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We thank Dr Steiner for his comments on our recent paper on endstage renal disease (ESRD) among prior living kidney donors. 1 We agree that diabetes as a cause of ESRD for living kidney donors (7.8% of ESRD cases) may be underrepresented in our cohort because of relatively short follow-up time for most donors (median 10.3 years, interquartile range 5.4-15.1). Longer term research on donor outcomes, such as Matas and colleagues' recent work with their cohort in Minnesota, is beginning to inform our understanding of the long-term (ie, >20 years) risks of donation.
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