Associated Anomalies and Complications of Multicystic Dysplastic Kidney

Round 1

Reviewer 1 Report

Interesting study, advances knowledge related to underlying findings in MCKD. Minor typos and grammatical errors related to English language. 

Author Response

Dear Madam/Sir,

 

Thank you for your benevolent comments. Regarding minor typos and grammatical errors related to English language, I corrected them as much as possible, with assistance of Oxford Advanced Dictionary of Current English.

Reviewer 2 Report

This contribution assessed multicystic dysplastic kidneys (MCDK) in children, their complications, and associated congenital genitourinary anomalies. The authors have noted children with a unilateral MCDK have a very good prognosis if the contralateral kidney is normal. Associated congenital genitourinary anomalies are common. The authors have noted cryptorchidism was the most common associated anomaly among boys, which is unique for this study.

This contribution is well organized and well presented. The authors have properly reviewed previous reports. 

Author Response

Dear Madam/Sir,

 

Thank you for your kind and encouraging comments.

Reviewer 3 Report

 

Line 14: Missing full stop and then an additional full stop added, please correct this sentence

Line 40: Can the authors go into more detail about the genetic predispositions? The intro is very brief

Line 49: I suggest inputting your Medical Ethics Committee number and the waivering of patient consent here for clarity

Line 61: I find the use of a comma instead of a point a bit odd in the numbers? From line 73, points are used)

General comment: There is only one small table for the results section, could the authors not provide anymore data? Such as bar charts for average blood pressure? Or gender/age biases in the anomalies observed? Data outputs from urinoculture?

Line 73: It might help to briefly explain what cryptorchidism is to the reader as it is a major part of the manuscripts findings

Line 126: The use of a y to denotes years is too informal for a scientific publication

Line 142: Why does a 22q11.2 DS cause cryptorchidism? Can the authors give some explanation? Overall, the discussion doesn’t provide much explanation for the results they observed. For example, why does MCDK affect boys more than girls, can the authors suggest a reason for this and other disease features they report?

Line 145: This paragraph undercuts the entire manuscript – consider removing or heavily revising.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 4 Report

This study is well-designed and well-presented.  The results are discussed well and compared and contrasted to previous reports in a way that helps readers understand the significance.  While this report mostly corroborates previously published on the natural history of MCDK and associated renal and extrarenal manifestations, the clear finding in this paper that is different from previously published data is the association with cryporchidism in boys.  This unique finding is believable since all cases were validated by a pediatric urology and all cases required surgery. 

Although more robust studies on the history of MCDK exist - both larger single center studies and even meta-analyses - this association with cryptorchidism deserves publication.  The authors note a high rate of CAKUT in family histories in this study and this could suggest that this center has a more genetically homogeneous or founder population placing them at unique risk of  MCDK with cryptorchidism.  

Author Response

Dear Madam/Sir,

Thank you for your benevolent comments.