As Sentilhes et al1 state, we believe that the prolonged or immoderate use of tranexamic acid puts pregnant women with severe postpartum hemorrhage and subsequent acute kidney injury at high risk for renal cortical necrosis, and we therefore welcome the most recent guidelines urging caution and limiting use to a maximum of 2 injections of 1g each.2 These independent guidelines were published in March 2016, that is, 3 months after the formal acceptance of our study published in AJKD,3 so our conclusion was not a refutation of these guidelines.