Spontaneous remission of nephrotic syndrome in idiopathic membran-

Sir, We thank Dr Solak for his comments about our article. Glomerulonephritis is a rare disorder, and various reports tell us that the incidence of glomerulonephritis is 12.5–47 per million population [1,2]. However, there are not enough data about the prevalence of glomerulonephritis. For this reason, we did not use a control group. Another reason was that we had a small patient population for an epidemiological study. So, in our opinion, using a control group would not increase the power of our study. Furthermore, we suggest that >10% frequency of glomerulopathy in this group is not because of simple chance. We also excluded the patients having hypertension or any other systemic diseases, or those who were using antihypertensives or analgesics which may be responsible for impaired kidney function to avoid interference in our study. As we wrote in the introduction part of our article [3], parasitic nephropathies occur in three forms by three mechanisms. Renal cyst formation usually occurs with physical invasion, not by immunological mechanisms [4]. Furthermore, in the literature, there is no evidence of glomerulopathy in kidneys involved by hydatid cysts, such as in our study [5,6]. So, it is not paradoxical that none of the patients who had renal cysts (5% of the study population) had evidence of renal injury. Although various factors such as type and process (acute or chronic) of glomerular disease and accompanying other renal injuries (tubulointerstitial nephritis, amyloidosis, etc.) can affect the response to the therapy, and sometimes patients may have spontaneous remission, it is not rational to say that glomerulopathy could not be related to hydatid disease in the absence of a consistent response to treatment in patients by lack of a control group. As we have seen in our cases, the presence of hydatid disease as the only aetiologic factor for glomerulopathy and the remission after a treatment that is targeted at only hydatid disease suggest that there is a causal connection between renal injury and hydatid disease.