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Comment & Response
July 2016

One-Third of Patients in a National Cohort Initiating Hemodialysis With a Catheter Despite 6 Months of Nephrology Care

Author Affiliations
  • 1Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
  • 2Division of Vascular and Endovascular Therapy, The Johns Hopkins Medical Institutes, Baltimore, Maryland
JAMA Surg. 2016;151(7):687. doi:10.1001/jamasurg.2015.5559

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.