

Total Fixed 
Remuneration 
($000s)

Total 
Variable 
Remuneration 
($000s)

Executive Directors
James 
McCullough

2023

Fergus Fleming

2022
2023
2022
Non-Executive Directors

Erik Lium 
(Mount Sinai 
representative)1

Christopher Mills

Chirag Parikh2

Daniel Levangie

Timothy Scannell

Ann Berman3

Catherine Coste4

2023

2022
2023
2022
2023
2022
2023
2022
2023
2022
2023
2022
2023
2022

601

601
351
378

24

27
24
27
24
88
24
27
24
7
5
27
-
-

30

20
16
16

406

-
154
-

-

-
-
-
-
-
-
-
-
-
-
-
-
-

-

-
-
-
-
-
-
-
-
-
-
-
-
-

-

-
-
-

-

-
-
-
-
-
-
-
-
-
-
-
-
-

20

27
18
75

-

-
-
-
-
-
-
-
-
-
-
-
-
-

1,057

648
539
469

24

27
24
27
24
88
24
27
24
7
5
27
-
-

651

648
385
469

24

27
24
27
24
88
24
27
24
7
5
27
-
-

406

-
154
-

-

-
-
-
-
-
-
-
-
-
-
-
-
-

Notes to the remuneration table

a. All amounts presented were earned in respect of the financial period.

b. This is the taxable value of benefits paid or payable in respect of the financial period. For executive directors, 

benefits include health, dental, vision, life and long-term disability insurance paid for by the Company

c. The remuneration committee has concluded that executive bonuses will be paid out at 75% of targets for the 

financial year ended 30 June 2023.

d. The amount shown relates to the market value of the EIP and other equity awards vesting during the year using 

the Company’s AIM closing price at the end of the quarter in which the award vested less associated exercise 
price.

e. The amount shown relates to Company contributions to the defined contribution scheme, plus any cash in lieu.

1. Dr. Lium sits on our board as a representative of the Icahn School of Medicine at Mount Sinai. This fee is 

invoiced annually by Mt. Sinai.

2.

In the financial year ended 30 June 2022, in addition to $26,621 in board fees, Chirag Parikh’s remuneration 
includes consulting services performed for Renalytix. Chirag received $500/hr for consulting services in the 
financial year ended 30 June 2022.

3. Ann Berman resigned from the board in September 2022.

4. Catherine Coste joined the board on 30 June 2023 and did not receive remuneration in the financial year ended 

30 June 2023 or the financial year ended 30 June 2022.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       49

ANNUAL PERFORMANCE BONUS – 2022/2023 financial year
In the 2023 financial year, all employees were eligible for an annual discretionary cash bonus, whereby performance 
objectives were established at the beginning of the financial year by reference to suitably challenging corporate goals.

For the 2023 financial year, the company refined the annual bonus calculation as annual bonuses for all staff (including 
Executive Directors) were calculated and achieved by reference to both corporate and individual  performance.

The achievement against the scorecard of corporate goals was as follows:

Corporate goals

Weighting %

Revenue
Executive Team Performance
Insurance Coverage
Technology and Innovation
Governance, Inclusion and Operations Team
Total

30%
20%
20%
25%
5%
100%

2023 
Achievement %
0%
25%
50%
200%
50%

Specific targets associated with each corporate goal are commercially sensitive and have been omitted to protect 
competitive information. However, full details of the targets will be disclosed when they are no longer considered 
commercially sensitive.

Achievement against objectives is given careful consideration by the Committee prior to finalisation of bonus 
outcomes. The Committee reviewed the formulaic outcome of the scorecard and concluded that 75% of corporate goals 
were met and the scorecard outcome, as shown above, reflected the performance of the Executive Directors in the year, 
accordingly no discretion was exercised to alter the formulaic outcome. As a result of corporate performance, the 
following bonuses were calculated for the Company’s executive directors and approved by the Board.

James McCullough
Fergus Fleming

Bonus 
scorecard 
Outcome 
($000s)

% of salary

Maximum 
opportunity 
Cash 
amount 
($000s)

% of salary

406
154

68%
44%

541
193

90%
55%

During the year ended 30 June 2023, no Executive Directors or non-executive directors were awarded options or other 
awards under the EIP scheme. There was no change in the exercise price or date of existing options.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       50

 
EXECUTIVE DIRECTORS’ SHARE AWARDS
Shareholdings as at 30 June 2023 for each director who has held office during the 2023 financial year are set out in the 
table below (together with interests held by his or her connected persons):

Directors’ Interests In Shares At 30 June 2023

Director

Current Directors
James McCullough1
Fergus Fleming
Mount Sinai (Board 
Seat)
Christopher Mills2
Chirag Parikh
Daniel Levangie
Timothy Scannell
Catherine Coste

Total shares 
owned 
outright plus 
vested options

Shares owned 
outright

Percentage of 
issued share 
capital

Vested but 
not exercised

Unvested but 
subject to 
performance

Unvested and 
not subjected 
to 
performance

2,746,386
1,107,642

2,746,386
569,481

14,823,853
10,072,500
115,724
17,500
78,964
—

14,619,352
10,072,500
—
—
68,964
—

2.9%
0.6%

15.5%
10.6%
—
—
0.1%
—

—
538,161

204,501

—
115,724
17,500
10,000
—

—
—

—
—
—
—
—
—

—
—

—
—
—
22,500
30,000
—

1. James McCullough shareholding includes 2,746,386 shares held through his family trust, The McCullough 2020 

Irrevocable Trust (the “Trust”).

2. Christopher Mills is partner and Chief Investment Officer of Harwood Capital LLP. Harwood Capital LLP is 

Investment Manager to North Atlantic Smaller Companies Investment Trust plc and investment adviser to Oryx 
International Growth Fund Limited. Christopher’s shareholding is made up of 6,145,001 ordinary shares held by 
North Atlantic Smaller Companies Investment Trust PLC, 2,780,000 ordinary shares are held by Oryx 
International Growth Fund Limited and 801,124 ordinary shares are held by Harwood Capital LLP.

3. Executive Directors are encouraged to build a meaningful shareholding so as to align their interests with those of 

shareholders but no formal shareholders requirements apply.

4. Save as noted, no connected persons hold any interests.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       51

 
REMUNERATION COMMITTEE REPORT (CONTINUED)

Performance Graph and Table
The following graph shows Renalytix’s cumulative Total Shareholder Return (“TSR”) from the Company’s November 
2018 IPO on AIM relative to the FTSE AIM All Share Index and the Nasdaq Biotech Index. These two indices were 
chosen due to Renalytix’s listing on both exchanges and the sector in which it operates. For the period from 6 
November 2018 to 30 June 2023  Renalytix Plc data relates to AIM TSR, and from 17 July 2020 the data relates to 
Nasdaq TSR (as show by the separate line).

TSR is defined as the return on investment obtained from holding a company’s shares over a period. It includes 
dividends paid, the change in capital value of the shares and any other payment made to or by shareholders within the 
period.

ALIGNING PAY WITH PERFORMANCE

CEO Remuneration Compared With Annual Growth In TSR:
The total remuneration figure for the CEO (James McCullough) is shown in the table below, along with the value of 
bonuses, and EIP vesting, as a percentage of the maximum opportunity. As 2021 was the first year reported since listing 
on Nasdaq and therefore the first year which this disclosure was required, it is not possible to provide meaningful 
comparative data from period prior to that date. 

James McCullough
Total remuneration
Actual bonus as a % of the maximum
Actual share award vesting as % of the maximum

2023
($000s)

2022
($000s)

2021
($000s)

1,057

75%
—

648

0%
—

1,193

50%
—

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       52

 
Percentage Change In Remuneration Of The Directors and Employees
Set out below is the change between the financial years 2021 to 2023 in base salary, benefits, pension and annual 
performance bonus for all the directors and the Company’s employees.

James McCullough
Fergus Fleming
Mount Sinai
Christopher Mills
Chirag Parikh
Daniel Levangie
Timothy Scannell
Ann Berman 1
Catherine Coste 2

Percent change FY22 - 
FY23

Percent change FY21 - 
FY22
Salary Benefits Bonus Salary Benefits Bonus Salary Benefits Bonus
36%
371%
512% 116%

Percent change FY20 - 
FY21

0%
-7%
-9%
-9%
-73%
-9%
262%
-80%
-

48%
1%
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-

3%
3%
-
-
-
-
-
-
-

-68% -100% 58%
-8%
-100% 58%
-
-
-
-
-
-
-

-
-
-
-
-
-
-

-
-
-
-
-
-
-

-
-
-
-
-
-
-

-
-
-
-
-
-
-

1. Ann Berman resigned from the board in September 2022.

2. Catherine Coste joined the board in June 2023 therefore she did not receive remuneration for the 2023 financial 

year (or any prior year). 

Relative Importance Of Spend On Pay
Total revenue and administrative expenditures have been selected as comparators for the employee costs as no dividends 
have been paid and these two financial measures are strong indicators of the activity within the Company and of its 
performance.

Total employee remuneration ($000s)
Average number of employees
Revenue ($000s)
Administrative expenditures ($000s)
No dividends distributions or share buyback transactions occurred 
in either 2023 or 2022

Year ended 
30 June 
2023

Year ended 
30 June 
2022

Change
 ($000’s)

Change
(%)

20,887
82
3,403
43,056

26,527
93
2,970
58,290

(5,641)
(11)
433
(15,234)

-21%
-12%
15%
-26%

—

—

—

Statement Of Implementation Of Policy In 2023/24
Base salary: There was no change in James McCullough’s or Fergus Fleming’s base salary for the 2022/2023 financial 
year. The 2023/2024 salary increases have not been determined but are expected to be effective 1 January 2024 and are 
expected to be in line with market rates for all of eligible employees, being those that had joined the business prior to 1 July 
2023.

Pension and benefits: In 2023/2024, Executive Directors are eligible for the same benefits as provided to all senior 
employees. The Executive Directors are each entitled to the maximum employer pension contribution of 5% of their 
respective base salary which is paid into a defined contribution pension scheme / paid in cash in lieu of pension 
contributions.

Annual performance bonus: For 2023/2024, the Executive Directors’ annual cash bonus target payouts are 90% of base 
salary for the executive director and 55% of the base salary for the chief technology officer. The Committee considers 
overall corporate performance and individual performance when determining the final bonus amount to be awarded to an 
Executive Director. Performance will be tested against targets set by the Committee at the start of the year and will comprise 
a combination of corporate goals and individual goals for James McCullough and Fergus Fleming.

Specific targets are commercially sensitive and therefore are not disclosed in advance. However, full details of the targets 
and performance against them will be disclosed when they are no longer considered commercially sensitive.

The Chairman and non-executive directors will continue to be paid their current level of fees.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       53

 
Payments For Loss Of Office (Audited Information)
There were no loss of office payments in 2022/2023.

Payments To Past Directors (Audited Information)
The Company made payments of $5,000 to Ann Berman for her service as a director for the financial year ended 30 June 
2023. Ann Berman resigned from the board in September 2022. 

Clawback
The Committee shall make any required amendments to the malus and clawback policy or adopt a new Dodd-Frank 
compliant policy as required by the SEC and Nasdaq.

Shareholder Voting On Remuneration Matters At AGM
The table below sets out the previous votes cast at our AGM in 2022 in respect of the previous Directors’ Remuneration 
Report and the votes cast at our AGM in 2021 in respect of the Remuneration Policy.

Votes For

Number

%
80.64% 29,678,455
70.34% 25,272,488

Votes Against

Votes Withheld

%

Number

Number

19.36%
7,125,845
29.66% 10,658,539

11,996
26,932

Directors' Remuneration Report
Directors' Remuneration Policy

Daniel J. Levangie
Chair of the Remuneration Committee

27 October 2023

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       54

 
Audit Committee Report

RENALYTIX PLC

AUDIT COMMITTEE REPORT 

FOR THE YEAR ENDED 30 JUNE 2023

The Audit Committee reports to the Board on matters concerning the Group’s internal financial controls, financial 
reporting and risk management systems, identifying any matters in respect of which it considers that action or 
improvement is needed and making recommendations as to the steps to be taken.

Composition of the Audit Committee

The Audit Committee is appointed by the Board compromised Catherine Coste (Committee Chair) Dan Levangie and 
Erik Lium. Catherine Coste has experience of chairing and holding non-executive position with number of Boards. 
Whilst no non-executive member of the Board held an accounting qualification during the 2022 financial year, 
Catherine Coste, Dan Levangie and Erik Lium were both deemed competent by virtue of their experience and relevant 
experience to the sector in which the Company operates.

Role of the Audit Committee

The Audit Committee operates within defined terms of reference and its main functions are:

▪

▪

▪

▪

▪

▪

▪

 to monitor the internal financial control and risk management systems on which the Group is reliant;

 to consider whether there is a need for the Group to have its own internal audit function;

 to monitor the integrity of the Group’s financial statements and formal announcements relating to the Group’s 
financial performance, reviewing significant financial reporting judgements contained in them;

to review arrangements by which staff may, in confidence, raise concerns about possible improprieties in matters 
of financial reporting or any other matter;

to meet the independent Auditor of the Group to review their proposed audit programme of work and the 
subsequent Audit Report and to assess the effectiveness of the audit process and the levels of fees paid in respect 
of both audit and non-audit work;

 to make recommendations to the Board in relation to the appointment, re-appointment or removal of the Auditor, 
and to negotiate their remuneration and terms of engagement on audit and non-audit work; and 

to monitor and review annually the external Auditor’s independence, objectivity, effectiveness, resources and 
qualification.

External audit

The Group’s external auditors are PKF Littlejohn LLP and are Ernst Young LLP.

The effectiveness and independence of the external audits and auditors are reviewed annually by reference to the 
auditor’s attendance at Committee meetings, their audit plan, audit fieldwork, post-audit management letter and the 
judgment of the Committee having discussed the matter with the finance director.

The Board has reviewed its safeguards and policies in place for non-audit services and is satisfied that these are 
sufficiently robust to ensure that both auditors maintain their audit objectivity and independence. PKF Littlejohn LLP 
report to the Board annually on their independence from the Company. Non-audit services are provided only if such 
services do not conflict with their statutory responsibilities and ethical guidance.

Taking all of the above into consideration, the Committee concluded the auditors were both effective and independent 
during the year. 

Review of financial statements and risks identified Financial statements issued by the Company need to be fair, 
balanced, and understandable. The Audit Committee reviews the Annual Report as a whole and makes 
recommendations to the Board. The Audit Committee has advised the Board that, in its opinion, the Annual Report and 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       55

Financial Statements are fair, balanced and understandable and provides the information necessary for shareholders to 
assess the Company’s position and performance, business model and strategy. The Company’s unaudited interim 
results are also reviewed by the Audit Committee prior to their publication. 

Key risk areas, and audit and accounting matters considered by the Committee

Generally, there is a close relationship between the Company’s income statement and its cash flows, with few 
significant judgmental items or longer-term unsettled items remaining on the balance sheet. 

The main accounting and audit risks identified during the year, including as also described in the auditor’s report, were:

▪

▪

▪

▪

capitalisation of intangible costs and impairment review;

recoverability of amounts due from subsidiary;

funding and going concern risk assessments; and

revenue recognition.

No significant adjustments or matters of concern were identified by the external audit.

Internal control and consideration of the need for the internal audit

The Board believes that due to the size of the business there is currently no requirement for an internal audit function. 
This matter is reviewed annually. 

The finance function for the Group is managed by the Chief Finance Officer with use of an internal team of 
accountants. Reliance with regard to internal control effectiveness is placed on the close involvement of the executive 
officers and the Company Secretary in the day to day management and control of the business, with the Audit 
Committee retaining oversight of financial information provided to the Board and the Group’s accounting and internal 
control policies and procedures.

Recommendations for amendments or improvements are made as needed. 

During the year there were no significant matters raised by the external auditors, nor any significant matters of concern 
identified with regard to internal control elsewhere that required action by the Committee.

Therefore, it is judged that the current size, financial position, complexity and risk profile of the Group does not justify 
the cost of an internal audit function. This will be kept under annual review.

Catherine Coste
Chair of the Audit Committee 

27 October 2023

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       56

 
 
INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF RENALYTIX PLC

Opinion 

We  have  audited  the  financial  statements  of  Renalytix  Plc  (the  ‘parent  company’)  and  its  subsidiaries  (the 
‘group’)  for  the  year  ended  30  June  2023  which  comprise  the  Consolidated  Income  Statement,  the 
Consolidated Statement of Comprehensive Income, the Consolidated and Company Statements of Financial 
Position,  the  Consolidated  and  Company  Statements  of  Cash  Flows,  the  Consolidated  and  Company 
Statements  of  Changes  in  Equity  and  notes  to  the  financial  statements,  including  significant  accounting 
policies. The financial reporting framework that has been applied in their preparation is applicable law and UK-
adopted  international  accounting  standards  and  as  regards  the  parent  company  financial  statements,  as 
applied in accordance with the provisions of the Companies Act 2006. 

In our opinion: 

•

•

•

•

the  financial  statements  give  a  true  and  fair  view  of  the  state  of  the  group’s  and  of  the  parent 
company’s affairs as at 30 June 2023 and of the group’s loss for the year then ended; 

the  group  financial  statements  have  been  properly  prepared  in  accordance  with  UK-adopted 
international accounting standards;

the  parent  company  financial  statements  have  been  properly  prepared  in  accordance  with  UK-
adopted international accounting standards and as applied in accordance with the provisions of the 
Companies Act 2006; and

the financial statements have been prepared in accordance with the requirements of the Companies 
Act 2006. 

Basis for opinion 

We  conducted  our  audit  in  accordance  with  International  Standards  on  Auditing  (UK)  (ISAs  (UK))  and 
applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities 
for  the  audit  of  the  financial  statements  section  of  our  report.  We  are  independent  of  the  company  in 
accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, 
including  the  FRC’s  Ethical  Standard  as  applied  to  listed  entities,  and  we  have  fulfilled  our  other  ethical 
responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained 
is sufficient and appropriate to provide a basis for our opinion. 

Material uncertainty related to going concern

We draw attention to note 3 in the financial statements, which indicates that the group incurred a net loss of 
$45.8m during the year ended 30 June 2023 and the directors’ forecast a need for additional financing within 
the going concern period. As stated in note 3, these events or conditions, along with the other matters as set 
forth in note 3, indicate that a material uncertainty exists that may cast significant doubt on the group’s and 
company’s ability to continue as a going concern. Our opinion is not modified in respect of this matter.

In auditing the financial statements, we have concluded that the director’s use of the going concern basis of 
accounting  in  the  preparation  of  the  financial  statements  is  appropriate.  Our  evaluation  of  the  directors’ 
assessment of the group’s and company’s ability to continue to adopt the going concern basis of accounting 
included:

•

•

•

Obtaining management’s base case forecast for the period to the 31 October 2024 and testing the 
mathematical accuracy of the base case forecast, including a review of the cash position at and 
after the year end; 

Assessing the historical accuracy of management’s forecasts;

Reviewing management's assessment of going concern, including their evaluation of future funding 
requirements, the likelihood of achieving the required growth in revenue and the ability to realise 
additional cost reductions; and 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       57

 
 
 
•

Critically  assessing  the  disclosures  made  within  the  financial  statements  for  consistency  with 
management’s assessment of going concern. 

Our responsibilities and the responsibilities of the directors with respect to going concern are described in the 
relevant sections of this report. 

Our application of materiality 

We apply the concept of materiality both in planning and performing our audit, and in evaluating the effect of 
misstatements. At the planning stage, materiality is used to determine the financial statement areas that are 
included within the scope of our audit.

Materiality for the group financial statements as a whole was $423,000 (2022: $743,000) with performance 
materiality  set  at  $253,000  (2022:  $445,800),  being  60%  of  group  materiality.  Materiality  for  the  financial 
statements as a whole was based upon 1% of the group’s gross assets.

In  determining  materiality,  we  considered  gross  assets  a  key  benchmark  for  the  group  as  the  group  holds 
product trademarks and licences and product development costs are capitalised in the group. We consider 
gross assets to be a key metric used by shareholders owing to the historic investment in the product technology 
held by the group. We have also set a separate, lower materiality, for revenue to reflect the early stages of 
revenue  generation  which  would  not  be  captured  sufficiently  using  group  materiality.  We  have  determined 
materiality for revenue as $70,000 (2022: $59,000) and performance materiality as $42,000 (2022: $35,400), 
calculated at 2% of revenue. 

The percentages applied to these benchmarks have been selected to bring into scope all significant classes 
of  transactions,  account  balances  and  disclosures  relevant  for  the  shareholders,  and  also  to  ensure  that 
matters that would have a significant impact on the reported result were appropriately considered.

In determining performance materiality, significant judgements made were in respect to our experience with 
auditing the financial statements of the group in previous year, based on the number and quantum of identified 
misstatements in prior period audits.

We agreed with the audit committee that we would report all individual audit differences identified for the group 
during  the  course  of  our  audit  in  excess  of  $21,000  (2022:  $37,150)  together  with  any  other  audit 
misstatements below that threshold that we believe warrant reporting on qualitative grounds.

Materiality  applied  to  the  parent  company  financial  statements  was  $235,000  (2022:  $328,000)  with 
performance materiality set at $170,000 (2021: $197,000), being 60% of the parent company materiality.

The benchmark for materiality of the parent company was 0.25% of gross assets. The significant judgements 
used by us in determining this were that gross assets are the primary measure used by the shareholders in 
assessing  the  future  performance  of  the  company’s  trading  subsidiary.  The  percentage  applied  to  this 
benchmark has been selected to bring into scope all significant classes of transactions, account balances and 
disclosures relevant for the shareholders, and also to ensure that matters that would have a significant impact 
on the reported profit or loss were appropriately considered.

In  determining  performance  materiality,  significant  judgements  made  were  in  respect  our  experience  with 
auditing the financial statements of the parent company in previous years.

We agreed with the audit committee that we would report all individual audit differences identified for the parent 
company during the course of our audit in excess of $15,000 (2022: $16,000) together with any other audit 
misstatements below that threshold that we believe warrant reporting on qualitative grounds.

Our approach to the audit

In  designing  our  audit,  we  determined  materiality  and  assessed  the  risks  of  material  misstatement  in  the 
financial statements. In particular, we looked at areas involving significant accounting estimates and judgement 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       58

 
 
 
 
 
 
 
 
 
 
 
by the directors such as the recoverability of intangible fixed assets, as outlined in the Key Audit Matter section 
below, and considered events that are inherently uncertain. 
We also addressed the risk of management override of controls, including among other matters consideration 
of  whether  there  was  evidence  of  bias  that  represented  a  risk  of  material  misstatement  due  to  fraud.  All 
significant and/or material subsidiary undertakings were audited directly by PKF Littlejohn LLP and subject to 
full scope audits. 

Key audit matters 

Key audit matters are those matters that, in our professional judgment, were of most significance in our audit 
of the financial statements of the current period and include the most significant assessed risks of material 
misstatement (whether or not due to fraud) we identified, including those which had the greatest effect on: the 
overall audit strategy, the allocation of resources in the audit; and directing the efforts of the engagement team. 
These matters were addressed in the context of our audit of the financial statements as a whole, and in forming 
our opinion thereon, and we do not provide a separate opinion on these matters.  In addition to the matter 
described  in  the  Material  uncertainty  related  to  going  concern  section  we  have  determined  the  matters 
described below to be the key audit matters to be communicated in our report.

Key Audit Matter
Recoverability of intangible fixed assets (refer 
notes 6 and 19) - group 
Intangible  assets  have  a  carrying  value  of 
$12,511,000 
following 
categories: 

comprise 

and 

the 

•     Trademarks, trade names and licenses 
•     Trade secrets 
•     Product development costs 

Intangible  assets  that  are  measured  at  cost  less 
accumulated  amortisation  and  impairment  are 
assessed  at  the  end  of  each  reporting  period  for  
indicators  of  impairment.  The  group  has  incurred 
recurring  losses  and  negative  cash  flows  from 
operations since inception.

Where  indicators  of  impairment  under  IAS  36 
Impairment  of  Assets  are  present,  management 
estimates the recoverable amounts using value in 
use  calculations.  These 
involve  significant 
estimation and judgement from management due 
to  the  inherent  uncertainty  and  subjectivity  over 
forecasting  and  discounting  future  cash  flows. 
Additionally,  significant 
is  required 
when  estimating  the  useful  economic  lives  of 
intangible assets.

judgement 

Given the judgements and estimates involved this 
was a key focus for our audit.

How our scope addressed this matter

Our work on this matter included:

•

•

Confirming  the  group  held  good  title  to 
the intangible assets. 

Assessing  whether  any  indicators  of 
impairment under IAS 36 Impairment of 
Assets  (including  regulatory 
issues, 
progress  on  obtaining  milestones 
towards 
commercialisation, 
development  of  competing  technology 
and  products  entering 
the  market) 
existed  at  the  reporting  date  which 
required  an  impairment  charge  to  be 
recognised in the Statement of Income. 

•

Testing  the  forecasts  and  value  in  use 
calculations to include: 

o

o

o

o

Evaluation  and  challenge  of  the 
key  assumptions  and  inputs  used 
by management;

The  performance  of  a  sensitivity 
analysis  on 
to 
reasonably  possible  changes  in 
key assumptions and inputs; 

the  headroom 

Checking 
accuracy of the financial model;

the  mathematical 

Assessing 
previous 
results.

the 
forecasts 

accuracy 

of 
to  actual 

•

Performing 
assessment of impairment.

an 

independent 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       59

 
 
 
 
 
 
 
Carrying value of investments in subsidiaries 
and recoverability of intercompany receivable 
(refer note 20)
Investments in subsidiaries have a carrying value 
of  $118,487,000  and  are  carried  at  cost  less 
impairment.

The recoverability of the carrying value is ultimately 
dependent  on  the  trading  performance  of  the 
subsidiary  undertakings.  The  subsidiaries  have 
incurred recurring losses and negative cash flows, 
therefore  there  is  a  risk  that  the  carrying  value  is 
impaired.

The assessment of recoverability utilises the same 
value  in  use  calculations  as  those  used  for  the 
impairment assessment of intangible assets, which 
involve  significant  management  judgement  and 
estimation. 

Our work on this matter included:

•

Testing  the  forecasts  and  value  in  use 
calculations to include: 

o

o

o

o

Evaluation  and  challenge  of  the 
key  assumptions  and  inputs  used 
by management;

The  performance  of  a  sensitivity 
analysis  on 
to 
reasonably  possible  changes  in 
key assumptions and inputs; 

the  headroom 

Checking 
accuracy of the financial model;

the  mathematical 

Assessing 
previous 
results.

the 
forecasts 

accuracy 

of 
to  actual 

•

•

Reviewing  management’s  impairment 
paper and assessment of recoverability, 
providing  appropriate  challenge  and 
corroborating key assumptions.

Comparing  the  carrying  value  to  the 
market value of the group.

Other information

The  other  information  comprises  the  information  included  in  the  annual  report,  other  than  the  financial 
statements and our auditor’s report thereon. The directors are responsible for the other information contained 
within the annual report. Our opinion on the financial statements does not cover the other information and, 
except  to  the  extent  otherwise  explicitly  stated  in  our  report,  we  do  not  express  any  form  of  assurance 
conclusion thereon. Our responsibility is to read the other information and, in doing so, consider whether the 
other  information  is  materially  inconsistent  with  the  financial  statements  or  our  knowledge  obtained  in  the 
course of the audit, or otherwise appears to be materially misstated. If we identify such material inconsistencies 
or  apparent  material  misstatements,  we  are  required  to  determine  whether  this  gives  rise  to  a  material 
misstatement in the financial statements themselves. If, based on the work we have performed, we conclude 
that there is a material misstatement of this other information, we are required to report that fact. 
We have nothing to report in this regard. 

Opinions on other matters prescribed by the Companies Act 2006 

In our opinion, based on the work undertaken in the course of the audit: 

•

•

the information given in the strategic report and the directors’ report for the financial year for which 
the financial statements are prepared is consistent with the financial statements; and 

the strategic report and the directors’ report have been prepared in accordance with applicable legal 
requirements. 

Matters on which we are required to report by exception 

In the light of the knowledge and understanding of the company and its environment obtained in the course of 
the audit, we have not identified material misstatements in the strategic report or the directors’ report. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       60

 
 
 
 
 
 
We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 
requires us to report to you if, in our opinion: 

•

•

•

•

adequate accounting records have not been kept, or returns adequate for our audit have not been 
received from branches not visited by us; or 

the financial statements are not in agreement with the accounting records and returns; or 

certain disclosures of directors’ remuneration specified by law are not made; or 

we have not received all the information and explanations we require for our audit.

Responsibilities of directors 

As  explained  more  fully  in  the  directors’  responsibilities  statement,  the  directors  are  responsible  for  the 
preparation of the financial statements and for being satisfied that they give a true and fair view, and for such 
internal control as the directors determine is necessary to enable the preparation of financial statements that 
are free from material misstatement, whether due to fraud or error. 
In  preparing  the  financial  statements,  the  directors  are  responsible  for  assessing  the  company’s  ability  to 
continue as a going concern, disclosing, as applicable, matters related to going concern and using the going 
concern basis of accounting unless the directors either intend to liquidate the company or to cease operations, 
or have no realistic alternative but to do so. 

Auditor’s responsibilities for the audit of the financial statements 

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free 
from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our 
opinion. Reasonable assurance is a high level of assurance but is not a guarantee that an audit conducted in 
accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise 
from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be 
expected to influence the economic decisions of users taken on the basis of these financial statements. 
Irregularities,  including  fraud,  are  instances  of  non-compliance  with  laws  and  regulations.  We  design 
procedures  in  line  with  our  responsibilities,  outlined  above,  to  detect  material  misstatements  in  respect  of 
irregularities,  including  fraud.  The  extent  to  which  our  procedures  are  capable  of  detecting  irregularities, 
including fraud is detailed below:

• We  obtained  an  understanding  of  the  group  and  parent  company  and  the  sector  in  which  they 
operate to identify laws and regulations that could reasonably be expected to have a direct effect 
on the financial statements. We obtained our understanding in this regard through discussions with 
management, and experience of the AI diagnostics sector.  

• We determined the principal laws and regulations relevant to the group and parent company in this 

regard to be those arising from:

o

o

o

o

o

o

o

Companies Act 2006

AIM listing rules

General Data Protection Regulation

Quoted Companies Alliance compliance

Food and Drug Administration Agency

Local laws and regulations in United Kingdom and the United States of America where the 
group operates; and

Local tax and employment law where each member of the group operates

• We designed our audit procedures to ensure the audit team considered whether there were any 
indications of non-compliance by the group and parent company with those laws and regulations. 
These procedures included, but were not limited to:

o

o

Enquires of management 

Review of Board minutes

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       61

o

o

Review of legal expenses

Review of Regulatory News Services announcements

• We also identified the risks of material misstatement of the financial statements due to fraud. We 
considered, in addition to the non-rebuttable presumption of a risk of fraud arising from management 
override of controls, the potential for management bias was identified in relation to the recoverability 
of intangible fixed assets and the recoverability of investments in subsidiaries. As noted in the key 
audit matters section, we addressed this by challenging the assumptions and judgements made by 
management when auditing those significant accounting estimates. 

• We addressed the risk of fraud arising from management override of controls by performing audit 
procedures  which  included,  but  were  not  limited  to:  the  testing  of  journals;  reviewing  accounting 
estimates for evidence of bias; and evaluating the business rationale of any significant transactions 
that are unusual or outside the normal course of business.

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including 
those leading to a material misstatement in the financial statements or non-compliance with regulation.  This 
risk increases the more that compliance with a law or regulation is removed from the events and transactions 
reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. 
The  risk  is  also  greater  regarding  irregularities  occurring  due  to  fraud  rather  than  error,  as  fraud  involves 
intentional concealment, forgery, collusion, omission or misrepresentation.

A further description of our responsibilities for the audit of the financial statements is located on the Financial 
Reporting  Council’s  website  at:  www.frc.org.uk/auditorsresponsibilities.  This  description  forms  part  of  our 
auditor’s report. 

Use of our report

This report is made solely to the company’s members, as a body, in accordance with Chapter 3 of Part 16 of 
the  Companies  Act  2006.    Our  audit  work  has  been  undertaken  so  that  we  might  state  to  the  company’s 
members those matters we are required to state to them in an auditor’s report and for no other purpose.  To 
the  fullest  extent  permitted  by  law,  we  do  not  accept  or  assume  responsibility  to  anyone,  other  than  the 
company and the company's members as a body, for our audit work, for this report, or for the opinions we have 
formed.

David Thompson (Senior Statutory Auditor)                                                                  
For and on behalf of PKF Littlejohn LLP                                       
Statutory Auditor                                                         

15 Westferry Circus
Canary Wharf 
London E14 4HD

Date: 27 October 2023                                              

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       62

                                  
 
 
 
FINANCIAL STATEMENTS

Consolidated Income Statement

FOR THE YEAR ENDED 30 JUNE 2023

Continuing Operations
Revenue
Cost of Sales
Gross profit
Administrative expenses
Operating loss
Share of Net loss in Associate accounted for using the equity method
Gain (loss) on financial assets at fair value through profit or loss
Fair value adjustment of convertible debt
Finance (costs) income - net
Loss before tax
Taxation
Loss for the Period
Earnings per Ordinary share from continuing operations
Basic
Diluted

Notes

Year to 30 
June 2023
$'000

Year to 30 
June 2022
$'000

8

9

22
29
14

15

16
16

3,403
(2,702)
701
(43,056)
(42,355)
(9)
(1,273)
(3,093)
509
(46,221)
(2)
(46,223)

$
$

(0.56) $
(0.56) $

2,970
(2,052)
918
(58,290)
(57,372)
9
(5,900)
3,998
9,637
(49,628)
(7,104)
(56,732)

(0.78)
(0.82)

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       63

 
Consolidated Statement of 
Comprehensive Income

FOR THE YEAR ENDED 30 JUNE 2023

Loss for the period – continuing operations
Other comprehensive income:
Items that may be subsequently reclassified to profit or loss
Changes in the fair value of the convertible notes
Currency translation differences
Other comprehensive (loss)/income for the period
Total comprehensive loss for the period

Year to 30 June 
2023
$'000

Year to 30 June 
2022
$'000

(46,223)

(56,732)

719
(337)
382
(45,841)

536
(11,742)
(11,206)
(67,938)

Items stated above are disclosed net of tax. The income tax relating to each component of other comprehensive income is 
disclosed in note 15.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       64

 
Consolidated and Company’s Statements 
of Financial Position

AS AT 30 JUNE 2023

Assets
Non-current assets:
Property, plant and equipment
Right of use asset
Intangible assets
Investment in subsidiaries
Investments accounted for using the equity method
Note receivable
Deferred tax assets
Other long term assets
Total non-current assets

Current Assets
Inventory
Security Deposits
Financial asset at fair value through profit or loss
Trade and other receivables
Due from subsidiaries
Prepaid and other current assets
Cash and cash equivalents
Total current assets
Total assets

Equity attributable to owners of the parent
Share capital
Share premium
Share-based payment reserve
Accumulated other comprehensive income
Retained earnings/(deficit)
Total equity

Liabilities
Current liabilities:

Trade and other payables
Deferred revenue
Current lease liabilities
Note payable current
Current due to affiliated company

Total current liabilities

Non-current liabilities
Note payable non-current
Non-current lease liabilities
Total non-current liabilities
Total liabilities
Total equity and liabilities

Notes

17
18
19
20
33
23
15

21
22
22
23

24
25

26
26
27

28
8
18
29
30

29
18

Group                  
As at 30 
June 2023
$'000

Group                  
As at 30 
June 2022
$'000

Company             
As at 30 
June 2023
$'000

Company               
As at 30 
June 2022
$'000

1,027
194
12,511
-
-
-
-
51
13,783

718
132
1,460
776
-
566
24,682
28,334
42,117

1,368
355
14,020
-
9
75
-
-
15,827

1,160
141
2,744
901
-
1,152
41,333
47,431
63,258

-
-
12,180
118,487
-
-
-
1
130,668

-
-
1,460
-
4,156
184
8,574
14,374
145,042

-
-
13,605
89,112
-
-
-
-
102,717

-
-
2,744
234
-
299
28,313
31,590
134,307

299
104,953
13,513
(1,127)
(99,184)
18,454

241
85,444
11,954
(1,509)
(52,961)
43,169

299
104,953
13,299
(380)
9,373
127,544

241
85,444
11,840
(5,119)
23,763
116,169

11,513
-
156
4,463
-
16,132

7,485
46
7,531
23,663
42,117

7,281
46
163
4,660
55
12,205

7,682
202
7,884
20,089
63,258

1,466
-
-
4,463
4,084
10,013

7,485
-
7,485
17,498
145,042

5,796
-
-
4,660
-
10,456

7,682
-
7,682
18,138
134,307

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       65

 
 
 
The notes on pages 70 to 92 are an integral part of these financial statements.

The Company has elected to take the exemption under section 408 of the Companies Act 2006 not to present the Parent 
Company income statement. The loss for the Parent Company for the year was ($14,389,422). (Year ended 30 June 2022: 
loss of $15,154,820). 

The financial statements were approved and authorized for issue by the Board on 27 October 2023 and signed on its behalf 
by:

Christopher Mills                                              James R. McCullough

Chairman                                                                           Chief Executive Officer

Company number: 11257655

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       66

                                            
 
Consolidated and Company’s Statements 
of Cash Flows

FOR THE YEAR ENDED 30 JUNE 2023

Notes

Cash flows from operating activities:
Loss before income tax
Adjustments for
Depreciation
Amortisation and impairment charges
Share-based payments
Share of net (profit)/loss of associate
Reversal of Kantaro Liability
Unrealized loss (gain) on financial asset at fair value through 
profit or loss
Fair value adjustment of convertible debt
Foreign Exchange loss (gain)

Changes in working capital

Trade and other receivables
Prepaid assets and other current assets
Related party receivable
Inventory
Security Deposits
Trade and other payables
Deferred Revenue

Net cash used in operating activities

Cash flows from investing activities:
Purchases of property and equipment (PPE)
Purchase of intangibles
Investment in Renalytix Inc
Net cash generated by/(used in) investing activities

Cash flows from financing activities
Proceeds from convertible notes
Repayment of convertible notes
Payment of debt issuance costs
Payments of issuance costs for the Securities Purchase 
Agreement
Issue of shares (net of issue costs)
Proceeds from the issuance of ordinary shares under employee 
share purchase plan
Proceeds from exercise of stock options
Lease payments
Net cash generated from financing activities
Net increase/(decrease) in cash and  cash equivalents
Cash and cash equivalents at beginning of period
Effect of exchange rate changes on cash
Cash and cash equivalents at end of period

25

Group                  
As at 30 
June 2023

Group 
As at 30 
June 
2022
$'000

$'000

Company
As at 30 
June 2023

Company
As at 30 
June 2022

$'000

$'000

(46,221)

(49,628)

(14,389)

(15,154)

341
2,151
1,560
9
(55)

1,273
3,093
(1,008)

125
1,298
75
442
141
4,148
(46)
(32,674)

-
-
-
-

-
(4,288)
-

-
19,306

261
-
(160)
15,119
(17,555)
41,333
904
24,682

304
2,309
7,010
(9)
(295)

5,900
(3,998)
(7,354)

(307)
(698)
-
(807)
-
1,904
(76)
(45,745)

(591)
(103)
-
(694)

18,020
-
(1,382)

(218)
8,804

211
198
(118)
25,516
(20,924)
65,159
(2,902)
41,333

-
1,906
49
-
-

1,273
3,093
-

2,699
121
-
-
-
312
-
(4,936)

-
-
(31,008)
(31,008)

-
(4,288)
-

-
19,306

261
-
-
15,279
(20,665)
28,313
926
8,574

-
2,100
63
-
-

5,900
(3,998)
-

-
253
-
-
-
1,417
-
(9,419)

-
(103)
-
(103)

18,020
-
(1,382)

(218)
8,804

211
198
-
25,633
16,111
15,063
(2,861)
28,313

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       67

 
Consolidated Statement of Changes 
in Equity

FOR THE YEAR ENDED 30 JUNE 2023

At 30 June 2021
Comprehensive income
Loss for the period
Other comprehensive income
Changes in fair value of convertible notes
Currency translation differences
Total comprehensive income

Transactions with Owners
Issuance of Ordinary Shares in US
Less issue costs
Share-based payments
Shares issues under ESPP
Exercise of Stock Options
Total transactions with owners of the parent, 
recognized directly in equity
At 30 June 2022
Comprehensive income
Loss for the period
Other comprehensive income
Changes in fair value of convertible notes
Currency translation differences
Total comprehensive income

Transactions with Owners
Share-based payments
Shares issues under ESPP
Shares issued under Securities Purchase Agreement
Less issue costs
Total transactions with owners of the parent, 
recognized directly in equity
At 30 June 2023

Share 
Capital
$'000

233

Share 
Premium
$'000

76,457

Share-
based
payment 
reserve
$'000

4,940

-

-
-
-

8
-
-
-
-

-

-
-
-

-

-
4
4

8,796
(218)
-
211
198

-
-
7,010
-
-

Accumulated 
other
comprehensive 
income
$'000

Retained 
earnings
$'000

Total 
Equity
$'000

9,701

3,771

95,102

-

(56,732)

(56,732)

536
(11,746)
(11,210)

-
-
(56,732)

536
(11,742)
(67,938)

-
-
-
-
-

-
-
-
-
-

8,804
(218)
7,010
211
198

8
241

8,987
85,444

7,010
11,954

-
(1,509)

-
(52,961)

16,005
43,169

-

-
-
-

-

-
-
-

-
260
20,240
(991)

1,559
-
-
-

-

-
-
-

-
1
57
-

58
299

-

(46,223)

(46,223)

719
(337)
382

-
-
(46,223)

719
(337)
(45,841)

-
-
-
-

-
-
-
-

1,559
261
20,297
(991)

21,126
18,454

19,509
104,953

1,559
13,513

-
(1,127)

-
(99,184)

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       68

 
Company’s Statement of Changes 
in Equity

FOR THE YEAR ENDED 30 JUNE 2023

At 30 June and 1 July 2021
Comprehensive income
Loss for the period
Other comprehensive income
Changes in fair value of convertible notes
Currency translation differences
Total comprehensive income

Transactions with Owners
Issuance of Ordinary Shares in US
Less issue costs
Share-based payments
Shares issued under the ESPP
Exercise of Stock Options
Total transactions with owners of the parent, 
recognized directly in equity
At 30 June and 1 July 2022
Comprehensive income
Loss for the period
Other comprehensive income
Changes in fair value of convertible notes
Currency translation differences
Total comprehensive income

Transactions with Owners
Share-based payments
Shares issued under Securities Purchase Agreement
Less issue costs
Shares issued under the ESPP
Exercise of Stock Options
Total transactions with owners of the parent, 
recognized directly in equity
At 30 June 2023

Share 
Capital
$'000

233

Share 
Premium
$'000

76,457

Share-
based
payment 
reserve
$'000

4,940

Accumulated 
other
comprehensive 
income
$'000

Retained 
earnings
$'000

9,687

38,917

Total 
Equity
$'000
130,234

-

-
-
-

8
-
-
-
-

-

-
-
-

-

-
-
-

-

(15,154)

(15,154)

536
(15,342)
(14,806)

-
-
(15,154)

536
(15,342)
(29,960)

8,796
(218)
-
211
198

-
-
6,900
-
-

-
-
-
-
-

-
-
-
-
-

8,804
(218)
6,900
211
198

8
241

8,987
85,444

6,900
11,840

-
(5,119)

-
23,763

15,895
116,169

-

-
-
-

-
57
-
1
-

-

-
-
-

-

-
-
-

-
20,240
(991)
260
-

1,459
-
-
-
-

-

(14,390)

(14,390)

(337)
5,076
4,739

-
-
(14,390)

-
-
-
-
-

-
-
-
-
-

(337)
5,076
(9,651)

1,459
20,297
(991)
261
-

58
299

19,509
104,953

1,459
13,299

-
(380)

-
9,373

21,026
127,544

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       69

 
Notes to the Financial Statements

1. GENERAL INFORMATION AND BASIS OF PRESENTATION

Renalytix Plc (the “Company”) is a company incorporated in the United Kingdom. The Company is a public limited 
company, which is listed on the AIM market of the London Stock Exchange and Nasdaq global market. The address of the 
registered office is Finsgate, 5-7 Cranwood Street, London, United Kingdom, EC1V 9EE. The Company was incorporated 
on 15 March 2018 and its registered number is 11257655.

The principal activity of the Company and its subsidiaries (together “the Group”) is as a developer of artificial intelligence- 
enabled diagnostics for kidney disease.

The financial statements are presented in United States Dollars (“USD”) because that is the currency of the primary 
economic environment in which the Group operates.

2. BASIS OF PRESENTATION

The Group and Company’s financial statements have been prepared in accordance with UK-adopted International 
Accounting Standards and with the requirements of the Companies Act 2006.

The preparation of financial statements in conformity with IFRS requires the use of certain critical accounting estimates. It 
also requires management to exercise its judgment in the process of applying the Group’s accounting policies.

New standards, amendments, and interpretations not adopted by the group

The group did not adopt any new standards, amendments or interpretations in year as they did not have a material impact on 
the financial statements.

New standards, amendments, and interpretations issued but not effective for the period 
ended 30 June 2023, and not early adopted

A number of new standards and amendments to standards and interpretations are effective for annual periods beginning on 
or after 1 January 2023 and have not been applied in preparing these financial statements. None of these is expected to have 
a significant effect on the financial statements of the Group or Parent Company.

▪

▪

▪

▪

▪

▪

Amendments to IAS 1: Presentation of Financial Statements, Disclosure of Accounting Policies

Amendments to IAS 8: Definition of Accounting Estimates

Amendments to IFRS 17: Insurance Contracts

Amendments to IAS 12: Deferred Tax Related to Assets and Liabilities Arising From a Single Transaction

Amendments to IFRS 16: Leases on Sale and Leaseback

Amendments to IAS 7 and IFRS 7: Supplier Finance Arrangement

3. SIGNIFICANT ACCOUNTING POLICIES

The principal accounting policies applied in the preparation of these financial statements are set out below.

Going concern

The Group and Company meet their day-to-day working capital requirements through the use of cash reserves.

The Directors have considered the applicability of the going concern basis in the preparation of these financial statements. 

The Group and Company have incurred recurring losses and negative cash flows from operations since inception. The 
Company anticipates incurring additional losses until such time, if ever, that it can generate significant sales of 
KidneyIntelX or any future products currently in development. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       70

As a result of our losses and our projected cash needs, the Directors have concluded that substantial doubt exists about the 
Group and Company’s ability to continue as a going concern. Substantial additional capital will be necessary to fund the 
Group and Company's operations, expand its commercial activities and develop other potential diagnostic related products. 
The Company plans to seek additional funding through public or private equity offerings, debt financings, other 
collaborations, strategic alliances and licensing arrangements. The Group and Company may not be able to obtain financing 
on acceptable terms, or at all, and the Group and Company may not be able to enter into strategic alliances or other 
arrangements on favorable terms, or at all. The terms of any financing may adversely affect the holdings or the rights of the 
Group and Company’s shareholders. If the Group and Company is unable to obtain funding, the Group and Company could 
be required to delay, curtail or discontinue research and development programs, product portfolio expansion or future 
commercialization efforts, which could adversely affect its business prospect. 

The Group and Company’s ability to continue as a going concern is contingent upon successful execution of management’s 
intended plan over the next twelve months to improve the Group and Company’s liquidity and profitability, which includes, 
without limitation:

▪

▪

▪

Seeking additional capital through public or private equity offerings, debt financings, other collaborations, 
strategic alliances and licensing arrangements

Implementation of various additional operating cost reduction options that are available to the Group and 
Company 

The achievement of a certain volume of assumed revenue

The consolidated financial statements do not include any adjustments that may result from the outcome of this going 
concern uncertainty.

Basis of consolidation

The consolidated financial statements incorporate the financial statements of the Company and its subsidiary undertakings. 
The Group controls an entity when the Group is exposed to, or has rights to, variable returns from its involvement with the 
entity and has the ability to affect those returns through its power over the entity. The existence and effect of potential voting 
rights that are currently exercisable or convertible are considered when assessing whether the Group controls another entity.

Subsidiaries are fully consolidated from the date on which control is transferred to the Group. They are de-consolidated from 
the date that control ceases.

The Group uses the acquisition method of accounting to account for business combinations. The consideration transferred 
for the acquisition of a subsidiary is the fair values of the assets transferred, the liabilities incurred and the equity interests 
issued by the Group. The consideration transferred includes the fair value of any asset or liability resulting from a contingent 
consideration agreement. Acquisition related costs are expensed as incurred. Identifiable assets acquired and liabilities and 
contingent liabilities assumed in a business combination are measured initially at their fair values at the acquisition date.

Inter-company transactions, balances and unrealized gains on transactions between Group companies are eliminated. 
Unrealized losses are also eliminated. Accounting policies of subsidiaries have been changed where necessary to ensure 
consistency with the policies adopted by the Group.

Associates are entities over which the Group has significant influence but not control over the financial and operating 
policies. Investments in associates are accounted for using the equity method of accounting and are initially recognized at 
cost. The Group’s share of its associates’ post-acquisition profits or losses is recognized in profit or loss, and its share of 
post-acquisition movements in reserves is recognized in other comprehensive income. The cumulative post-acquisition 
movements are adjusted against the carrying amount of the investment.

Foreign currency translation

▪

Functional and presentational currency

Items included in the financial statements of each of the Group’s entities are measured using the currency of the primary 
economic environment in which the entity operates (the functional currency). The consolidated financial statements are 
presented in United States Dollars, which is the Group’s presentational currency. The functional currency of the Parent 
Company is GB Pounds.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       71

▪

Transactions and balances

Foreign currency transactions are translated into the functional currency using the exchange rates prevailing at the dates of 
the transactions where items are re-measured. Foreign exchange gains and losses resulting from the settlement of such 
transactions and from the translation at year-end exchange rates of monetary assets and liabilities denominated in foreign 
currencies are recognized in the income statement within ‘administrative expenses’.

▪ Group companies

The results and financial position of all the Group entities that have a functional currency different from the presentational 
currency are translated into the presentational currency as follows:

▪

▪

▪

assets and liabilities for each balance sheet presented are translated at the closing rate at the date of that balance 
sheet;

income and expenses for each income statement are translated at average exchange rates; and

all resulting exchange differences are recognized in other comprehensive income.

On consolidation, exchange differences arising from the translation of the net investment in foreign operations are taken to 
other comprehensive income. When a foreign operation is partially disposed of or sold, exchange differences that were 
recorded in equity are recognized in the income statement as part of the gain or loss on sale.

Segmental reporting

Operating segments are reported in a manner consistent with the internal reporting provided to the chief operating decision- 
maker. The chief operating decision-maker, who is responsible for allocating resources and assessing performance of the 
operating segments, has been identified as the Executive Directors who make strategic decisions. At present the Directors 
consider the business to operate in a single segment.

Property, plant and equipment

Property, plant and equipment are stated at historical cost less accumulated depreciation and any provision for impairment. 
Historical cost includes expenditure that is directly attributable to the acquisition of the asset and bringing the asset to its 
working condition for its intended use.

Subsequent costs are included in the asset’s carrying amount or recognized as a separate asset, as appropriate, only where it 
is probable that future economic benefits associated with the asset will flow to the Group and the cost of the asset can be 
measured reliably. The carrying amount of the replaced part is derecognized. All other repairs and maintenance are charged 
to the income statement during the financial period in which they are incurred.

Depreciation on assets is calculated using the straight-line method to allocate their cost to their residual values over their 
estimated useful lives, as follows:

Fixtures and fittings 20%

The assets’ residual values and useful economic lives are reviewed regularly, and adjusted if appropriate, at the end of each 
reporting period.

An asset’s carrying value is written down immediately to its recoverable amount if the asset’s carrying amount is greater 
than its estimated recoverable amount.

Gains and losses on the disposal of assets are determined by comparing the proceeds with the carrying amount and are 
recognized in administration expenses in the income statement.

Intangible assets

(a) Trademarks, trade names and licenses

Separately acquired trademarks and licenses are shown at historical cost. Trademarks and licenses acquired in a business 
combination are recognized at fair value at the acquisition date. Trademarks and licenses have a finite useful life and are 
carried at cost less accumulated amortisation. Amortisation is calculated using the straight-line method to allocate the cost of 
trademarks and licenses over the contractual license period of 10 to 15 years and is charged to administrative expenses in the 
income statement.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       72

(b) Development costs and trade secrets

Development costs have a finite useful life and are carried at cost less accumulated amortisation.

Expenditure incurred on the development of new or substantially improved products or processes is capitalized, provided 
that the related project satisfies the criteria for capitalisation, including the project’s technical feasibility and likely 
commercial benefit. All other research and development costs are expensed to profit or loss as incurred.

Development costs are amortised over the estimated useful life of the products with which they are associated. Amortisation 
commences when a new product is in commercial production. The amortisation is charged to administrative expenses in the 
income statement. Amortisation is calculated using the straight-line method over 15 years. The estimated remaining useful 
lives of development costs are reviewed at least on an annual basis.

The carrying value of capitalized development costs is reviewed for potential impairment at least annually and if a product 
becomes unviable and an impairment is identified the deferred development costs are immediately charged to the income 
statement.

Trade secrets, including technical know-how, operating procedures, methods and processes, are recognized at fair value at 
the acquisition date. Trade secrets have a finite useful life and are carried at cost less accumulated amortisation. 
Amortisation is calculated using the straight-line method over 15 years.

Impairment of non-financial assets

Assets that have an indefinite life or where amortisation has not yet commenced are tested annually for impairment. Assets 
that are subject to amortisation are reviewed for impairment whenever events or changes in circumstances indicate that the 
carrying amount may not be recoverable. An impairment loss is recognized for the amount by which the carrying amount 
exceeds its recoverable amount.

The recoverable amount is the higher of an asset’s fair value less costs to sell and value in use. In assessing value in use, the 
estimated future cash flows are discounted to their present value using a pre-tax discount rate that reflects current market 
assessments of the time value of money and the risks specific to the asset for which the estimates of future cash flows have 
not been adjusted.

For the purposes of assessing impairment, assets are grouped at the lowest levels for which there are separately identifiable 
cash flows. Impairment losses recognized for cash-generating units, to which goodwill has been allocated, are credited 
initially to the carrying amount of goodwill. Any remaining impairment loss is charged pro rata to the other assets in the 
cash-generating unit.

Where an impairment loss subsequently reverses, the carrying amount of the asset (cash-generating unit) is increased to the 
revised estimate of its recoverable amount, but so that the increased carrying amount does not exceed the carrying amount 
that would have been determined had no impairment loss been recognized for the asset (cash-generating unit) in the prior 
period. A reversal of an impairment loss is recognized in the income statement immediately. If goodwill is impaired 
however, no reversal of the impairment is recognized in the financial statements.

Financial assets

Classification

The Company classifies its financial assets in the following categories: loans and receivables at amortised cost and financial 
assets at fair value through profit or loss. The classification depends on the purpose for which the financial assets were 
acquired and management determines the classification of its financial assets at initial recognition.

(a) Loans and receivables

Financial assets are classified as at amortised cost only if both of the following criteria are met: the asset is held within a 
business model whose objective is to collect contractual cash flows, and the contractual terms give rise to cash flows that are 
solely payments of principal and interest. Loans and receivables are non-derivative financial assets with fixed or 
determinable payments that are not quoted on an active market. They are included in current assets, except for maturities 
greater than 12 months after the balance sheet date. These are classified as non-current assets. The Company’s loans and 
receivables comprise ‘trade and other receivables’ and cash and cash equivalents in the balance sheet.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       73

(b) Financial assets at fair value through profit or loss

The Group classifies the following financial assets at fair value through profit or loss (“FVPL”):

▪

▪

equity investments that are held for trading, and

equity investments for which the entity has not elected to recognize fair value gains and losses 
through Other Comprehensive Income.

(c) Financial assets at fair value through other comprehensive income

Financial assets at fair value through other comprehensive income comprise equity securities that are not held for trading 
and which the Group has irrevocably elected at initial recognition to recognize in this category. The Group considers this 
category to be more relevant for assets of this type.

(d) Financial liabilities at fair value through profit or loss

The Group classifies the following financial assets at fair value through profit or loss (“FVPL”):

▪

Convertible debt recorded at fair value through profit or loss. 

Cash and cash equivalents

Cash and short-term deposits in the balance sheet comprise cash at bank and in hand and short- term deposits with an 
original maturity of three months or less.

For the purposes of the cash flow statements, cash and cash equivalents consist of cash and short-term deposits as defined 
above.

Share capital and premium

Ordinary Shares are classified as equity. Proceeds in excess of the nominal value of shares issued are allocated to the share 
premium account and are also classified as equity. Incremental costs directly attributable to the issue of new Ordinary Shares 
or options are deducted from the share premium account.

Other reserves - equity

The share-based payment reserve is used to recognize the fair value of equity settled share-based payment transactions.

Foreign currency reserve is used to record the exchange differences on translation of entities in the Group which have a 
functional currency different to the presentation currency.

Retained earnings includes all current and prior period results as disclosed in the income statement.

Trade and other payables

Trade payables are obligations to pay for goods or services that have been acquired in the ordinary course of business from 
suppliers. Accounts payable are classified as current liabilities if payment is due within one year or less (or in the normal 
operating cycle of the business if longer). If not, they are presented as non-current liabilities. Trade payables are recognized 
initially at fair value and subsequently measured at amortised cost using the effective interest method.

Current and deferred income tax

Income tax comprises current and deferred tax. Tax is recognized in the income statement, except to the extent that it relates 
to items recognized in other comprehensive income where the associated tax is also recognized in other comprehensive 
income.

The current income tax charge is calculated on the basis of the tax laws enacted or substantively enacted at the balance sheet 
date in the countries where the Company and its subsidiary operate and generate taxable income. Management evaluates 
positions taken in tax returns with respect to situations in which applicable tax regulation is subject to interpretation and 
establishes provisions where appropriate on the basis of amounts expected to be paid to the tax authorities.

Deferred tax is recognized, using the liability method, on all temporary differences at the balance sheet date between the tax 
bases of assets and liabilities and their carrying amounts for financial reporting purposes. Deferred tax liabilities are 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       74

recognized in respect of all temporary differences except where the deferred tax liability arises from the initial recognition of 
goodwill in business combinations.

Deferred tax assets are recognized for all deductible temporary differences, carry-forward of unused tax assets and tax 
losses, to the extent that they are regarded as recoverable. They are regarded as recoverable where, on the basis of available 
evidence, there will be sufficient taxable profits against which the future reversal of the underlying temporary differences 
can be deducted.

The carrying value of the amount of deferred tax assets is reviewed at each balance sheet date and reduced to the extent that 
it is no longer probable that sufficient taxable profit will be available to allow all, or part, of the tax asset to be utilized.

Deferred tax assets and liabilities are measured at the tax rates that are expected to apply to the year when the asset is 
realized or the liability is settled, based on the tax rates (and tax laws) that have been substantively enacted at the balance 
sheet date.

Deferred income tax assets and liabilities are offset when there is a legally enforceable right to offset current tax assets 
against current tax liabilities and when the deferred income tax assets and liabilities relate to income taxes levied by the 
same taxation authority on either the taxable entity or different taxable entities where there is an intention to settle the 
balances on a net basis.

Leases

Leases are recognized as a right-of-use asset and a corresponding lease liability at the date on which the leased asset is 
available for use by the Group.

Assets and liabilities arising from a lease are initially measured on a present value basis. Lease liabilities include the net 
present value of the following lease payments:

▪

▪

▪

▪

▪

fixed payments (including in-substance fixed payments), less any lease incentives receivable

variable lease payment that are based on an index or a rate, initially measured using the index or 
rate as at the commencement date

amounts expected to be payable by the group under residual value guarantees

the exercise price of a purchase option if the group is reasonably certain to exercise that option, 
and

payments of penalties for terminating the lease, if the lease term reflects the group exercising that 
option.

Lease payments to be made under reasonably certain extension options are also included in the measurement of the liability.

The lease payments are discounted using the interest rate implicit within the lease. If that rate cannot be readily determined, 
the Group’s incremental borrowing rate is used, being the rate that the Group would have to pay to borrow the funds 
necessary to obtain an asset of similar value to the right-of-use asset in a similar economic environment with similar terms, 
security, and conditions.

Where the Group is exposed to potential future increases in variable lease payments based on an index or rate, amounts are 
not included in the lease liability until they take effect. When adjustments to lease payments based on an index or rate take 
effect, the lease liability is reassessed and adjusted against the right-of-use asset.

Lease payments are allocated between principal and finance cost. The finance cost is charged to the income statement over 
the lease period so as to produce a constant periodic rate of interest on the remaining balance of the liability for each period.

Right-of-use assets are measured at cost comprising the following:

▪

▪

▪

▪

the amount of the initial measurement of lease liability

any lease payments made at or before the commencement date less any lease incentives received

any initial direct costs

restoration costs

Right-of-use assets are generally depreciated over the shorter of the asset’s useful life and the lease term on straight line 
basis. If the Group is reasonably certain to exercise a purchase option, the right-of-use asset is depreciated over the 
underlying asset’s useful life.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       75

Revenue recognition

The Group recognizes revenue when a customer obtains control of contracted goods or services. The Group records the 
amount of revenue that reflects the consideration that it expects to receive in exchange for those goods or services. The 
Group applies the following five-step model in order to determine this amount: (i) identification of the promised goods or 
services in the contract; (ii) determination of whether the promised goods or services are performance obligations, including 
whether they are distinct in the context of the contract; (iii) measurement of the transaction price, including the constraint on 
variable consideration; (iv) allocation of the transaction price to the performance obligations; and (v) recognition of revenue 
when (or as) the Group satisfies each performance obligation.

The Group only applies the five-step model to contracts when it is probable that it will collect the consideration to which it 
is entitled in exchange for the goods or services that it transfers to the customer. The Group reviews the contract to 
determine which performance obligations it must deliver and which of these performance obligations are distinct. Certain 
contracts have options for the customer to acquire additional services. The Group evaluates these options to determine if a 
material right exists. If, after that evaluation, it determines a material right does exist, it assigns value to the material right 
based upon the renewal option approach. The Group recognizes as revenue the amount of the transaction price that is 
allocated to each performance obligation when that performance obligation is satisfied or as it is satisfied. The Group uses 
present right to payment and customer acceptance as indicators to determine the transfer of control to the customer occurs at 
a point in time. Sales tax and other similar taxes are excluded from revenues.

Cost of revenue

Cost of revenue consists of costs directly attributable to the services rendered, including labor costs directly related to 
revenue generating activities.

Employee benefits

(a) Pension obligations

The Group makes contributions to defined contribution pension plans. A defined contribution plan is a pension plan under 
which the Group pays fixed contributions into a separate entity with the pension cost charged to the income statement as 
incurred. The Group has no further obligations once the contributions have been paid.

(b) Share-based compensation

The Group operates an equity-settled, share-based compensation plan, under which the Group receives services from 
employees and others as consideration for equity instruments of the Group. Equity-settled share-based payments are 
measured at fair value at the date of grant and are expensed over the vesting period based on the number of instruments that 
are expected to vest. For plans where vesting conditions are based on share price targets, the fair value at the date of grant 
reflects these conditions. Where applicable the Group recognizes the impact of revisions to original estimates in the income 
statement, with a corresponding adjustment to equity for equity-settled schemes. Fair values are measured using appropriate 
valuation models, taking into account the terms and conditions of the awards.

When the share-based payment awards are exercised, the Company issues new shares. The proceeds received net of any 
directly attributable transaction costs are credited to share capital (nominal value) and share premium.

National insurance on share options

To the extent that the share price at the balance sheet date is greater than the exercise price on options granted to UK citizens 
under unapproved share-based payment compensation schemes, provision for any National Insurance Contributions has 
been based on the prevailing rate of National Insurance. The provision is accrued over the performance period attaching to 
the award.

Interest income

Interest income is accrued on a time basis, by reference to the principal outstanding and at the effective interest rate 
applicable, which is the rate that exactly discounts estimated future cash receipts through the expected life of the financial 
asset to that asset’s net carrying amount.

Exceptional items

These are items of an unusual or non-recurring nature incurred by the Group and include transactional costs and one-off 
items relating to business combinations, such as acquisition expenses.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       76

Assets classified as held for sale

Assets are classified as held for sale if their carrying amount will be recovered principally through a sale transaction rather 
than through continuing use and a sale is considered highly probable. They are measured at the lower of their carrying value 
and fair value less costs to sell. An impairment loss is recognized for any subsequent write-down of the asset to fair value 
less costs to sell.

4. FINANCIAL RISK MANAGEMENT

Financial risk factors

The Company’s activities expose it to a variety of financial risks. The Company’s Board monitors and manages the financial 
risks relating to the operations of the Company.

(a) Market Risk

Foreign exchange risk

The Company operates internationally and is exposed to foreign exchange risk primarily with respect to the US Dollar and 
the Pounds Sterling. Foreign exchange risk arises from future commercial transactions and recognized assets and liabilities.

(b) Credit Risk

Credit risk relates mainly to cash at bank. The Company only deposits cash with major banks with high quality credit 
standing and limits exposure to any one counterparty.

(c) Liquidity Risk

The Company’s continued future operations depend on its ability to raise sufficient working capital through the issue of 
share capital and generate revenue.

5. CAPITAL RISK MANAGEMENT

The Company manages its capital to ensure that it will be able to continue as a going concern while maximizing the return to 
stakeholders. The Company’s capital structure primarily consists of equity attributable to the owners, comprising issued 
capital, reserves and retained losses.

6. CRITICAL ACCOUNTING ESTIMATES AND JUDGMENTS

The Company makes estimates and assumptions regarding the future. Estimates and judgments are continually evaluated 
based on historical experience and other factors, including expectations of future events that are believed to be reasonable 
under the circumstances. In the future, actual results may differ from these estimates and assumptions. The estimates and 
assumptions that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities 
within the next financial year relate to:

▪

▪

▪

Capitalisation and recoverability of intangible assets (note 19);

Share based payments (note 27).

Convertible debt recorded at fair value through profit or loss (note 29).

7. SEGMENTAL REPORTING

The Group operates as a single segment.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       77

8. REVENUE

Testing services revenue

Testing services revenue is generated from the KidneyIntelX platform, which provides analytical services to customers. 
Each individual test is a performance obligation that is satisfied at a point in time upon completion of the testing process 
(when results are reported) which is when control passes to the customer and revenue is recognized. During the year ended 
30 June 2023, the Company recognized $3.1 million of testing services revenue. Sales tax and other similar taxes are 
excluded from revenues. There was $2.7 million of testing services revenue recognized in the 2022 accounting period.

During the year ended 30 June 2023, the Company performed testing and provided approved KidneyIntelX risk scores for 
approximately 100 samples or $0.1 million of potential revenue where collectability was determined to not be reasonably 
assured. The Company will continue to assess each contract to determine whether the collectability criterion is met and 
recognize revenue when collectability is reasonable assured.  

Pharmaceutical services revenue

Pharmaceutical services revenue is generated from the provision of analytical services to customers. Contracts with 
customers generally include an initial upfront payment and additional payments upon achieving performance milestones. 
The Company uses present right to payment and customer acceptance as indicators to determine the transfer of control to the 
customer which may occur at a point in time or over time depending on the individual contract terms. Sales tax and other 
similar taxes are excluded from revenues. During the year ended 30 June 2023, the Company recognized $0.3 million of 
pharmaceutical services revenue. There was $0.2 million of pharmaceutical services revenue recognized in the 2022 
accounting period

Deferred revenue

Deferred revenue represents the allocated transaction price to the material right which will be recognized as revenue when 
the renewal options are exercised which is expected to occur over the next 24 months.

The following table summarizes the changes in deferred revenue:

Balance, beginning of period
Deferral of revenue
Revenue recognized
Balance, end of period

9. EXPENSES – ANALYSIS BY NATURE

Employee benefit expense
Contract labour
Depreciation and amortisation
Professional fees
Laboratory supplies
Other expenses
Total administration expenses

Year ended 30 
June 2023
$'000

Year ended 30 
June 2022
$'000

45
-
(45)
-

122
150
(227)
45

Year ended 30 
June 2023
$'000

Year ended 30 
June 2022
$'000

20,887
2,772
2,061
10,176
621
6,538
43,055

26,527
6,245
2,254
12,951
851
9,462
58,290

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       78

10. AUDITOR’S REMUNERATION

Fees payable to the Company’s auditor for the audit of the parent Company and 
consolidated financial statements
Total administration expenses

Year ended 30 
June 2023
$'000

Year ended 30 
June 2022
$'000

71
71

71
71

11. DIRECTORS’ REMUNERATION

Retirement benefits are accruing to two current executive directors under a defined contribution scheme. See further 
disclosures within the Remuneration Report on page 38. The highest paid director received aggregate emoluments, 
excluding the effect of the share based payments charge, totaling $1,057,000 (2022: $648,000).

Aggregate emoluments
Share based payments
Contribution to defined contribution pension scheme
Total

Year ended 30 June 2023
$'000

Year ended 30 June 2022
$'000

1,638
-
83
1,721

1,189
292
102
1,583

12. EMPLOYEE BENEFIT EXPENSE

Group
Year ended 30 June 
2023
$'000

Group
Year ended 30 June 
2022
$'000

Company
Year ended 30 June 
2023
$'000

Company
Year ended 30 June 
2022
$'000

Wages, salaries and Bonus
Social security costs and 
Benefits
Share based payment 
expenses
Total

14,529

4,798

1,560
20,887

15,006

4,511

7,010
26,527

469

404

49
922

345

286

61
692

13. MONTHLY AVERAGE NUMBER OF PEOPLE EMPLOYED

The monthly average number of people (including Executive Directors) employed was:

Administration
Research and development
COGS
Total

Group
Year ended 
30 June 
2023
$'000

Group
Year ended 
30 June 
2022
$'000

Company
Year ended 
30 June 
2023
$'000

Company
Year ended 
30 June 
2022
$'000

52
23
7
82

68
25
-
93

1
5
-
6

6
-
-
6

The total number of employees (FTEs) in the Group at 30 June 2023 was 80 (2022: 110), and in the Company was 6 (2022: 
8).

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       79

14. FINANCE INCOME AND COSTS

Finance costs:
Interest expense
Royalty expense
Finance income:
Interest income
Gain/(Loss) on Foreign Exchange
Other Income
Net finance income/(loss)

15. INCOME TAX

Group
Deferred tax
Total deferred tax
Income tax (charge)/credit

Year ended 30 
June 2023
$'000

Year ended 30 
June 2022
$'000

(3)
-

118
(144)
538
509

(2)
(169)

12
9,677
119
9,637

Year ended 30 June 
2023
$'000

Year ended 30 June 
2022
$'000

-
-
-

(7,104)
(7,104)
(7,104)

No deferred asset is calculated on losses in FY23 as the probability of future utilization is considered too remote.

Factors affecting the future tax charge

The standard rate of corporation tax in the UK is 25%.

Changes to UK Corporation tax rates were enacted as part of The Finance (No.2) Act 2021 which received Royal Assent on 
10 June 2021. The main rate remained at 19% before increasing to 25% from 1 April 2023.

Loss before tax
Tax Calculated at domestic tax rates applicable to the UK Standard of tax at 25% 
(2022: 19%)
Tax effects of:
     Expenses not deductible for tax purposes
     Losses on which no deferred tax asset is recognized
Tax credit for the year

Current Year Valuation Allowance

Prior year deferred tax asset
Reversal of tax asset at 30 June

Tax expense

Total Income Tax (Expense)/Credit

Year ended 30 
June 2023
$'000

Year ended 30 
June 2022
$'000

46,221

11,555

(872)
(85)
10,598
(10,598)
-
-
(2)
(2)

49,628

9,429

4,490
(578)
13,341
(13,341)
7,097
(7,097)
(7)
(7,104)

Net losses can be carried forward indefinitely to offset future taxable profits however management has concluded that the 
realization of deferred tax assets to be less than probable and recorded a full valuation allowance. No deferred asset is 
calculated on losses in the UK totaling $14,389,422 where the probability of future utilization is considered too remote.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       80

16. EARNINGS PER SHARE

Basic net loss per ordinary share is computed by dividing net loss by the weighted average number of ordinary shares 
outstanding during each period. Diluted net loss per ordinary share includes the effect, if any, from the potential exercise or 
conversion of securities, such as options which would result in the issuance of incremental ordinary shares. Potentially 
dilutive securities outstanding as of June 30, 2023 have been excluded from the computation of diluted weighted average 
shares outstanding as they would be anti-dilutive. Therefore, the weighted average number of shares used to calculate both 
basic and diluted net loss per share are the same.

For the financial year ended June 30, 2022, the diluted net loss per share calculation included the dilutive effect of 
convertible debt as well as the impact of the $3.9 million fair value gain related to the convertible debt, which further 
increase net loss used in the diluted loss per share calculation. 

The following is a reconciliation of basic net loss per share to diluted net loss per share for the financial years ended June 
30, 2023 and 2022.

Basic earnings per share
Average shares outstanding - basic
Convertible debt shares
Adjusted average shares outstanding - diluted
Diluted earnings per share

Year ended 30 June 2023
$

Year ended 30 June 2022
$

(0.56)
82,210,050
-
82,210,050
(0.56)

$

(0.78)
72,861,251
976,048
73,837,496
(0.82)

$

The following potentially dilutive securities have been excluded from the computation of diluted weighted-average shares of 
ordinary shares outstanding as they would be anti-dilutive:

Stock options to purchase ordinary shares
Restricted stock units
Conversion of convertible note

Year ended 30 June 2023
4,968,576
40,340
5,441,199
10,450,115

Year ended 30 June 2022
4,554,901
—
—
4,554,901

The Company was incorporated on 15 March 2018 with 50,000 ordinary shares of £1.00 each, and as a result of subdivisions 
(100:1 on 4 May 2018 and then 4:1 on 24 October 2018), the resulting founding shares became 20,000,000 at £0.0025 each.

17. PROPERTY, PLANT AND EQUIPMENT

Group

Fixtures and fittings
$’000

Cost
At 1 July 2021
Additions
Foreign translation
At 30 June 2022
Depreciation
At 1 July 2021
Charge for the period
At 30 June 2022
Net book value at 30 June 2022
Cost
At 1 July 2022
Additions
Foreign translation
At 30 June 2023
Depreciation
At 1 July 2022
Charge for the period
At 30 June 2023
Net book value at 30 June 2023

1,286
591
-
1,877

205
304
509
1,368

1,877
-
-
1,877

509
341
850
1,027

The depreciation charge of $341k related to Property, Plant and Equipment has been charged to administration 
expenses ($266k) and cost of goods sold ($75k).

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       81

 
18. LEASES

(i) Amounts recognized in the statement of financial position

The balance sheet shows the following amounts relating to leases:

Group
As at 30 June 2023
$'000

Group
As at 30 June 2022
$'000

Company
As at 30 June 2023
$'000

Company
As at 30 June 2022
$'000

Right-of-use assets
Properties
Total right-of-use assets
Lease liabilities
Current
Non-current
Total lease liabilities

194
194

156
46
202

355
355

163
202
365

-
-

-
-
-

Right-of-use assets have been measured at the amount equal to the lease liability.

Lease liabilities were measured at the present value of the remaining lease payments, discounted using the Group’s 
incremental borrowing rate.

(ii)

Amounts recognized in the Statement of Comprehensive income

The statement of profit or loss shows the following amounts relating to leases:

Group
As at 30 June 2023
$'000

Group
As at 30 June 2022
$'000

Company
As at 30 June 2023
$'000

Company
At 30 June 2022
$'000

Depreciation charge - 
Right-of-use assets
Properties
Total right-of-use 
assets
Interest expense 
(included in finance 
cost)

160

160

3

126

126

2

-

-

-

The total cash outflow for leases in the year to 30 June 2023 was $160k (2022: $126k) for the Group and $Nil (2022: 
$nil) for the Company.

(iii)

The group’s leasing activities and how these are accounted for

The group leases various offices. Rental contracts for offices are made for fixed periods of between 1 and 5 years, but 
may have extension options as described below.

Lease payments to be made under reasonably certain extension options are also included in the measurement of the 
liability.

The lease payments are discounted using the interest rate implicit in the lease. If that rate cannot be readily 
determined, which is generally the case for leases in the group, the lessee’s incremental cash rate is used, being the 
rate that the individual lessee would forego to release the funds necessary to obtain an asset of similar value to the 
right-of-use asset in a similar economic environment with similar terms, security and conditions.

-
-

-
-
-

-

-

-

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       82

19. INTANGIBLE FIXED ASSETS

Group

Trademarks, 
Trade Names 
& Licenses
$’000

Trade 
Secrets

$’000

Development 
Costs

$’000

Total

$’000

Cost
At 1 July 2021
Additions
Foreign translation
At 30 June 2022
Amortisation
At 1 July 2021
Charge for the period
Foreign Translation
At 30 June 2022
Net book value
At 30 June 2022
Cost
At 1 July 2022
Additions
Foreign translation
At 30 June 2023
Amortisation
At 1 July 2022
Charge for the period
Foreign Translation
At 30 June 2023
Net book value
At 30 June 2023

10,553
-
(1,274)
9,279

3,254
1,018
(483)
3,789

5,490

9,279
-
381
9,660

3,789
923
199
4,911

4,750

7,136

(861)
6,275

535
688
(125)
1,098

5,177

6,275
-
258
6,533

1,098
624
75
1,797

4,736

4,429
103
(477)
4,055

308
459
(65)
702

3,353

4,055
-
144
4,199

702
432
40
1,174

3,025

22,118
103
(2,612)
19,609

4,097
2,165
(673)
5,589

14,020

19,609
-
783
20,392

5,589
1,978
314
7,881

12,511

Amortisation expense of $1,858,697 has been charged to administration costs and $119,776 has been charged to cost 
of goods sold. Amortisation expense of $2,164,779 was charged in the prior year ended 30 June 2022.

Licenses entail agreements with Icahn School of Medicine at Mount Sinai for rights to intellectual property and data 
to support the KidneyIntelX diagnostic assay. Trade secrets refer to the Company’s acquisition of the biomarker 
business from EKF, which includes intellectual property licensed from Joslin Diabetes Centre and forms a key 
component of the KidneyIntelX product. Development costs include proprietary software development and diagnostic 
assay design for KidneyIntelX.

Assets that are subject to amortisation are reviewed for impairment whenever events or changes in circumstances 
indicate that the carrying amount may not be recoverable. An impairment loss is recognized for the amount by which 
the carrying amount exceeds its recoverable amount.

The recoverable amount is the higher of an asset’s fair value less costs to sell and value in use. In assessing value in 
use, the estimated future cash flows are discounted to their present value using a pre-tax discount rate that reflects 
current market assessments of the time value of money and the risks specific to the asset for which the estimates of 
future cash flows have not been adjusted.

The Group has tested the carrying value for impairment at the balance sheet date. The recoverable amount was 
assessed in the basis of value in use. The assessed value exceeded the carrying value and no impairment loss was 
recognized. The key assumptions in the calculation to assess value in use are future revenues and costs and the ability 
to generate future cash flows. Recent working capital projections approved by the Board were used as well as 
forecasts for a further four years, followed by an extrapolation of expected cash flows and the calculation of a 
terminal value. For prudence the expected growth rate used for longer term growth was zero. The projected results 
were discounted at a rate which is a prudent evaluation of the pre-tax rate which reflects current market assessments 
of the value of money and the risks specific to the business, reflecting an assessment of the risk-adjusted weighted 
average cost of capital of 20%. The headroom in the value in use calculation is not sensitive to changes in key 
assumptions.

For the purposes of assessing impairment, assets are grouped at the lowest levels for which there are separately 
identifiable cash flows. Any impairment loss is charged pro rata to the other assets in the cash generating unit.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       83

The remaining average useful lives of the intangible assets is as follows:

Trademarks trade names & licenses

Trade secrets

Development Costs

10-15 years

15 years

15 years

The Company holds capitalized development costs with a cost of $4,198,837 and net value of $3,024,981. These 
projects were placed into service in FY21.

20. INVESTMENTS IN SUBSIDIARIES - PARENT

Company
At beginning of Period
Capital Contribution relating to share based payment
Capital Contribution to Subsidiary
Conversion of intercompany loan to equity investment
At end of Period

Year ended 30 
June 2023
$'000

Year ended 30 
June 2022
$'000

89,112
1,511
27,864
-
118,487

4,588
2,824

81,700
89,112

Investments in Group undertakings are recorded at cost which is the fair value of the consideration paid, less any 
impairment. The Company had the following subsidiaries as of 30 September 2023.

Name of Company

Proportion held

Class of shareholding

Nature of business

Renalytix AI, Inc.1

100%

Ordinary

Renalytix AI Limited 2

100%

Ordinary

Developer of artificial 
intelligence-enabled clinical 
diagnostic solutions for kidney 
disease
Developer of artificial 
intelligence-enabled clinical 
diagnostic solutions for kidney 
disease

1. Renalytix AI Inc. is incorporated in the United States of America and has their principal place of business at 1460 
Broadway, New York, New York 10036. Renalytix AI Inc. is included in the consolidation. The proportions of 
voting shares held by the parent company do not differ from the proportion of Ordinary Shares held.

2. Renalytix AI Limited is incorporated in the Republic of Ireland and has their principal place of business at 29 
Lower Patrick Street, Kilkenny, Ireland. Renalytix AI Ltd. is included in the consolidation. The proportions of 
voting shares held by the parent company do not differ from the proportion of Ordinary Shares held.

21. INVENTORY

Finished Goods

Group
As at 30 
June 2023
$'000

Group
As at 30 
June 2022
$'000

Company
As at 30 
June 2023
$'000

Company
As at 30 
June 2022
$'000

718

1,160

-

-

The Directors are of the opinion that the replacement values of inventories are not materially different to the carrying 
values stated above. The carrying values above are stated net of impairment provisions of $Nil (30 June 2022: $Nil).

The cost of inventories recognized as expense and included in ‘cost of sales’ amounted to $313k (Year to 30 June 2022: 
$266k). The Company held no inventories at 30 June 2023 and 30 June 2022.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       84

22. FINANCIAL INSTRUMENTS

(a) Assets at amortised cost

Assets as per balance sheet
Security deposits
Cash and cash equivalents
Total

Group
30 June 2023
$'000

Group
30 June 2022
$'000

Company
30 June 2023
$'000

Company
30 June 2022
$'000

132
24,682
24,814

141
41,333
41,474

-
8,574
8,574

-
28,313
28,313

Receivables in the analysis above are all categorized as “loans and receivables” for the Group and Company.

(b) Assets at fair value

Assets as per balance sheet
Investment in Verici Dx
Total

Group
30 June 2023
$'000

Group
30 June 2022
$'000

Company
30 June 2023
$'000

Company
30 June 2022
$'000

1,460
1,460

2,744
2,744

1,460
1,460

2,744
2,744

Fair value for the investment in Verici Dx was determined by reference to their published price quotation in an active market 
(classified as level 1 in the fair value hierarchy).

(c) Liabilities at amortised cost

Liabilities as per balance sheet
Accounts payable
Accrued expenses
Lease Liabilities
Total

(d)Liabilities at fair value

Liabilities as per balance sheet
Note payable
Total

Group
30 June 2023
$'000

Group
30 June 2022
$'000

Company
30 June 2023
$'000

Company
30 June 2022
$'000

2,936
8,568
202
11,706

2,460
4,821
365
7,646

504
878
-
1,382

400
695
-
1,095

Group
30 June 2023
$'000

Group
30 June 2022
$'000

Company
30 June 2023
$'000

Company
30 June 2022
$'000

11,948
11,948

12,342
12,342

11,948
11,948

12,342
12,342

The note payable relates to our convertible debt instrument and is classified as Level 3 in the fair value hierarchy.

(e) Credit quality of financial assets
The Group is exposed to credit risk from its operating activities and from its financing activities, including deposits 
with banks and financial institutions, foreign exchange transactions and other financial instruments.

The Group’s maximum exposure to credit risk, due to the failure of counterparties to perform their obligations as at 30 
June 2023, in relation to each class of recognized financial assets, is the carrying amount of those assets as indicated in 
the accompanying balance sheets.

Trade Receivables

The credit quality of trade receivables that are neither past due nor impaired have been assessed based on historical 
information about the counterparty default rate.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       85

Cash at Bank

The credit quality of cash has been assessed by reference to external credit ratings, based on reputable credit agencies’ 
long- term issuer ratings:

AA+
Total

Group
30 June 2023
$'000

Group
30 June 2022
$'000

Company
30 June 2023
$'000

Company
30 June 2022
$'000

24,682
24,682

41,333
41,333

8,574
8,574

28,313
28,313

23. TRADE AND OTHER RECEIVABLES

Trade Receivables
Due from affiliates
Total

Group
As at 30 June 2023
$'000

Group
As at 30 June 2022
$'000

Company
As at 30 June 2023
$'000

Company
As at 30 June 2022
$'000

776
-
776

901
75
976

-
-
-

-
-
-

Due to their short term nature, the Directors consider that the carrying amount of trade and other receivables 
approximates to their fair value.

24. PREPAIDS AND OTHER CURRENT ASSETS

Prepaids
Other Current Assets
Prepaids and Other 
Current Assets

Group
As at 30 June 2023
$'000

Group
As at 30 June 2022
$'000

Company
As at 30 June 2023
$'000

Company
As at 30 June 2022
$'000

538
27

566

1,116
36

1,152

170
14

184

284
16

300

25. CASH AND CASH EQUIVALENTS

Cash at Bank
Cash and cash 
equivalents

Group
As at 30 June 2023
$'000

Group
As at 30 June 2022
$'000

Company
As at 30 June 2023
$'000

Company
As at 30 June 2022
$'000

24,682

24,682

41,333

41,333

8,574

8,574

28,313

28,313

The Directors consider that the carrying value of cash and cash equivalents approximates to their fair value

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       86

26. SHARE CAPITAL

Group and Company

15-Mar-18
4-May-18
24-Oct-18
24-Oct-18
6-Nov-18
At 30 June 2019

Formation
100:1 subdivision
4:1 subdivision
Biomarker business acquisition
Placing & offer (listing on AIM)

Movement

50,000
-
-
15,427,704
18,388,430

29-Jul-19

15-May-20
At 30 June 2020
17-Jul-20
4-Mar-21
25-Jun-21
At 30 June 2021
7-Jul-21
17-Jul-21
31-Aug-21
1-Nov-21
31-Mar-22
6-Apr-22
At 30 June 2022
12-Sep-22
8-Feb-23
7-Mar-23
At 30 June 2023

Placing & Secondary Offering 
(AIM)
Cancellation of Share premium

5,600,000
-

Placing & Offering (Nasdaq)
Shares issued under the ESPP
Exercise of Stock Options

12,613,500
17,652
150,000

Exercise of Stock Options
Exercise of Stock Options
Shares issued under the ESPP
Exercise of Stock Options
Shares issued under the ESPP
Private Placement

27,500
5,000
10,920
68,224
22,814
2,428,688

Shares issues under ESPP
Private Placement
Shares issues under ESPP

131,412
18,722,960
166,674

Total 
Number of
Shares

Ordinary 
Shares
$'000

Share 
Premium
$'000

Total
$'000

50,000
5,000,000
20,000,000
35,427,704
53,816,134
53,816,134

59,416,134
59,419,134
59,416,134
72,029,634
72,047,286
72,197,286
72,197,286
72,224,786
72,229,786
72,240,706
72,308,930
72,380,014
74,760,432
74,760,432
74,891,844
93,614,804
93,781,478
93,781,478

66
-
-
49
60
175

17
-
192
40
-
1
233
-
-
-
-
-
8
241
-
57
1
299

-
-
-
6,547
27,485
34,032

16,597
(50,629)
-
76,094
111
252
76,457
46
40
121
112
90
8,578
85,444
116
19,248
144
104,952

66
-
-
6,596
27,545
34,207

-
-
192
76,134
111
253
76,690
46
40
121
112
90
8,586
85,685
116
19,305
145
105,251

Ordinary Shares have a par value of £0.0025 each. All issued shares are fully paid.

27. SHARE OPTIONS AND SHARE-BASED PAYMENTS
In November 2018, Company established the Renalytix AI plc Share Option Plan (the “Plan”) and a U.S. Sub-Plan and 
Non-Employee Sub-Plan. In July 2020, the Company's board of directors adopted and the Company's shareholders 
approved the 2020 Equity Incentive Plan (the “EIP”), which superseded the 2018 Share Option Plan. The equity 
incentive plan provides for the Company to grant options, restricted share awards and other share-based awards to 
employees, directors and consultants of the Company. As of June 30, 2023, there were 14,246,664 shares available for 
future issuance under the EIP. 

The Plan is administered by the board of directors. The exercise prices, vesting and other restrictions are determined at 
their discretion, except that all options granted have exercise prices equal to the fair value of the underlying ordinary 
shares on the date of the grant and the term of stock option may not be greater than ten years from the grant date.

With respect to the options granted as of June 30, 2023, 2,984,801 vest equally over twelve quarters following the grant 
date, 962,477 options which vest 25% on the one year anniversary and equally over twelve quarters following the one 
year anniversary, 500,000 which vest 1/12th immediately and the remainder equally over the remaining eleven quarters, 
471,300 which vest 25% on the one year anniversary, 50% on the two year anniversary, 25% on the three year 
anniversary, 40,000 which vest quarterly over two years and 10,000 which vest on the vesting commencement date.  If 
options remain unexercised after the date one day before the tenth anniversary of grant, the options expire. On 
termination of employment, any options that remain unexercised are either forfeited immediately or after a delayed 
expiration period, depending on the circumstances of termination. Upon the exercise of awards, new ordinary shares are 
issued by the Company. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       87

Details of the share options outstanding during the period are as follows:

Outstanding at June 30, 2022

Granted
Exercised
Forfeited

Outstanding at June 30, 2023
Exercisable at June 30, 2023
Vested and expected to vest at June 30, 2023

Number of
shares under
option plan

Weighted-
average
exercise price
per option

4,599,899
571,300

$
$
— $
(202,623) $
$
4,968,576
$
4,008,293
$
4,968,576

5.06
1.91
-
9.86
4.50
4.39
4.50

Weighted-
average
remaining
contractual
life (in years)
8.1

6.7
6.2
6.7

The weighted average fair value of each share option granted has been estimated using a Black-Scholes model and is 
£1.51 ($1.91). The inputs into the model are a weighted average share price of £1.49 ($1.88), exercise price of £1.04 
($1.31), expected volatility of 66.9%, no expected dividend yield, weighted-average term of 6.1 years and weighted-
average risk-free interest rate of 3.2%. None of the granted stock options were exercised in the year ended 30 June 
2023.

The aggregate intrinsic value of the outstanding options is $0. The Group recognized total expenses of $1,559,495 
($1,292,152 within G&A expense, $255,830 within R&D expense and $11,513 within COGS expense) relating to 
equity-settled share-based payment transactions during the period to 30 June 2023. The weighted average remaining 
contractual term of the options is 7.6 years.

Activity for restricted stock units for the year ended June 30, 2023 is as follows:

Non-vested balance at June 30, 2022

Granted
Vested
Forfeited

Non-vested balance at June 30, 2023

Number of
Restricted 
Stock Units

Weighted-
average
Grant Date 
Fair Value
-
1.53
1.44
1.69
1.61

— $
$
$
$
$

135,000
(82,800)
(11,860)
40,340

The total fair value of restricted stock units vested during the year ended June 30, 2023 was $0.1 million. There were no 
vested restricted stock units at June 30, 2022. Restricted stock units vest upon the achievement of time-based service 
requirements.

At June 30, 2023, total unrecognized compensation expense related to non-vested restricted stock units was 
approximately $0.05 million. Unrecognized compensation expense relating to restricted stock units that are deemed 
probably of vesting is expected to be recognized over a weighted-average period of approximately 1.4 years.

28. TRADE AND OTHER PAYABLES

Accounts payable
Due to subsidiaries
Payroll taxes payable
Accrued expenses
Total

Group
As at 30 
June 2023
$'000

Group
As at 30 
June 2022
$'000

Company
As at 30 
June 2023
$'000

Company
As at 30 
June 2022
$'000

2,935
-
128
8,450
11,513

2,460
-
139
4,682
7,281

504
4,084
8
954
5,550

400
4,701
-
695
5,796

The carrying amount of the trade and other payables balances denominated in GBP are £399k for the Group and 
Company (2022 - £37k).

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       88

29. CONVERTIBLE DEBT
In April 2022, the Company issued amortising senior convertible bonds with a principal amount $21.2 million due in 
April 2027 (the "Bonds"). The Bonds were issued at 85% par value with total net proceeds of $18.0 million and accrue 
interest at an annual rate of 5.5%, payable quarterly in arrears, in cash or ADSs valued at the ADS Settlement Price at 
the option of the Company. The Bonds contain various conversion and redemption features. The initial conversion price 
for the Convertible Bonds of $8.70 has been set at a 20 per cent. premium to the Reference ADS Price. The Conversion 
Price may reset down at 12, 24 and 36 months, depending on share price performance and save in limited 
circumstances, the Bonds have a hard floor in the conversion price of $7.25. Between amortisation dates, the 
Convertible Bond Investor retains the right to advance future amortisation payments, provided that (a) there shall be no 
amortisation advancements during the first 12 months, (b) no more than 2 amortisation advancements may occur in any 
12 month period, and (c) no more than 1 amortisation advancement may occur in any 3 month period.

The Convertible Bond Investor is also permitted to defer up to two amortisation payments to a subsequent amortisation 
date. The Company retains the option to repay any deferred amortisation in cash at 100 per cent. of the nominal 
amount. In July 2022, the Company made a cash amortization payment of $1.4 million, which consisted of $1.1 million 
of principal and $0.3 million of interest.   In October 2022, the Company made an interest payment of $0.3 million. In 
January 2023, the Company made a cash amortization payment of $1.4 million, which consisted of $1.1 million of 
principal and $0.3 million of interest. In April 2023, the Company made a cash amortization payment of $1.4 million, 
which consisted of $1.1 million of principal and $0.3 million of interest. As of 30 June 2023, $18.0 of principal was 
outstanding.

On issuance, the Company elected to account for the Bonds at fair value with qualifying changes in fair value being 
recognized through the statements of operations until the Bonds are settled. Changes in fair value related to instrument-
specific credit risk are recognized through comprehensive loss until the Bonds are settled. The fair value of the bonds is 
determined using a scenario-based analysis that estimates the fair value based on the probability-weighted present value 
of expected future investment returns, considering each of the possible outcomes available to the noteholders, and 
therefore falls under level 3 of the fair value hierarchy. Significant assumptions used in the fair value analysis include 
the volatility rate, risk-free rate, dividend yield and risk yield. The fair value of the Bonds was determined to be $16.9 
million on issuance, which is the principal amount of the Bonds. On issuance, total debt issuance costs of $1.4 million 
were immediately expensed as a component of general and administrative expense in consolidated statement of 
operations during the year ended 30 June 2022. As of 30 June 2023, the fair value of the Bonds was determined to be 
$11.9 million. During the twelve months ended 30 June 2023, the Company recognized a decrease in fair value of the 
Notes related to the instrument-specific credit risk of $0.3 million in the comprehensive loss and an increase in fair 
value related to non-instrument specific credit risk of $3.1 million as a loss in the consolidated statement of operations. 
The Company recognized a decrease in fair value of the Notes related to the instrument-specific credit risk of $0.5 
million in the comprehensive loss and a decrease in fair value related to non-instrument specific credit risk of $4.0 
million as a gain in the consolidated statement of operations during the year ended 30 June 2022.

30. RELATED PARTY TRANSACTIONS
In May 2018, the Company secured its cornerstone license agreement with ISMMS for research and clinical study work 
and intended commercialization by the Company. As part of the collaboration, ISMMS became a shareholder in the 
Company and has subsequently made equity investments both in the Company’s IPO in November 2018 and the 
subsequent sale of ordinary shares in July 2019. As of 30 June, 2023 and 2022, amounts due to ISMMS totaled $3.4 
million and $2.6 million, respectively. During the years ended 30 June, 2023, 2022, 2021, the Company incurred 
expenses of $3.3 million, $3.1 million and $1.3 million, respectively. 

In connection with the formation of Kantaro, the Company entered into a five-year Advisory Services Agreement 
(“Advisory Agreement”) pursuant to which the Company has agreed to provide certain advisory services to Kantaro. 
Pursuant to the Kantaro Operating Agreement, Kantaro issued 750 Class A Units to Mount Sinai in exchange for Mount 
Sinai granting licenses to Kantaro under certain intellectual property rights of Mount Sinai and 250 Class A Units to the 
Company as the sole consideration for the services to be rendered by the Company under the Advisory Agreement. A 
portion of the Company’s units are subject to forfeiture if, prior to December 31, 2021, Kantaro terminates the 
Advisory Agreement as a result of an uncured material breach of the Advisory Agreement or in the event the Company 
is acquired by a hospital or health system that serves all or any portion of the service areas served by Mount Sinai. The 
Company determined the fair value of the services to be provided under the Advisory Agreement was $2.0 million and 
the fair value of the Class A units received from Kantaro was $2.0 million. Fair value was determined using discounted 
cash flows which is a Level 3 measurement in the fair value hierarchy. The method requires several judgments and 
assumptions which include discount rates and future cash flows, among others. As a result of the prior year impairment 
charge discussed in Note 3, the carrying value of the Kantaro investment was written down to zero.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       89

A contributing factor to the impairment consideration for Kantaro was lower forecasted sales volume and consequently, 
a lower time commitment from Renalytix employees. Based on these circumstances, the Company adjusted the liability 
to perform services to Kantaro under the Advisory Agreement during the year ended June 30, 2021. On December 31, 
2022, the members and managers of Kantaro decided that it was in the best interest of Kantaro to wind up the business 
and unanimously signed a termination agreement. As part of the termination agreement, the members agreed to wind up 
Kantaro's business and dissolve it reasonably promptly after the effective date of the termination agreement. The 
termination agreement relieved Renalytix of its obligation to provide services to Kantaro, and the total liability 
associated with the services was written off. 

For the twelve months ended June 30, 2023, the Company recognized $0.02 million, in the statement of operations 
related to services performed under the Advisory Agreement. For the twelve months ended June 30, 2023 $0.01 million 
of costs incurred related to the performance of the Advisory Agreement services were included within research and 
development and $0.01 million were included in general and administrative expense, respectively. For the twelve 
months ended June 30, 2022, the Company recognized $0.1 million statements of operations related to services 
performed under the Advisory Agreement. For the twelve months ended June 30, 2022, $0.05 million of costs incurred 
related to the performance of the Advisory Agreement services were included within research and development and 
$0.07 million were included within general and administrative expense.

In addition to the equity granted at formation, in May 2020 the Company and Mount Sinai each committed to making a 
loan to Kantaro. Mount Sinai committed to lend an initial amount of $0.3 million and an additional $0.5 million 
thereafter. The Company committed to lend an initial amount of $0.08 million and an additional $0.17 million 
thereafter. Each loan bears interest at a per year rate equal to 0.25%, compounded monthly, until repaid, and is 
repayable from the first amounts that would otherwise constitute cash available for distribution to the members of 
Kantaro (provided that each loan repayment will be made, 75% to Mount Sinai and 25% to the Company based on each 
investor’s proportionate ownership). The Company loaned Kantaro $0.25 million and initially recorded a note 
receivable. Upon liquidation of the joint venture, Kantaro paid Renalytix $0.2 million for repayment of the loan. 
Renalytix recognized a gain of $0.1 million in the statement of operations as prior to repayment, the loan had a carrying 
value of approximately $0.075 million.

In June 2020, the Company and Mount Sinai entered into a registration rights agreement pursuant to which the 
Company has granted Mount Sinai the following registration rights:

▪

▪

▪

▪

Demand Registration on Form F-3 – Mount Sinai is entitled to demand registrations on Form F-3, if 
we are then eligible to register shares on Form F-3, including up to two underwritten offerings in any 
12-month period.

Demand Registration on Form F-1 or Form S-1 – At any time following one year after the completion 
of the global offering, if we are not eligible to register shares on Form F-3 or S-3, Mount Sinai is entitled 
to a maximum of one demand registration on Form F-1 or Form S-1 during any 12-month period, subject 
to specified exceptions.

Piggyback Registration – Mount Sinai is entitled to certain piggyback registration rights, subject to certain 
marketing and other limitations in the context of an underwritten offering.

Expenses – We will pay all registration expenses incident to the performance of our obligations under the 
registration rights agreement.

Mount  Sinai’s  registration  rights  will  terminate  at  such  time  as  Rule  144,  or  another  similar  exception  under  the 
Securities  Act,  is  available  for  the  unlimited  public  sale  of  all  of  Mount  Sinai’s  registrable  securities  without  any 
volume or manner of sale limitations, subject to specified exceptions.

On  February  9,  2023,  the  Company  entered  into  security  purchase  agreements  to  sell  an  aggregate  of  3,699,910 
Ordinary Shares, and 7,511,525  ADS, at a price of $2.17 per ADS and £0.90 per Ordinary Share. The private placement 
generated gross cash proceeds of $20.3 million, the net proceeds of which will be used for sales and marketing, clinical 
product development, and corporate support and financing costs. Certain related parties, directors of the company and 
executive officers participated in the private placement.

Mount Sinai subscribed for a total of 1,382,489 new American Depositary Shares at $2.17 per ADS. Christopher Mills, 
Non-Executive  Chairman,  and  his  related  parties  subscribed  for  a  total  of  346,375  Ordinary  Shares  at  £0.90  per 
Ordinary Share.

In the year ended June 30, 2022 , the Company also entered into a private placement agreement to sell, an aggregate 
of 2,428,688 shares of common stock (the “PIPE Shares”), for a purchase price of $3.625 per share and an aggregate 
purchase price of $8.8 million. Certain related parties, directors of the company and executive officers participated in 
the private placement.

Mount Sinai subscribed for a total of 1,103,448 new ordinary shares at $3.625 per ordinary share. EKF Diagnostics 
Holdings, subscribed for a total of 137,930 new ordinary shares at $3.625 per ordinary share. Christopher Mills, Non-
Executive Chairman, and his related parties subscribed for a total of 551,724 new ordinary shares at $3.625 per ordinary 
share. Timothy Scannell, Non-Executive Director, subscribed for a total of 68,964 new ordinary shares at $3.625 per 
ordinary share. Thomas McLain, President, subscribed for a total of 55,172 new ordinary shares at $3.625 per ordinary 
share. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       90

31. CONTINGENT LIABILITIES
The Group has a contract with Icahn School of Medicine at Mount Sinai which give rise to contingent liabilities:

Mount Sinai Collaboration Agreement

The Group is subject to the following one-off milestone payment obligations:

▪

▪

$1.5 million once worldwide sales of Licensed Products reach $50 million; and

$7.5 million once worldwide sales of Licensed Products reach $300 million.

In addition, royalties of 4-5% are payable to Mount Sinai on net sales of KidneyIntelX™, and 15% or 25% (depending 
on timing) of income from sublicensing. The Group is also subject to an annual data transfer fee of $50,000.

Joslin Diabetes Center Agreement

The Group  has a  contract  with Joslin  Diabetes  Center  under  which  the  Group  is liable for  the  following costs  and 
payments:

▪

▪

▪

▪

5% royalty on net sales of Joslin Licensed Products and Joslin Licensed Processes;

25% of royalties received by the Group from sublicensing;

A one-off milestone payment of $300,000 once total net sales reach $2 million; and

A one-off milestone payment of $1 million once total net sales reach $10 million

As of June 30, 2023, the Company has accrued for the $300,000 sales milestone due to Joslin as total net sales of $2 
million were achieved in the year.

32. ULTIMATE CONTROLLING PARTY
The Directors believe there to be no ultimate controlling party.

33. EQUITY METHOD INVESTMENTS
In May 2020, the Group and Mount Sinai entered into the Kantaro Operating Agreement in order to form Kantaro 
Biosciences LLC (“Kantaro”) for the purpose of developing and commercializing laboratory tests for the detection of 
antibodies against SARS-CoV-2 originally developed by Mount Sinai. In connection with the formation of Kantaro, 
the Group entered into the Advisory Agreement, pursuant to which the Group has agreed to provide certain advisory 
services to Kantaro.

Pursuant to the Kantaro Operating Agreement, Kantaro issued 750 Class A Units to Mount Sinai in exchange for Mount 
Sinai granting licenses to Kantaro under certain intellectual property rights of Mount Sinai and 250 Class A Units to 
the Group in respect of the services to be rendered by the Group under the Advisory Agreement. A portion of the units 
are subject to forfeiture if, prior to December 31, 2020, Kantaro terminates the Advisory Agreement as a result of the 
uncured material breach of the Advisory Agreement or in the event we are acquired by a hospital or health system that 
serves all or any portion of the service areas served by Mount Sinai. The Group account for the investment in Kantaro 
using the equity method of accounting as the Group can exert significant influence over, but do not control, Kantaro.

In addition to the equity granted at formation, the Group and Mount Sinai each committed to making a loan to Kantaro.

Mount  Sinai  committed  to  lend  an  initial  amount  of  $250,000  and  an  additional  $500,000  thereafter.  The  Group 
committed to lend an initial amount of $83,333 and an additional $166,667 thereafter. Each loan bears interest at a per 
annum rate equal to 0.25%, compounded monthly, until repaid, and is repayable from the first amounts that would 
otherwise constitute cash available for distribution to the members of Kantaro (provided that each loan repayment will 
be made, 75% to Mount Sinai and 25% to us). All services provided by the Group under the Advisory Agreement are 
subject to the oversight and direction of the board of managers of Kantaro.

On December 31, 2022, the members and managers of Kantaro decided that it was in the best interest of Kantaro to 
wind up the business and unanimously signed a termination agreement. As part of the termination agreement, the 
members agreed to wind up Kantaro's business and dissolve it reasonably promptly after the effective date of the 
termination agreement. The termination agreement relieved Renalytix of its obligation to provide services to Kantaro, 
and the total liability associated with the services was written off.  Upon liquidation of the joint venture, Kantaro paid 
Renalytix $0.2 million for repayment of the loan. Renalytix recognized a gain of $0.1 million in the statement of 
operations as prior to repayment, the loan had a carrying value of approximately $0.075 million. As of June 30, 2023, 
Kantaro was completely dissolved and the Group no longer retained an interest in the entity. 

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       91

34. SUBSEQUENT EVENTS
On July 17, 2023, the Company announced the repayment of $1.06 million of the Company's convertible bond through 
the issuance of 526,211 American Depositary Shares ("ADS"). 1,052,422 new ordinary shares of £0.0025 each in the 
capital of the Company (the "Ordinary Shares") were issued to settle the conversion of 526,211 ADSs, with each ADS 
representing two Ordinary Shares. After settlement of the repayment, the principal remaining under the convertible 
bond will be reduced by $1.06 million to $15.90 million.

On October 17, 2023, the Company announced the repayment of $1.06 million of the Company's convertible bond 
through the issuance of 150,000 Ordinary Shares and 1,092,694 American Depositary Shares ("ADS"). 2,185,388 new 
ordinary  shares  of  £0.0025  each  in  the  capital  of  the  Company  (the  "Ordinary  Shares")  were  issued  to  settle  the 
conversion of 1,092,694 ADSs, with each ADS representing two Ordinary Shares. After settlement of the repayment, 
the principal remaining under the convertible bond will be reduced by $1.06 million to $14.84 million.

 | Renalytix plc Annual Report and Financial Statements

                                                                                                                       92

 
Additional Financial Information

RECONCILIATION OF IFRS TO US GAAP
Since Renalytix’s initial listing on Nasdaq, the Company has followed accounting principles generally accepted in the 
United  States  of  America  (‘US  GAAP’),  both  for  internal  as  well  as  external  purposes.  The  information  below  is 
unaudited and does not form part of the statutory accounts.

Renalytix Form 10-K, which is based on US GAAP, contains differences from its Annual Report, which is based on IFRS.

The Form 10-K an Annual Report are available on the Company’s website (www.renalytix.com). In order to help readers 
to understand the difference between the Group’s two sets of financial statements, Renalytix has provided, on a voluntary 
basis, a reconciliation from IFRS to U.S. GAAP as follows:

BALANCE SHEET

Assets
Cash
Accounts receivable
Prepaid expenses and other current assets
Note receivable – Kantaro
Property, plant and equipment, net
Intangibles, net
Investment in Verici
Right of use asset
Other assets
Total assets

Liabilities and stockholder's equity
Current Liabilities:

Note payable – current
Accounts payable
Accrued expenses and other current liabilities
Accrued expenses – related party
Current lease liability
Deferred Revenue
Note payable – non current
Noncurrent lease liabilities
Total Liabilities

Stockholders’ (deficit) equity:

GAAP

IFRS

As at 30 June 
2023
$'000

As at 30 June 
2023
$'000

GAAP vs 
IFRS

Difference

$'000

24,682
776
1,424
-
1,027
-
1,460
159
1,101
30,629

4,463
2,936
6,644
1,963
130
-
7,485
41
23,662

24,682
776
1,416
-
1,027
12,511
1,460
194
51
42,117

4,463
11,513
-
-
156
-
7,485
46
23,663

-
-
8
-
-
(12,511)
-
(35)
1,050
(11,488)

-
8,577
(6,644)
(1,963)
26
-
-
5
1

13
(67,990)
323
79,141
11,487
11,488

(a)

(b)

(c)
(d)

(e)
(e)
(e)
(d)

(d)

(f)
(g)
(h)
(i)

Ordinary shares, £0.0025 par value per share: 98,750,054 shares 
   authorized; 93,781,478 and 74,760,432 shares issued and 
   outstanding at June 30, 2023 and June 30, 2022, respectively
Additional paid in capital
Accumulated other comprehensive (loss) income
Accumulated deficit
Total stockholders' (deficit) equity
Total liabilities and stockholders’ (deficit) equity

286
186,456
(1,450)
(178,325)
6,967
30,629

299
118,466
(1,127)
(99,184)
18,454
42,117

a. Represents other immaterial presentation differences between US GAAP & IFRS

b. Under IFRS, the acquisition of licenses and subsequent development efforts are capitalized and presented as intangible 
assets. Under U.S. GAAP, such costs are expensed as incurred until technological feasibility has been achieved or the 
assets are deemed to have future alternative use. In addition to capitalized software costs which are recorded as property 
and equipment under US GAAP and Intangibles under IFRS.

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                                                                                                                       93

c. Represents difference in the timing of the adoption of IFRS 16 in connection with the Company’s commercial 
laboratory in Utah. The Company has deferred the adoption of ASC 842 under U.S. GAAP until July 1, 2022.

d. Difference is attributable to capitalized software costs which are recorded as other assets under U.S. GAAP and 

Intangibles under IFRS.

e. Accounts payable and other current liabilities are presented in the aggregate within the Annual report while broken out 

separately on the US GAAP 10-K. Difference represents other immaterial presentation differences and audit 
adjustments.

f. Represents other immaterial audit adjustments.

g. Represents cancellation of share premium account and reduction in accumulated deficit under IFRS in anticipation of a 
distribution of FractalDx net assets to the shareholders of Verici in prior year. In addition, stock based compensation is 
recognized on a straight line basis under U.S. GAAP and a graded vesting basis under IFRS which creates timing 
differences as to when expenses are recorded.

h. Represents the difference in weighted average foreign exchange rates and spot rates used for translation of financial 

statements under IFRS and U.S. GAAP.

i. Represents cancellation of share premium and reduction in accumulated deficit under IFRS in anticipation of a 
distribution of FractalDx net assets to the shareholders of Verici and differences noted within the Company’s 
consolidated statement of operations and comprehensive loss.

RECONCILIATION OF NET LOSS

Net loss in accordance with IFRS
Stock compensation expense
Amortisation of intangibles
Other adjustments
Net loss in accordance with US GAAP

Year ended 30 June 2023
$'000

(46,223)
(1,376) (j)
1,963 (k)
29 (l)

(45,607)

j. Stock based compensation is recognized on a straight line basis under U.S. GAAP and a graded vesting basis under 

IFRS which creates timing differences as to when expenses are recorded.

k. Amortisation expense is higher on the IFRS books as a result of the higher intangible asset balance. Under IFRS, the 
acquisition of licenses and subsequent development efforts are capitalized and presented as intangible assets. Under 
U.S. GAAP, such costs are expensed as incurred until technological feasibility has been achieved or the assets are 
deemed to have future alternative use.

l. The remaining difference represents the aggregation of other immaterial audit adjustments and small accounting 

standard difference.

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