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

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.