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

Abstract

Box 1 | Prevailing attitudes of medical professionals emerging from public review and participant survey Agreement with goal of standardizing nomenclature, with acknowledgment of challenges Regarded multiplicity of terms and lack of adherence to established definitions as confusing and potentially leading to errors Anticipated that a standardized nomenclature would help foster consistency in trial design, execution, and reporting Judged consistency between terms used in scholarly and patient communities to be an important goal, but not one overriding the need for precision and efficiency Journal editors strongly agreed that having a more standardized nomenclature for kidney disease would be useful for their journals, but they anticipated time constraints of journal personnel to be the biggest barrier to implementation Qualified endorsement of replacing "renal" with "kidney" Felt that foregrounding "kidney" would be easier for patients and their families Perceived a greater likelihood of raising awareness, attracting funding, and influencing public policy with consistent use of "kidney" Cautioned against a wholesale switch because "renal" may be less awkward in some contexts and may be necessary in others (e.g., ESRD as a CMS definition) Dissatisfaction with "end-stage" as a descriptor of kidney disease Recognized that this wording can be demoralizing and stigmatizing for patients Considered the implication of imminent death to be outdated Frustrated by imprecision in its use (ranging from being a synonym for dialysis patients to a descriptor of patients with kidney failure with or without kidney replacement therapy) Recognition of the need for ongoing attention to nomenclature issues Noted that standardization of nomenclature is dependent on uptake of consensus definitions B where definitions are in flux or are more contentious, standardization of that nomenclature set may be premature B enhancing adoption of definitions requires continued effort Highlighted the need for harmonization with ongoing, broader-scope ontology efforts Expected that improved understanding of molecular mechanisms will lead to more-precise definitions and nomenclature CMS, Centers for Medicare & Medicaid Services; ESRD, end-stage renal disease.

Timing of kidney biopsy in type 2 diabetic patients: a stepwise approach

“…2). In patients with diabetic retinopathy (Table 3), 100 had isolated DN (group 1) and 12 had NDRD ± DN (group 2); the urinary RBC count was significantly higher in group 2 then group 1 (8 [4,43] vs. 4 [4,8] /HPF, P = 0.004; ROC cut-off value: 5.5/HPF, AUC = 0.743) ( Figure S1), and group1 had a significantly higher prevalence of PDR (56% vs. 16.7%, P = 0.01) and PRP (54% vs. 16.7%, P = 0.029). In patients without diabetic retinopathy (Table 4), 20 had isolated DN (group 3) and 28 had NDRD ± DN (group 4); the urinary RBC count was significantly higher in group 4 than group 3 (6 [4, 15.5] vs. 3.5 [1,4] /HPF, P < 0.001; ROC cut-off value: 6.0/HPF, AUC = 0.786) ( Figure S2), and group 3 had significantly longer duration of DM (10 [3.5, 19] vs. 2 [1, 7.5] years, P = 0.004; ROC cut-off value: 4.5 years, AUC = 0.745) ( Figure S3).…”

“…In patients with PDR, there was no significant difference between patients with diabetic retinopathy and NDRD ± DN (Table S1). In patients with non-proliferative diabetic retinopathy (NPDR), patients with NDRD ± DN had significantly higher urinary RBC count (8 [4,43] vs. 4 [4,8] /HPF, P = 0.024) ( (Table S3).…”

“…Type 2 diabetes mellitus (DM), with its increasing prevalence, is one of the most crucial health problems [1,2], and diabetic nephropathy (DN) is the leading cause of kidney failure with replacement therapy worldwide [3,4]. DN is usually diagnosed clinically based on its typical presentations (i.e., a long-standing duration of diabetes, presence of diabetic retinopathy, albuminuria without hematuria, and gradually progressive loss of eGFR), and absence of clinical or laboratory evidence of other kidney diseases [5][6][7].…”

Utilizing imbalanced electronic health records to predict acute kidney injury by ensemble learning and time series model

“…In this study, AKI is defined as serum creatinine increases by 0.3 mg/dl (26.5 μ mol/l) or more in 48 hours or a rise to at least 1.5-fold from baseline within seven days in light of Kidney Disease Improving Global Outcomes (KDIGO) classification [ 20 ]. Table 1 shows the summary characteristics of the study samples.…”

Nomenclature for kidney function and disease: executive summary and glossary from a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference

“…As described in detail in the conference report [8], the meeting 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 the severity of these; (iv) to use the KDIGO definition and classification of CKD rather than alternative descriptions to define and classify it; and (v) to use specific kidney measures, such as albuminuria or decreased glomerular filtration rate, rather than ‘abnormal’ or ‘reduced’ kidney function to describe alterations in kidney structure and function (Table 1). Accordingly, the proposed glossary contains five corresponding sections and comprises specific items for which there was general agreement among the conference participants (https://kdigo.org/conferences/nomenclature/; Table 2) [8]. For each section, the glossary includes preferred terms, abbreviations, descriptions, and terms to avoid, with the acknowledgment that journals may choose which of the recommendations to implement and that journal style will dictate when and how to abbreviate terms to be consistent with nomenclature for other diseases.…”