Avalilação PREreview de Mapping renal impairment and cardiac structure and function: a comprehensive analysis of prospective cohort study, Mendelian randomization and shared genetic etiology

This study investigates the genetic links between renal impairment and cardiac structural and functional changes. The rationale for the analysis is well explained and the analysis is solid. Please find below some suggestions for further improvement. 

1. The abstract is well-structured but could benefit from a brief mention of the study's limitations to provide a balanced overview. Please add a sentence about the study's limitations, such as its cross-sectional design and focus on a European population. 2. The introduction provides a clear rationale for the study and highlights the gap in existing research. It could include more details on the biological plausibility of the genetic links between kidney function and cardiac structure. Please expand on the known pathophysiological mechanisms that might underpin the observed associations. 3. Some complex methodologies, such as Mendelian randomization and ρ-HESS, may not be fully accessible to all readers. Please provide a brief, non-technical explanation or supplementary figure explaining these methods for clarity. 4. The use of LDSC and ρ-HESS is appropriate, but the rationale for choosing these specific methods over others could be more explicitly stated. 5. Please include a statement on the treatment of missing data (e.g., imputation methods) in the methods section. 6. The discussion could address the potential impact of confounding variables in more detail. For example, please discuss how potential confounders (e.g., lifestyle factors, comorbidities) were controlled for or could have influenced the results. 7. The broader implications for clinical practice and future research are briefly mentioned. You may elaborate on how these findings might influence clinical screening practices or the development of interventions targeting both renal and cardiac health.

Competing interests

The author declares that they have no competing interests.