Reviewer ’s report  
 
Title: Elobixibat alleviates c hronic constipation in hemodialysis patients: A questionnaire -based 
study  
 
Version: 0 Date: 13 Aug 2019  
 
Reviewer: Makoto Arai  
 
Reviewer's report:  
 
The authors reported the effect of elobixibat on hemodialysis patients with chronic constipation. 
Elobixibat is a new drug for chronic constipation and is safe for patients with end -stage kidney 
disease.  
 
 
Major Commnents  
 
(1) To reveal the effect of elobixibat on hemodialysis patients, "control" group is necessary. For 
example, patients with normal renal function who receiv ed  elobixibat, or hemodialysis patients 
with other drug or without elobixibat.  
 
(2) The authors should show how to select the patients. I think that many patients undergo 
hemodialysis  in the authors' institute, but only 27 patients were enrolled in this study, which 
might cause selection bias.  
 
 
Minor Comments  
 
(1) The number of institutes of hemodialysis and patients in each institute should be shown.  
 
(2) In Figure 2, the change in BSFS is not a good indicator. I think that absolute value of BSFS is 
importa nt and we aimed it to be about 4.  
 
(3) In Table 3, "Mean ± SD and Median [IQR]" should be described.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work in clude the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing inter ests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you currently applying for any patents relating to the c ontent 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I h ave no competing interests.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report  
including any attachments I upload  will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wi sh to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Elobixibat alleviates c hronic constipation in hemodialysis patients: A questionnaire -based 
study  
 
Version: 0 Date: 13 Aug 2019  
 
Reviewer: Makoto Arai  
 
Reviewer's report:  
 
The authors reported the effect of elobixibat on hemodialysis patients with chronic constipation. 
Elobixibat is a new drug for chronic constipation and is safe for patients with end -stage kidney 
disease.  
 
 
Major Commnents  
 
(1) To reveal the effect of elobixibat on hemodialysis patients, "control" group is necessary. For 
example, patients with normal renal function who receiv ed  elobixibat, or hemodialysis patients 
with other drug or without elobixibat.  
 
(2) The authors should show how to select the patients. I think that many patients undergo 
hemodialysis  in the authors' institute, but only 27 patients were enrolled in this study, which 
might cause selection bias.  
 
 
Minor Comments  
 
(1) The number of institutes of hemodialysis and patients in each institute should be shown.  
 
(2) In Figure 2, the change in BSFS is not a good indicator. I think that absolute value of BSFS is 
importa nt and we aimed it to be about 4.  
 
(3) In Table 3, "Mean ± SD and Median [IQR]" should be described.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work in clude the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing inter ests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you currently applying for any patents relating to the c ontent 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I h ave no competing interests.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report  
including any attachments I upload  will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wi sh to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Elobixibat alleviates c hronic constipation in hemodialysis patients: A questionnaire -based 
study  
 
Version: 0 Date: 13 Aug 2019  
 
Reviewer: Makoto Arai  
 
Reviewer's report:  
 
The authors reported the effect of elobixibat on hemodialysis patients with chronic constipation. 
Elobixibat is a new drug for chronic constipation and is safe for patients with end -stage kidney 
disease.  
 
 
Major Commnents  
 
(1) To reveal the effect of elobixibat on hemodialysis patients, "control" group is necessary. For 
example, patients with normal renal function who receiv ed  elobixibat, or hemodialysis patients 
with other drug or without elobixibat.  
 
(2) The authors should show how to select the patients. I think that many patients undergo 
hemodialysis  in the authors' institute, but only 27 patients were enrolled in this study, which 
might cause selection bias.  
 
 
Minor Comments  
 
(1) The number of institutes of hemodialysis and patients in each institute should be shown.  
 
(2) In Figure 2, the change in BSFS is not a good indicator. I think that absolute value of BSFS is 
importa nt and we aimed it to be about 4.  
 
(3) In Table 3, "Mean ± SD and Median [IQR]" should be described.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work in clude the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing inter ests, considering the following questions:  
 
1.  Have you in the past five years received reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation t hat may in any way gain or 
lose financially from the publication of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you currently applying for any patents relating to the c ontent 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or salary from an organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I h ave no competing interests.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report  
including any attachments I upload  will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wi sh to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant