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that this wording can be demoralizing and stigmatizing for patients Considered the implication of imminent death to be outdated Frustrated by imprecision in its use (ranging from being a synonym for dialysis patients to a descriptor of patients with kidney failure with or without kidney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.
A primary obligation of medical journals is the responsible, professional, and expeditious delivery of knowledge from researchers and practitioners to the wider community. 1 The task of journal editors, therefore, rests not merely in selecting what to publish, but in large measure judging how it can best be communicated. The challenge of improving descriptions of kidney function and disease in medical publishing was the impetus for a KDIGO (Kidney Disease: Improving Global Outcomes) Consensus Conference held in June 2019. The conference goals included standardizing and refining kidney-related nomenclature used in English-language scientific articles and developing a glossary that can be used by journals. 2 The rationale for the conference was that the worldwide burden of kidney disease is rising, but public awareness remains limited, underscoring the need for effective communication by stakeholders in the kidney health community. [3][4][5][6] Despite this need, the nomenclature for describing kidney function and disease lacks uniformity and clarity. Two decades ago, a survey of hundreds of published articles and meeting abstracts reported a broad array of overlapping, confusing terms for chronic kidney disease (CKD) and advocated adoption of unambiguous terminology. 7 Nevertheless, terms flagged by that analysis as problematic, such as "chronic renal failure" and "pre-dialysis," still appear in current-day publications. A coherent, shared nomenclature could improve communication at all levels, to not only foster better appreciation of the burden of disease but also aid understanding of how patients feel about their disease, allow more effective communication between kidney disease specialists and other clinicians, advance more straightforward comparison and integration of datasets, enable better recognition of gaps in knowledge for future research, and facilitate more comprehensive public health policies for acute and chronic kidney disease.Developing consistent, patient-centered, and precise descriptions of kidney function and disease in the scientific literature is an important objective to align communication in clinical practice, research, and public health. Although some terms have been in use for decades, the increased exchange of information among stakeholders makes it timely to revisit nomenclature in order to ensure consistency. The goal is to facilitate communication within and across disciplines and between practitioners and patients, with the ultimate hope of improving outcomes through consistency and precision.
A primary obligation of medical journals is the responsible, professional, and expeditious delivery of knowledge from researchers and practitioners to the wider community [1]. The task of journal editors, therefore, rests not merely in selecting what to publish, but in large measure judging how it can best be communicated. The challenge of improving descriptions of kidney function and disease in medical publishing was the impetus for a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference held in June 2019. The conference goals included standardizing and refining kidney-related nomenclature used in English-language scientific articles and developing a glossary that can be used by journals [2]. The rationale for the conference was that the worldwide burden of kidney disease is rising, but public awareness remains limited, underscoring the need for effective communication by stakeholders in the kidney health community [3-6]. Despite this need, the nomenclature for describing kidney function and disease lacks uniformity and clarity. Two decades ago, a survey of hundreds of published articles and meeting abstracts reported a broad array of overlapping, confusing terms for chronic kidney disease (CKD) and advocated adoption of unambiguous terminology [7]. Nevertheless, terms flagged by that analysis as problematic, such as "chronic renal failure" and "pre-dialysis," still appear in current-day publications. A coherent, shared nomenclature could improve communication at all levels, to not only foster better appreciation of the burden of disease but also aid understanding of how patients feel about their disease, allow This article is being published in Kidney International Reports and reprinted concurrently in several journals. The articles cover identical concepts and wording but vary in minor stylistic and spelling changes, detail, and length of manuscript, in keeping with each journal's style. Any of these versions may be used in citing this article. Excerpts are adapted with permission of KDIGO and the International Society of Nephrology.
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 by journals in scientific publications. Guiding principles of the conference were that the revised nomenclature should be patient-centred, 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 the 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 AKD and AKI; (iv) to use the KDIGO definition and classification of chronic kidney disease (CKD) rather than alternative descriptions to define and classify the severity of CKD; 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. A proposed five-part glossary contains specific items for which there was general agreement. Conference attendees acknowledged limitations of the recommendations and glossary but considered that standardizing scientific nomenclature is essential for improving communication.
has received research support from AstraZeneca, the National Institute of Diabetes and Digestive and Kidney Diseases, and the National Kidney Foundation; Kai-Uwe Eckardt has received consultancy fees from Akebia, Bayer, and Genzyme, speaker honoraria from Bayer and Vifor, and research support from Amgen, AstraZeneca, Bayer, Fresenius Medical Care, and Genzyme; Nijsje M. Dorman has equity ownership/ stock options from Eli Lilly & Co; Michel Jadoul has received consultancy fees from Astellas, AstraZeneca, GSK, MSD, and Vifor Fresenius Medical Care Renal Pharma, speaker honoraria from AbbVie, Amgen, Menarini, MSD, and Vifor Fresenius Medical Care Renal Pharma, travel support from Amgen, and research support from Alexion, Amgen, Janssen-Cilag, Otsuka, and Roche; and Wolfgang C. Winkelmayer has received consultancy fees from Akebia, AMAG, Amgen, AstraZeneca, Bayer, Daiichi-Sankyo, Relypsa, and ZS Pharma, speaker honoraria from FibroGen, and research support from the National Institutes of Health. The remaining authors disclose no conflicts. This article is being published in Kidney International Reports and reprinted concurrently in several journals. The articles cover identical concepts and wording but vary in minor stylistic and spelling changes, detail, and length of manuscript, in keeping with each journal's style. Any of these versions may be used in citing this article. Excerpts are adapted with permission of Kidney Disease: Improving Global Outcomes (KDIGO) and the International Society of Nephrology.
This article is being published in Kidney International Reports and reprinted concurrently in several journals. The articles cover identical concepts and wording but vary in minor stylistic and spelling changes, detail, and length of manuscript, in keeping with each journal's style. Any of these versions may be used in citing this article. Excerpts are adapted with permission of KDIGO and the International Society of Nephrology.
Perhaps half of the proteins encoded by the human genome are phosphorylated, and this post-translational modification helps regulate vital processes such as signal transduction and the cell cycle. However, monitoring phosphorylation by Western blotting can be frustrating. Although anti-phosphotyrosine antibodies are reliable, antibodies against phosphoserine and phosphothreonine tend to be sequence dependent. A number of non-antibody-based dyes have been introduced, but high backgrounds and poor sensitivities limit their popularity. 32 P-labeling is a context-independent alternative to Westerns, but its toxicity can perturb cells, and few relish the hassle of working with this beta emitter. Another option, mass spectrometry (MS), suffers from low ionization and fragmentation of phosphopeptides, necessitating sophisticated instrumentation not usually available for routine use. Undaunted by this litany of disappointment in phosphoprotein detection, Iliuk et al. describe sensitive phosphorylation analysis via a modified Western blotting method. The technique, published in Molecular and Cellular Proteomics, uses a soluble hyperbranched nanopolymer called pIMAGO. The reagent is functionalized with titanium ions, which have affinity and selectivity for phosphate groups. The authors previously used this property for enriching phosphopeptides before MS, and
This article is being published in Kidney International Reports and reprinted concurrently in several journals. The articles cover identical concepts and wording but vary in minor stylistic and spelling changes, detail, and length of manuscript, in keeping with each journal's style. Any of these versions may be used in citing this article. Excerpts are adapted with permission of KDIGO and the International Society of Nephrology.
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