We appreciate the detailed review and commentary on our manuscript [1] provided by Hays et al. [2]. We agree with their observation that, because the physical component summary (PCS) and Symptoms and Problems of Kidney Disease (SPKD) subscales are scored on different scales, direct comparison of the scores is not appropriate. For this reason, we were careful to note that the mean scores that we observed (36.6 vs 73.0 respectively) convey different impressions about patients’ perceptions of their health, but we did not make any attempt to interpret the specific meaning of the numeric difference. We agree with Hays et al. that, in the future, consistent use of a single scoring method for all KDQOL subscales would greatly facilitate interpretation and contextualization of these scores.

Hays et al. raised an important question with regard to the correlation of the general health rating item and the 5 subscale scores as reported in our manuscript. Upon review, we have determined that indeed the correlations reported in our manuscript were based on analyses that included a coding error. This was an honest mistake that was not captured at the time of submission, and we thank Hays et al. for bringing this to our attention. Upon reanalysis, we find correlations that are broadly consistent with those reported by Hays et al., and our manuscript will be corrected to reflect these findings. Importantly, we have conducted a detailed review of the entire dataset and analysis underlying the remaining results presented in the manuscript and found no additional errors. Thus, we stand by all of the other results and conclusions as originally presented.

Improving health-related quality of life, and the tools for its evaluation, remains a top priority for the entire end-stage kidney disease (ESKD) community. Like Hays et al., we believe that successful efforts in this regard will require the combined efforts of patients, providers, and researchers working in both industry and academia. We remain fully committed to participation in these collaborative endeavors.