We agree with the comments by Dr. Jacobs reminding us of the shortcomings of our study. Indeed, there was a difference in the time periods in which these two groups of patients were observed, with an overlap of 4 years. While this time difference may be a factor that influences survival, this is doubtful in view of the fact that no other change in treatment has occurred.
Indeed, Dr. Jacobs and our group may differ in the definition of renal disease, but I agree that we would not consider grade 1 proteinuria and 2 to 4 red blood cells in a casual urine sample as evidence of renal disease.