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We thank van Durme et al for their interest in our paper and for the opportunity to discuss these important methodological issues regarding possible overadjustment for chronic renal disease.1 However, there are a number of reasons that we would refute the suggestion of overadjustment in our analyses.
First, the definition of renal disease used as part of the Charlson comorbidity index (CCI), and thus the codes used to identify these conditions, was different to those used in our analysis. We were interested specifically in chronic kidney disease (CKD), defined as “kidney damage or glomerular filtration …
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