Acute Kidney Injury and Hypothyroidism in a Patient with CKD
Round 1
Reviewer 1 Report
I really enjoyed reading this case report of acute on chronic kidney injury induced by hypothyroidism. The case is well presented, it includes interesting renal histology pictures and the discussion is thorough. This is a good reminder to nephrologists that hypothyroidism can be a reversible cause of AKI and it should be systematically included in the differential.
I have only noticed a minor typo in line 92: "tubular" instead of "tubules".
Author Response
Reviewer 1-I really enjoyed reading this case report of acute on chronic kidney injury induced by hypothyroidism. The case is well presented, it includes interesting renal histology pictures and the discussion is thorough. This is a good reminder to nephrologists that hypothyroidism can be a reversible cause of AKI and it should be systematically included in the differential.
I have only noticed a minor typo in line 92: "tubular" instead of "tubules"
Authors’ reply-We sincerely thank the reviewer for his/her time and feedback. We are glad that the reviewer found the case interesting as much as we did. We have changed the typing error in line 92.
Reviewer 2 Report
The case report presented here by Chandra et al describes a case of Acute kidney injury in the absence of rhabdomyolysis, during severe hypothyroidism that resolves after attaining a euthyroid state (once on levothyroxine). The study includes renal biopsy findings ensuring the findings and suggests evaluation of the thyroid function during evaluation of an acute kidney injury.
The case report has been written pretty well in detail and interesting to read. However, would be better if it can be concise to some extent.
e.g., While describing the clinical course and laboratory and physical findings, tables may be included with due course of time (the follow‐up), alongside figure 1.
Is the patient still being investigated / labs assessment, if possible would be informative to incorporate with most recent updates, since the last tests included were from 2020.
Does the patient have a history of Hypothyroidism? The information may be provided in either case.
Author Response
Reviewer 2-The case report presented here by Chandra et al describes a case of Acute kidney injury in the absence of rhabdomyolysis, during severe hypothyroidism that resolves after attaining a euthyroid state (once on levothyroxine). The study includes renal biopsy findings ensuring the findings and suggests evaluation of the thyroid function during evaluation of an acute kidney injury.
The case report has been written pretty well in detail and interesting to read. However, would be better if it can be concise to some extent.
e.g., While describing the clinical course and laboratory and physical findings, tables may be included with due course of time (the follow‐up), alongside figure 1.
Is the patient still being investigated / labs assessment, if possible would be informative to incorporate with most recent updates, since the last tests included were from 2020.
Does the patient have a history of Hypothyroidism? The information may be provided in either case.
Authors’ reply-We sincerely thank the reviewer for his/her time and feedback. We have added a table (Table 1) in addition to the figure 1 to describe the renal function in relation to the thyroid function. This table reflects the most recent labs for the patient from August 2022. We have inserted the sentence that the patient had no prior history of any thyroid disorder.
Round 2
Reviewer 2 Report
The authors has revised the manuscript per the comments with a new table-labs; and good to be accepted.
