Dear Editor,

Regarding the letter to the editor about our article, Risk Factors for Liver Fibrosis in Diabetic Patients with End-Stage Chronic Kidney Disease¹, we would like to make the following points:

As highlighted in your letter, alcohol and tobacco are potential contributors to the progression of both chronic liver and kidney diseases. Our study collected data cross-sectionally from a group of patients enrolled in a chronic dialysis program, who were under multidisciplinary medical care. At the time of data collection, reported alcohol and tobacco use among these patients was nil. This finding may be attributed to the continuous healthcare provided, which emphasizes healthy lifestyle habits and highlights the potentially deleterious effects of these habits on their underlying health conditions. As a result, the patients may have ceased alcohol and tobacco use well before their inclusion in the study.

We did not consider it appropriate to gather this information retrospectively due to the challenge of accurately measuring exposure levels and the additional risk of reporting bias if patients felt they might be judged by healthcare personnel for disclosing substance use. The absence of this information in our study does not reflect a disregard for the potential impact of alcohol and tobacco on the progression of liver disease. Instead, it is due to the study’s methodological design, which precluded a precise examination of this association.

We appreciate your comments and will take them into consideration for future research in this area.

Referencia

Yepes-Barreto I, Romero-Flórez D, Coronado-Daza J. Factores de riesgo para fibrosis hepática en pacientes diabéticos con enfermedad renal crónica terminal. Revista colomb Gastroenterol. 2023;38(3):278-289. https://doi.org/10.22516/25007440.1061

Notes

Author notes

*Correspondencia: Ismael Yepes-Barreto. ismayep@yahoo.com