What's In A Name?

Shakespeare, via Romeo, asked this question most famously, but a bunch of kidney doctors sat in a conference center in Amsterdam for 1-1/2 days last week to ponder what we call things. At first, this sounds like a pointless intellectual exercise, but our words have an impact beyond what we are thinking.

First, common terminology lets one person know what the other is thinking, if all are tuned into the same glossary. When I say my patient has chronic kidney disease stage G3a, they know that the estimated glomerular filtration rate (eGFR) is between 45 and 59 mL/minute/1.73m^2 of body surface area. We used to call any reduction in kidney function for more than 3 months chronic renal failure; we now recognize that significant reductions in eGFR can occur without the kidneys "failing." Other terms have undergone standardization over the years.

Second, the patient's perspective also factors into the way we say things. When dialysis or transplant is necessary, we often say the patient has end-stage kidney failure. Many patients object to the use of end-stage because they feel it takes away hope. The phrase will not go away completely any time soon since "end-stage renal disease" is enshrined in US law, but we can use other words with the general public.

The consensus conference will eventually publish a statement, including a glossary of preferred terminology. I will let you know when that is available.