Time-Averaged Hematuria as a Prognostic Indicator of Renal Outcome in Patients with IgA Nephropathy
, Jiaqun Lin 1,2,†, Yumei Chen 1,2,†, Xiaohong Zhang 1,2, Zhenhuan Zou 1,2, Yi Chen 1,2, Jiong Cui 1,2, Binbin Fu 1,2, Guifen Li 1,2, Caiming Chen 1,2 and Jianxin Wan 1,2,*
Xuhui Ning
Round 1
Reviewer 1 Report
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Author Response
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Reviewer 2 Report
Dear Authors
Hematuria in IgAN as a progressive disease marker is highily controversial in literature.
The authors showed that time-averaged ( TA ) persistent hematuria over 28 RBC is associated with gross macrohematuria , low hemoglobin levels, low time-averaged (TA) serum albumine, and more severe renal pathologic lesions.
They studied 152 IgAN Chinese patients along 58 months of follow-up.
Comments and Questions
Line 152..... “ At the final follow-up the persistent hematuria group had significantly lower TA-serum albumine ...” Why is that ? Patients are not nephrotic so their urine albumine loss is minor. Discuss any possible inflammatory mediator.
Line 182....fig 3 ...Kaplan-Meier analysis curves ....A and B are misplaced.
Graphic colors ...red and brown (?) are very similar.
Line 191,,,and fig 4A ... Considering hypertension and gross hematuria the text and figure are not in agreement. Please rephrase.
Line 208.... RBC cutoff value is different in males ( 37.2 ) and females ( 201.2 ) Please discuss the possible causes for that.
Line 282......” The methods used to measure RBC in urine differ among laboratories ...”
Please discuss about other methods and their impact in controversial results in literature .
Line 300......It is well known in literature that RBC release of hemoglobin and related oxidative damage cause podocyte dysfunction and eventually fibrosis.
In your paper females show more persistent TA hematuria than males (fig 2B). So, I could guess that IgAN would be more aggressive in females than in males, which is not true in clinical practice. Do you have a explanation for that ?
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