Reviewer ’s report  
 
Title: Effect of Coexisting Diabetes Mellitus and Chronic Kidney Disease  on Mortality of 
Cirrhotic Patients with Esophageal Variceal Bleeding  
 
 
Version: 1 Date: 17 Dec 2015  
 
 
Reviewer: Vincenzo  La Mura  
 
 
Reviewer's report:  
 
I think that the etiologies of chronic kidney disease (CKD) should be detailed in a different way. 
The sum of the several conditions asso ciated with CKD (e.g. diabetes, hypertension, gout etc.) is 
over 100% in the current version of the manuscript. I believe this is the consequence that, often, 
hypertension, diabetes etc. can be simultaneously present in the same patients. I suggest to list  
the percentage of the etiologies as follows: diabetes alone (X%), diabetes + hypertension (Y%), 
diabetes + other etiologies (Z%), etiologies other than diabetes (W%)…and so on. At the same 
time, I wonder how was the mortality at 42 days and at one year fr om the index bleeding for each 
of the above -mentioned categories. Pursuing this analysis is in accordance with the aim of testing 
the influence of such frequent comorbidities, as diabetes and CKD are, on hard clinical end -
points related with portal hyperte nsion in cirrhosis.  
 
It would be interesting analyzing how many HCC were HBV positive HCC since chronic HBV 
infection increases, per se, the probability of developing a primitive liver cancer. Indeed behind 
the univariable association between HBV and the clinical outcomes cons idered in the analysis 
could be a high prevalence of HBV -related HCC. If so this could be commented in the 
discussion.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
Are the conclusions drawn ade quately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical  review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
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 interests, considering the following questions:  
 
1. Have you in the past five y ears received reimbursements, fees, funding, or salary from 
an organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may i n 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 content 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 com peting 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 have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for 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 wish to be included in my named report  can be included 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: Effect of Coexisting Diabetes Mellitus and Chronic Kidney Disease  on Mortality of 
Cirrhotic Patients with Esophageal Variceal Bleeding  
 
 
Version: 1 Date: 17 Dec 2015  
 
 
Reviewer: Vincenzo  La Mura  
 
 
Reviewer's report:  
 
I think that the etiologies of chronic kidney disease (CKD) should be detailed in a different way. 
The sum of the several conditions asso ciated with CKD (e.g. diabetes, hypertension, gout etc.) is 
over 100% in the current version of the manuscript. I believe this is the consequence that, often, 
hypertension, diabetes etc. can be simultaneously present in the same patients. I suggest to list  
the percentage of the etiologies as follows: diabetes alone (X%), diabetes + hypertension (Y%), 
diabetes + other etiologies (Z%), etiologies other than diabetes (W%)…and so on. At the same 
time, I wonder how was the mortality at 42 days and at one year fr om the index bleeding for each 
of the above -mentioned categories. Pursuing this analysis is in accordance with the aim of testing 
the influence of such frequent comorbidities, as diabetes and CKD are, on hard clinical end -
points related with portal hyperte nsion in cirrhosis.  
 
It would be interesting analyzing how many HCC were HBV positive HCC since chronic HBV 
infection increases, per se, the probability of developing a primitive liver cancer. Indeed behind 
the univariable association between HBV and the clinical outcomes cons idered in the analysis 
could be a high prevalence of HBV -related HCC. If so this could be commented in the 
discussion.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
Are the conclusions drawn ade quately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical  review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
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 interests, considering the following questions:  
 
1. Have you in the past five y ears received reimbursements, fees, funding, or salary from 
an organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may i n 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 content 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 com peting 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 have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for 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 wish to be included in my named report  can be included 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: Effect of Coexisting Diabetes Mellitus and Chronic Kidney Disease  on Mortality of 
Cirrhotic Patients with Esophageal Variceal Bleeding  
 
 
Version: 1 Date: 17 Dec 2015  
 
 
Reviewer: Vincenzo  La Mura  
 
 
Reviewer's report:  
 
I think that the etiologies of chronic kidney disease (CKD) should be detailed in a different way. 
The sum of the several conditions asso ciated with CKD (e.g. diabetes, hypertension, gout etc.) is 
over 100% in the current version of the manuscript. I believe this is the consequence that, often, 
hypertension, diabetes etc. can be simultaneously present in the same patients. I suggest to list  
the percentage of the etiologies as follows: diabetes alone (X%), diabetes + hypertension (Y%), 
diabetes + other etiologies (Z%), etiologies other than diabetes (W%)…and so on. At the same 
time, I wonder how was the mortality at 42 days and at one year fr om the index bleeding for each 
of the above -mentioned categories. Pursuing this analysis is in accordance with the aim of testing 
the influence of such frequent comorbidities, as diabetes and CKD are, on hard clinical end -
points related with portal hyperte nsion in cirrhosis.  
 
It would be interesting analyzing how many HCC were HBV positive HCC since chronic HBV 
infection increases, per se, the probability of developing a primitive liver cancer. Indeed behind 
the univariable association between HBV and the clinical outcomes cons idered in the analysis 
could be a high prevalence of HBV -related HCC. If so this could be commented in the 
discussion.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
Are the conclusions drawn ade quately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical  review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
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 interests, considering the following questions:  
 
1. Have you in the past five y ears received reimbursements, fees, funding, or salary from 
an organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may i n 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 content 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 com peting 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 have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for 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 wish to be included in my named report  can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant