We appreciate the points raised by Subramanian et al1,2 on the appropriateness of terms such as regional/endemic nephropathy and chronic kidney disease of unknown cause (CKDu). It is possible that novel terms such as KDUCAL, which highlight occupational hazards linked to specific occupations, could pressurize governmental authorities into safeguarding the interests of a vulnerable population while stimulating global research on an emerging risk factor for CKD. Although the authors model their proposed name on the basis of the epidemiologic and public health successes of disease nomenclatures such as Coal Workers Pneumoconiosis, emerging data for CKDu indicate a complex interplay of many factors, including genetics, environment, and occupations such as agriculture, although the relative contribution of each of the factors varies from one region to another.