Response to: Comment on "the effects of hemodialysis on tear osmolarity"

We thank Onder Ayyildiz and Gokhan Ozge for their interest and comment on our paper “The Effects of Hemodialysis on Tear Osmolarity” [1, 2]. They thought that detection of TO would be performed at the same time of the day regarding the duration of hemodialysis (HD) which may avoid the bias of the methodology according to the study of Niimi et al. [3]. Niimi et al. have enrolled 38 medically healthy neophytes. Their subjects reported to the CRC an average of 14±2.0 hours (7–17 hours) after awakening for baseline measurements and sleeping at the CRC, thereby allowing for uniform environmental exposure (e.g., humidity and temperature) and timely collection of measurements upon awakening. The physical conditions of our clinic are not suitable for all HD patients to report 7 hours after awakening for baseline measurements and sleeping one day thereby allowing for uniform environmental exposure (e.g., humidity and temperature) and timely collection of measurements upon awakening.