We appreciate Hirsch's critique of our article. We concur with his comment that HIV-associated nephropathy is an increasingly important cause of chronic renal insufficiency.1- 3 The primary purpose of our article though was not to provide a comprehensive list of the causes of chronic renal insufficiency, but rather to enumerate the most common causes and provide a framework for the evaluation and management of these patients. Unfortunately, this approach limited our ability to discuss individual disease entities. Nevertheless, we have outlined a comprehensive approach to several aspects of management of patients with chronic renal insufficiency.
Smith MC. Chronic Renal Insufficiency. Arch Intern Med. 1999;159(7):757. doi: