PONE-D-24-11117Implementation and first report of the Brazilian Kidney Biopsy RegistryPLOS ONE

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Additional Editor Comments:

Dear Author/s

Greetings

After the evaluations made by the reviewers, minor revision was decided.

Best regards

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: I thank the authors for sharing their work. The manuscript is well written and explains the prevalence of renal pathologies from the Brazilian Kidney Biopsy Registry.

I have the following comments:

1) If this is the first article mentioning about the design and purpose of the BKBR registry, then the methods section would need to be elaborated.

2) Please mention more about how the data is collected. Are pathologists supposed to enter the data or will data be transferred from an electronic health record into the web interface.

3) Was the data (after entry by different centers) validated. Are there any measures to prevent incorrect data entry

4) The database is managed by MySQL system but could you also mention how the website was programmed (the language used etc).

5) Please provide details about how data can be requested by other researchers

6) Were there any laboratory data collected, such as creatinine and eGFR as there are also important.

Reviewer #2: I would like to congratulate the authors for the conduct of a nationwide registry in the 5th largest country in the world with such a wide geographic & demographic variations during COVID times.

1. Please confirm that the registry data collection is prospective while analysis is retrospective

2. The registry involves the patients with nephrotic syndrome & non-nephrotic range proteinuria. In practice we often see patients with nephrotic range proteinuria without nephrotic syndrome, such as in secondary FSGS. How such patients were analysed in the study?

3. In the results, discussion & Figure 4, the authors mention stage of CKD. I believe that they mean eGFR at the time of biopsy. Nephrotic syndrome due to MCD often responds to immunosuppression. It is not appropriate to call it as CKD. The authors can mention the eGFR value instead of stage of CKD

4. Fig 7 does not add any additional information than what is given by Fig 6b

5. Fig 9 can also be omitted as it does not an additional information than what is mentioned in the text. Gender difference in various glomerular disease is an established fact & the registry findings are congruent

6. Fig 11: As mentioned above, the mention of the stage of CKD is inappropriate. Also, the bar diagram used is not appropriate for the message that is being mentioned. I would suggest that the authors can give a range of eGFR at the time of biopsy with a median value in a tabular format or a similar figure could be constructed

7. Fig 12 is also not necessary- mentioned in the text

8. Fig 13 particularly interests me with the finding that nearly 44% of the diabetic patients showed primarily non-diabetic pathology. If possible, please mention the biopsy indications in the 145 diabetic patients, and what were the findings in those 64 patients. Also, can you give data of the biopsy finding as per the clinical indication

9. During discussion, estimation of glomerular disease incidence may need to be explained in a simpler way

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Reviewer #1: No

Reviewer #2: Yes: Vipul Chakurkar

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Implementation and first report of the Brazilian Kidney Biopsy Registry

PONE-D-24-11117R1

Dear Dr. Noronha,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Junzheng Yang

Academic Editor

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Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors have made all the necessary changes to the manuscript and also addressed other potential concerns. I do not have anything further to add.

Reviewer #2: Thank you for your response. I am happy to know the authors are open to comments and ready to incorporate the suggestions in the registry

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: Dr Vipul Chakurkar

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