All reviews of published articles are made public. This includes manuscript files, peer review comments, author rebuttals and revised materials. Note: This was optional for articles submitted before 13 February 2023.
Peer reviewers are encouraged (but not required) to provide their names to the authors when submitting their peer review. If they agree to provide their name, then their personal profile page will reflect a public acknowledgment that they performed a review (even if the article is rejected). If the article is accepted, then reviewers who provided their name will be associated with the article itself.
The changes made by the authors to the revised version are in line with reviewers' and editor's suggestions. The concerns raised in the first round of reviews were satisfactorily resolved, so I consider the revised manuscript suitable for publication.
[# PeerJ Staff Note - this decision was reviewed and approved by Stefano Menini, a PeerJ Section Editor covering this Section #]
The study is interesting, but the very small sample size and the short follow-up are major drawbacks. Therefore, the conclusions statement should be lessen (for example, from "demonstrate" to "suggest"). In addition, more baseline characteristics are needed: besides the blood pressure (see reviewer 1 comments), data on diet, urinary urea, concomitant use of phosphate binders should be added.
The manuscript is well written, logic and easy to read. No concerns regarding this point.
Regarding the advantages for activated bamboo charcoal (ABC) over AST-120, the ABC was coated with sodium alginate to prevent it from being stuck in the stomach wall. In studies using Is AST-120, is AST-120 coated as well?
In the statistics section it is stated that Kruskal-Wallis test was used for continuous data whereas one-way ANOVA was used for categorical data. Please check if this is correct. ANOVA requires continuous data that can be assumed to be normally distributed.
Line 264 in the discussion raises an important issue. The baseline characteristics for the study groups are different. Especially if looking at the usage of ACE/ARB treatment and the presence of diabetes in the different study groups. Even though the fact that there is no statistical difference, with such low number of study participants (n=11-12) the baseline must be better controlled. One important parameter missing from the baseline characteristics is blood pressure. Differences in blood pressure control between study groups can influence kidney function. As presented the study cannot draw conclusions what factor is affecting kidney function. These limitations must be described very clear and any discussion and conclusion regarding the effect by ABC on kidney function must be softened.
a. The reporting grammar and style are clear acceptable
b. The introduction should include a comparison with basic principles of how these uremic toxins are cleared with, the chelating action actions oof some drugs/compounds used intreating poisons.
c. the article structure ias presented meets professional standards.
The authors need to provide a more fetailed steps in sample collection, regarding precautions taken to keep the sampling process within known regimen such as site. timing and preffered access site used.
All underlying data have been provided; they are robust, statistically sound, & controlled.
The discussion should be enhanced further, highlighting the metabolic and chemical bases for study choice of reagent used.
What immediate impact do this process have on the gut mucosa chemistry and toxicity profile.
Despite known to be relatively inert, what was the impact of activated bamboo charcoal on the chemistry (acidicity or otherwise., gut fluid retention and the effect of the gut.
All text and materials provided via this peer-review history page are made available under a Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.