Terminology in Transition: Nephrology - Nomenclature

AMA Manual of Style - Stacy L. Christiansen, Cheryl Iverson 2020

Terminology in Transition: Nephrology

The global organization dedicated to developing and implementing evidence-based clinical practice guidelines in kidney disease, KDIGO (Kidney Disease: Improving Global Outcomes), is spearheading an international effort to revise the nomenclature used to describe kidney function and disease.

The effort will focus on making terminology more patient-centered and precise, with the goal of greater uniformity in medical practice, research, scientific publication, and public health.

Some of the terminology to be harmonized includes the following:

Kidney vs renal: Select the more patient-friendly term (ie, kidney). Also, using these in parallel leads to different abbreviations for the same condition (eg, RRT [renal replacement therapy] and KRT [kidney replacement therapy]).

Kidney failure vs end-stage renal disease: Kidney failure is the preferred term except when referring to eligibility for medical care under US legislation or other regulations. Patients with kidney failure should be further described by the presence or absence of therapy by dialysis, transplant, or conservative care and by symptom severity.

Decreased glomerular filtration rate (GFR): Use this instead of decreased kidney function. Kidneys execute a variety of functions, not just glomelular filtration, so precision in terminology is preferred.

Chronic kidney disease (CKD): This is not the same as decreased GFR. CKD is defined as decreased GFR or markers of kidney damage, such as elevated albuminuria or abnormalities of the urine sediment or kidney imaging. People with normal GFR may have CKD.

Acute kidney disease (AKD): This is not the same as acute kidney injury (AKI). AKD conditions are present for less than 3 months, whereas AKI conditions have onset within a week.

The final recommendations and a complete glossary of related terms will be available in the near future and used to inform an update to this chapter in the manual online.

See also 13.0, Abbreviations.