To the Editor We appreciate Dr Onuigbo’s letter1 regarding our recent study2; it is humbling to read that the nephrology community at large is interested in our findings. We agree, in principle, that “renoprevention,” as Dr Onuigbo counsels, is wise. However, to target a syndrome that is described in his research3 as irreversible seems at odds with the scope and intent of our study.2 We cannot discern this syndrome from data contained within the US Renal Data System and encourage dedicated physician-scientists who see a large number of patients in a clinical setting, such as Dr Onuigbo, to identify, synthesize, and describe these trends requiring granular patient information as he has so successfully done.
Zarkowsky DS, Hicks CW, Malas MB. One-Third of Patients in a National Cohort Initiating Hemodialysis With a Catheter Despite 6 Months of Nephrology Care. JAMA Surg. 2016;151(7):687. doi:10.1001/jamasurg.2015.5559