Nomenclature for kidney function and disease: report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference

Andrew S Levey; Kai-Uwe Eckardt; Nijsje M Dorman; Stacy L Christiansen; Ewout J Hoorn; Julie R Ingelfinger; Lesley A Inker; Adeera Levin; Rajnish Mehrotra; Paul M Palevsky; Mark A Perazella; Allison Tong; Susan J Allison; Detlef Bockenhauer; Josephine P Briggs; Jonathan S Bromberg; Andrew Davenport; Harold I Feldman; Denis Fouque; Ron T Gansevoort; John S Gill; Eddie L Greene; Brenda R Hemmelgarn; Matthias Kretzler; Mark Lambie; Pascale H Lane; Joseph Laycock; Shari E Leventhal; Michael Mittelman; Patricia Morrissey; Marlies Ostermann; Lesley Rees; Pierre Ronco; Franz Schaefer; Jennifer St Clair Russell; Caroline Vinck; Stephen B Walsh; Daniel E Weiner; Michael Cheung; Michel Jadoul; Wolfgang C Winkelmayer

doi:10.1016/j.kint.2020.02.010

Nomenclature for kidney function and disease: report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference

Kidney Int. 2020 Jun;97(6):1117-1129. doi: 10.1016/j.kint.2020.02.010. Epub 2020 Mar 9.

Authors

Andrew S Levey¹, Kai-Uwe Eckardt², Nijsje M Dorman³, Stacy L Christiansen⁴, Ewout J Hoorn⁵, Julie R Ingelfinger⁶, Lesley A Inker⁷, Adeera Levin⁸, Rajnish Mehrotra⁹, Paul M Palevsky¹⁰, Mark A Perazella¹¹, Allison Tong¹², Susan J Allison¹³, Detlef Bockenhauer¹⁴, Josephine P Briggs¹⁵, Jonathan S Bromberg¹⁶, Andrew Davenport¹⁷, Harold I Feldman¹⁸, Denis Fouque¹⁹, Ron T Gansevoort²⁰, John S Gill⁸, Eddie L Greene²¹, Brenda R Hemmelgarn²², Matthias Kretzler²³, Mark Lambie²⁴, Pascale H Lane²⁵, Joseph Laycock²⁶, Shari E Leventhal²⁷, Michael Mittelman²⁸, Patricia Morrissey²⁹, Marlies Ostermann³⁰, Lesley Rees³¹, Pierre Ronco³², Franz Schaefer³³, Jennifer St Clair Russell³⁴, Caroline Vinck³⁵, Stephen B Walsh³⁶, Daniel E Weiner⁷, Michael Cheung³⁷, Michel Jadoul³⁸, Wolfgang C Winkelmayer³⁹

Affiliations

¹ Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA. Electronic address: [email protected].
² Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany. Electronic address: [email protected].
³ Managing Editor, American Journal of Kidney Diseases.
⁴ Managing Editor, Journal of the American Medical Association.
⁵ Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.
⁶ Harvard Medical School, Boston, Massachusetts, USA; Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁷ Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA.
⁸ Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada.
⁹ Kidney Research Institute, University of Washington School of Medicine, Seattle, Washington, USA; Harborview Medical Center Division of Nephrology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
¹⁰ Renal Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
¹¹ Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut, USA; Veterans Affairs Medical Center, West Haven, Connecticut, USA.
¹² Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.
¹³ Chief Editor, Nature Reviews Nephrology.
¹⁴ Renal Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; Department of Renal Medicine, University College London, London, UK.
¹⁵ Editor-in-Chief, Journal of the American Society of Nephrology.
¹⁶ Department of Surgery, Division of Transplantation, University of Maryland School of Medicine, Baltimore, Maryland, USA; Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
¹⁷ Royal Free London NHS Foundation Trust, London, UK.
¹⁸ Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Renal Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
¹⁹ Department of Nephrology, Centre Hospitalier Lyon Sud, Lyon, France.
²⁰ Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
²¹ Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
²² Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
²³ Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA; Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA.
²⁴ Institute for Science and Technology in Medicine, Keele University, Crewe, UK.
²⁵ Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
²⁶ Managing Editor, Pediatric Nephrology.
²⁷ Executive Editor, American Society of Nephrology, Washington, DC, USA.
²⁸ American Living Organ Donor Fund, Philadelphia, Pennsylvania, USA.
²⁹ Executive Managing Editor, Kidney International.
³⁰ Department of Critical Care, King's College London, Guy's & St Thomas' Hospital, London, UK.
³¹ Department of Pediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
³² Sorbonne Université, Paris, France; Institut National de la Santé et de la Recherche Médicale (Inserm), Unité Mixte de Recherche UMR S1155, Paris, France; Hôpital de jour - Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France.
³³ Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany.
³⁴ National Kidney Foundation, New York, New York, USA.
³⁵ Managing Editor, Nephrology Dialysis Transplantation.
³⁶ Center for Nephrology, University College London, London, UK.
³⁷ Kidney Disease: Improving Global Outcomes (KDIGO), Brussels, Belgium.
³⁸ Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium.
³⁹ Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.

PMID: 32409237
DOI: 10.1016/j.kint.2020.02.010

Abstract

The worldwide burden of kidney disease is rising, but public awareness remains limited, underscoring the need for more effective communication by stakeholders in the kidney health community. Despite this need for clarity, the nomenclature for describing kidney function and disease lacks uniformity. In June 2019, Kidney Disease: Improving Global Outcomes (KDIGO) convened a Consensus Conference with the goal of standardizing and refining the nomenclature used in the English language to describe kidney function and disease, and of developing a glossary that could be used in scientific publications. Guiding principles of the conference were that the revised nomenclature should be patient-centered, precise, and consistent with nomenclature used in the KDIGO guidelines. Conference attendees reached general consensus on the following recommendations: (i) to use "kidney" rather than "renal" or "nephro-" when referring to kidney disease and kidney function; (ii) to use "kidney failure" with appropriate descriptions of presence or absence of symptoms, signs, and treatment, rather than "end-stage kidney disease"; (iii) to use the KDIGO definition and classification of acute kidney diseases and disorders (AKD) and acute kidney injury (AKI), rather than alternative descriptions, to define and classify severity of AKD and AKI; (iv) to use the KDIGO definition and classification of chronic kidney disease (CKD) rather than alternative descriptions to define and classify severity of CKD; and (v) to use specific kidney measures, such as albuminuria or decreased glomerular filtration rate (GFR), rather than "abnormal" or "reduced" kidney function to describe alterations in kidney structure and function. A proposed 5-part glossary contains specific items for which there was general agreement. Conference attendees acknowledged limitations of the recommendations and glossary, but they considered standardization of scientific nomenclature to be essential for improving communication.

Keywords: acute kidney diseases and disorders; acute kidney injury; chronic kidney disease; kidney disease; kidney failure; kidney function; kidney measures; nomenclature; patient-centeredness; precision medicine.

Publication types

Practice Guideline
Research Support, Non-U.S. Gov't

MeSH terms

Acute Kidney Injury*
Albuminuria
Glomerular Filtration Rate
Humans
Kidney
Renal Insufficiency, Chronic* / diagnosis
Renal Insufficiency, Chronic* / therapy