failure; RIFLE, Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease; SCr, serum creatinine; TR, tubular reabsorption; TS, tubular secretion. a Journal style will dictate whether and when to abbreviate terms. b Ongoing discussion; may be revised by KDIGO AKI guideline update. c Ongoing discussion; may be revised by KDIGO AKD consensus conference. d Ongoing discussion; may be revised by KDIGO glomerulonephritis guideline update. AS Levey et al.: KDIGO nomenclature for kidney function and disease KDIGO conference report Kidney International (2020) 97, 1117–1129 1127 Strengths and limitations. A central strength of the proposed glossary is that it was based on existing KDIGO definitions, classifications, and nomenclature for acute and chronic kidney disease. In addition, it was developed using a systematic process, including articulation of a clear and transparent rationale (patient-centeredness and precision); capture of stakeholder viewpoints via focus groups, a survey, and a period of public comment; and attainment of consensus among attendees at the conference. Although the recommendations are not likely to answer all concerns, the consensus among conference attendees was that standardizing scientific nomenclature is a necessary first step to improving communications among clinicians and allied health professionals, researchers, and public health officials, and with patients, their families and caregivers, and the public. Limitations of the proposed glossary are that it is restricted to English and that nuances may be difficult to translate; only a limited number of stakeholders could participate due to practical reasons; it is not comprehensive (it does not include disease classification, dialysis, transplantation); and further specification may be required for studies in children. For these and other reasons, we consider the current recommendations for a glossary to be an important starting point, and they will require future expansion and updating. Implementation. Achieving consensus among conference attendees and publication of the conference report and glossary are only the first steps in implementation of a revised nomenclature. The glossary will be freely available on the KDIGO website (https://kdigo.org/conferences/ nomenclature/). To foster awareness, an Executive Summary highlighting the conference and its outputs will be simultaneously published in many journals represented at the meeting. In addition, elements of the glossary will be included in online updates to the newly released edition (11th) of the AMA Manual of Style. 31 Medical journals adopting the recommendations will need to determine how to implement them; this process will require education of editorial staff as well as proactive communication with authors, generally and with regard to specific manuscripts. If successful, further implementation in clinical practice, research, and public health will require more widespread dissemination and professional education. Improving communication with patients and the public will require efforts to improve patient education and health literacy for the public and guides to communication with patients. Professional societies, industry, and patient advocacy organizations will be critical to these efforts. Advances in research, particularly in precision medicine, will introduce myriad new terms and novel concepts, requiring incorporation into disease definitions and classifications. Although the recommendations are intended for clinical research, we anticipate that greater precision is also preferable for reporting of experimental studies. In addition, the increasing prominence and participation of patient and caregiver communities in defining research objectives and best practices in clinical care will further elucidate the characteristics of patient-centered terminology. Expanding and updating the KDIGO glossary on a continual basis can be accomplished as part of the activities of future KDIGO guideline Work Groups and conferences. APPENDIX: LIST OF PARTICIPANTS KDIGO Co-Chairs Michel Jadoul, Belgium and Wolfgang C. Winkelmayer, USA (Associate Editor, Journal of the American Medical Association). Conference Co-Chairs Andrew S. Levey, USA; Kai-Uwe Eckardt, Germany; Nijsje M. Dorman, USA (Managing Editor, American Journal of Kidney Diseases); and Stacy L. Christiansen, USA (Managing Editor, Journal of the American Medical Association). Breakout group Chairs Ewout J. Hoorn, The Netherlands; Julie R. Ingelfinger, USA (Deputy Editor, New England Journal of Medicine); Lesley A. Inker, USA; Adeera Levin, Canada; Rajnish Mehrotra, USA (Editor-in-Chief, Clinical Journal of the American Society of Nephrology); Paul M. Palevsky, USA (Deputy Editor, Journal of the American Society of Nephrology); Mark A. Perazella, USA (Deputy Editor, Kidney360); and Allison Tong, Australia. Other conference participants Susan J. Allison, UK (Chief Editor, Nature Reviews Nephrology); Neil Bennet, UK; Detlef Bockenhauer, UK; Josephine P. Briggs, USA (Editor-in-Chief, Journal of the American Society of Nephrology); Jonathan S. Bromberg, USA (Executive Editor, Transplantation); Andrew Davenport, UK (Editorial Board Member, Hemodialysis International); Harold I. Feldman, USA (Editor-in-Chief, American Journal of Kidney Diseases); Denis Fouque, France