Letters to the Editor – Brief papers about basic research or clinical experiences
Renal transplant patient in emergency department
El paciente trasplantado renal en urgencias
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"original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figs. 1 and 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 734 "Ancho" => 994 "Tamanyo" => 117922 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Thoracolumbar MRI: sagittal plane of MRI in T1 and T2 of the thoracolumbar spine showing a focal lesion in the left posterior elements of the D10 vertebra involving the pedicle, pars, and lamina. The lesion has an expansive character and is surrounded by a thin, newly-formed shell of periosteal bone with a maximum diameter of 3.7<span class="elsevierStyleHsp" style=""></span>cm, presenting soft tissue components and invading the spinal canal, resulting in clear cord compression with narrowing. An intermediate signal is observed in all pulse sequences and we believe it is consistent with a brown tumour (osteoclastoma).<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,2</span></a></p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Eva María Rodríguez-Gómez, Francisco Javier Ruiz-Escolano, Carlos Ramos-Font, Rocío Calurano-Casero, Sonia Cruz-Muñoz, María Pilar Bernáldez-Domínguez" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Eva María" "apellidos" => "Rodríguez-Gómez" ] 1 => array:2 [ "nombre" => "Francisco Javier" "apellidos" => "Ruiz-Escolano" ] 2 => array:2 [ "nombre" => "Carlos" "apellidos" => "Ramos-Font" ] 3 => array:2 [ "nombre" => "Rocío" "apellidos" => "Calurano-Casero" ] 4 => array:2 [ "nombre" => "Sonia" "apellidos" => "Cruz-Muñoz" ] 5 => array:2 [ "nombre" => "María Pilar" "apellidos" => "Bernáldez-Domínguez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0211699515001642" "doi" => "10.1016/j.nefro.2015.09.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699515001642?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251415001248?idApp=UINPBA000064" "url" => "/20132514/0000003500000006/v2_201703220324/S2013251415001248/v2_201703220324/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2013251415001236" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2015.12.003" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "111" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Nefrologia (English Version). 2015;35:588-90" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4285 "formatos" => array:3 [ "EPUB" => 293 "HTML" => 3382 "PDF" => 610 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letters to the Editor – Brief Case Reports</span>" "titulo" => "Encapsulating peritoneal sclerosis: A review of 3 cases" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "588" "paginaFinal" => "590" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Esclerosis peritoneal encapsulante: revisión de 3 casos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1272 "Ancho" => 1958 "Tamanyo" => 333868 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) CT scan: gastric and duodenal dilatation, with abundant intra-abdominal loculated fluid, and shift of small intestine loops. (B) Peritoneal biopsy; haematoxylin and eosin staining, and immunohistochemistry techniques.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carmen Merino Bueno, Laura del Rio García, José Joaquín Bande Fernández, Raúl García, Carlos Hidalgo Ordoñez, Carmen Rodríguez-Suárez, José Emilio Sánchez-Álvarez" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Carmen" "apellidos" => "Merino Bueno" ] 1 => array:2 [ "nombre" => "Laura" "apellidos" => "del Rio García" ] 2 => array:2 [ "nombre" => "José Joaquín" "apellidos" => "Bande Fernández" ] 3 => array:2 [ "nombre" => "Raúl" "apellidos" => "García" ] 4 => array:2 [ "nombre" => "Carlos" "apellidos" => "Hidalgo Ordoñez" ] 5 => array:2 [ "nombre" => "Carmen" "apellidos" => "Rodríguez-Suárez" ] 6 => array:2 [ "nombre" => "José Emilio" "apellidos" => "Sánchez-Álvarez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0211699515001630" "doi" => "10.1016/j.nefro.2015.09.012" "estado" => 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Gracia-Guindo, Nuria Ruiz-Fuentes, Javier de Teresa-Alguacil, José Manuel Osorio-Moratalla, Antonio Osuna-Ortega" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Maria del Carmen" "apellidos" => "Ruiz-Fuentes" "email" => array:1 [ 0 => "mcarmenrf2005@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "José" "apellidos" => "Vargas-Rivas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Carmen" "apellidos" => "de Gracia-Guindo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Nuria" "apellidos" => "Ruiz-Fuentes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Javier" "apellidos" => "de Teresa-Alguacil" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "José Manuel" "apellidos" => "Osorio-Moratalla" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "Antonio" "apellidos" => "Osuna-Ortega" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Nefrología, Complejo Hospitalario Universitario de Granada, Granada, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Urgencias, Hospital de Alta Resolución de Guadix, Guadix, Granada, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Estadística e IO, Universidad de Jaén, Jaén, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El paciente trasplantado renal en urgencias" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1606 "Ancho" => 2491 "Tamanyo" => 182330 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Most common reasons for attending emergency department in transplant patients.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Due to the growing number of patients with a renal transplant, their increased life expectancy, and the associated comorbidity, the medical care of such patients in the hospital emergency department continues to increase. There is a large variety of conditions that cause such patients to seek medical attention at the emergency department.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1–3</span></a> The aim of this study was to determine the factors associated with transplant patients’ attendance at the emergency department in the province of Granada, Spain, to evaluate repeat attendance, and determine the most common reasons for consultation.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Patients and methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">This was a retrospective observational cohort study of stable renal transplant patients based in the province of Granada over one year, including events in the first 6 months (No.<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>421, SICATA).</p><p id="par0015" class="elsevierStylePara elsevierViewall">The clinical data included were age, sex, aetiology of CKD, period of time on renal replacement therapy (RRT) and transplant, type of dialysis, number of transplants received, immunosuppressive treatment, clinical cardiovascular disease (CVD), diabetes mellitus, HCV, neoplasia, death, and commencement of RRT in the year studied.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The data for analysis were taken from routine reviews at the transplant outpatient clinic, and comprised urea, creatinine, MDRD, haemoglobin, calcium, phosphorus, cystatin C, homocysteine, CRP, PTH, and albuminuria.</p><p id="par0025" class="elsevierStylePara elsevierViewall">We reviewed the emergency department records in the hospitals of the regional area (province). Information was collected on attendance at emergency department, number of consultations, ethnic origin, reason for attendance, and patient destination after consultation, from two tertiary hospitals (Central-west and Central-east transplant areas), two district hospitals (Southern Management area and North-eastern area) and one “High-Resolution” Hospital (HAR-Guadix).</p><p id="par0030" class="elsevierStylePara elsevierViewall">The most common reasons for attendance were grouped as follows: infectious, musculoskeletal, gastrointestinal, cardiovascular, urological, ophthalmological, and accidents.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Statistical analysis was performed with SPSS<span class="elsevierStyleSup">®</span> v.19, and comprised descriptive analysis, analysis of contingency tables, Pearson's chi-square test and/or Fisher exact test, measures of association, and a logistic regression model.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">Our results show that in transplant patients, 46.56% presented to the emergency department at least once, vs 53.44% who did not use emergency services. Comparing the two groups (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), there were differences according to the presence of diagnosed CVD: 60.26% of patients with CVD attended the emergency department vs 39.74% with CVD who did not attend, <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.004; OR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.079 (CI, 1.218–3.442).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The estimated glomerular filtration rate using MDRD was significantly lower in the group of patients who attended the emergency department than in those who did not attend, 52.39<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>22.33<span class="elsevierStyleHsp" style=""></span>mL/min vs 60.69<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>20.49<span class="elsevierStyleHsp" style=""></span>mL/min. There was no significant interaction between CVD and MDRD.</p><p id="par0050" class="elsevierStylePara elsevierViewall">In the repeat attendance study (more than one consultation), the only associated factor was age; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.006, OR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1.031 (CI, 1.009–1.054).</p><p id="par0055" class="elsevierStylePara elsevierViewall">The most common reasons for consultation were infectious, musculoskeletal, gastrointestinal, cardiovascular, urological, ophthalmological, and accidents. Within the infectious causes, the most common site was urinary, followed by upper respiratory tract, pulmonary, gastrointestinal, and dermatological (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Fifty one percent of patients in the first post-transplant year generated 28 consultations with a different distribution: infectious, 32.14%; urological, 21.42%; and cardiovascular, 14.28%.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Regarding location, 71.02% of consultations occurred in the transplant centre. Patients came directly from home in 89.03% of cases. Patient destination was discharge to home in 77.02% of cases.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Patients referred to the transplant centre from non-transplant hospitals came from: Central-eastern area, 5.88%; Southern Management area, 21.21%; North-eastern area, 6.25%; HAR (Guadix), 25.92%. Of these referrals, 35.29% were discharged, 41.18% were admitted to the renal department, and 23.53% were admitted to other departments. The main reason for referral was infection (41.17%).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">This study shows that less than half of the transplant population attended a hospital emergency department in the Granada province in one year. For the same year, in the general population, the percentage attendance at the emergency department of provincial tertiary hospitals was 51%, suggesting no increased demand on services from our study population. Emergency department attendance was associated with diagnosed CVD as a risk factor and renal function as a protective factor. Repeated emergency department attendance was associated with increased age of recipient patients.</p><p id="par0080" class="elsevierStylePara elsevierViewall">There was a wide variety of reasons for consultation and diagnoses, the most common reason for consultation being infection,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> followed by musculoskeletal causes.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> In the first post-transplant year, infection remained the main reason for consultation, followed by urological causes. This difference could be attributed to the effect of immunosuppression in the first year, thereafter urological complications in post-transplant patients being more significant.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1,6</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">In the comparison between percentage of transplant patients and percentage of the general population referred from hospitals without a renal unit to a hospital with a transplant unit, there was a larger number of referrals from the transplant population to the reference hospital compared with the general population: <span class="elsevierStyleItalic">HAR</span> (25.92% vs 4.6%) and North-eastern area (6.25% vs 0.84%).</p><p id="par0090" class="elsevierStylePara elsevierViewall">Unterman et al.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> performed a retrospective descriptive analysis of visits to the emergency department of 1251 patients with solid organ transplants from 2000 to 2004 in Illinois; 378 were renal transplant recipients. The percentage attending the emergency department was higher than in our population (70.1% vs 46.56%), as was the percentage of hospital admissions (56% vs 21.67%). This difference could be related to our more frequent scheduled outpatient review system, which may result in a lower demand on hospital emergency departments from these patients and less need for admission from this unit. In such study the most common diagnosis was infection/fever, which was consistent with our results. The second most common diagnosis, depending on how recent was the transplantation, was, dehydration and non-infectious gastrointestinal/genitourinary disease (early post-transplant) and cardiopulmonary and musculoskeletal disease (late post-transplant). In the present study, there was a wide range of period elapsed since transplantation (mean 109 months), which could explain why musculoskeletal causes were the second most common reason for consultation. Tokalak et al.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a> described a wide variety of reasons for consultation in the emergency department in 78 patients with recent renal transplant; fever was the most common reason, and the rate of hospital admission was higher than that of our study.</p><p id="par0095" class="elsevierStylePara elsevierViewall">In conclusion, in the renal transplant population of the Granada province, there was a high emergency department attendance rate, similar to or even somewhat lower than that of the general population. The factors associated with attendance were CVD (risk factor) and renal function deterioration (protective factor). Information on the most common reasons for emergency department attendance and the care protocol in a determined geographical area could lead to improved coordination between emergency departments and renal units. Likewise, it may help to optimize the referral route between hospitals in regional areas and the transplant hospital.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Funding</span><p id="par0100" class="elsevierStylePara elsevierViewall">This study was cofinanced by <span class="elsevierStyleItalic">REDinREN</span> (Renal Research Network).</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Funding" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Ruiz-Fuentes MC, Vargas-Rivas J, de Gracia-Guindo C, Ruiz-Fuentes N, de Teresa-Alguacil J, Osorio-Moratalla JM, et al. El paciente trasplantado renal en urgencias. Nefrologia. 2015;35:591–593.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1606 "Ancho" => 2491 "Tamanyo" => 182330 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Most common reasons for attending emergency department in transplant patients.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Attendance at emergency department</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage<br>No (n) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Percentage<br>Yes (n) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Gender of recipient</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male/female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">59.6/40.4<br>(134/91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">58.2/41.8<br>(114/82) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Aetiology of CKD</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Glomerular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35.4 (79) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">31.3 (61) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Interstitial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.2 (34) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.3 (24) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ADPKD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14.3 (32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18.5 (36) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Unknown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11.2 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11.3 (22) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Vascular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.7 (13) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inherited \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.6 (7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>HTN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.1 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.6 (5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.4 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.1 (10) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Systemic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.7 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.1 (6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.5 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.6 (11) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Pretransplant RRT</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Prophylactic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.2 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.2 (6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">86.6 (187) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">85.5 (159) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>PD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9.3 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11.3 (21) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Type of transplant</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cadaveric \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">89.7 (200) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">91.8 (178) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Living related \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.3 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.1 (8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Living non-related \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.7 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.5 (3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> Asystolic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.3 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.6 (5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Acute rejection</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes/No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.4/91.6<br>(17/186) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.8/87.2<br>(22/150) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Relapse of underlying disease</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes/No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.4/97.8<br>(3/210) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.2/98.6<br>(4/176) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Cardiovascular disease</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes/No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14.6/85.4<br>(31/181) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26.3/73.7<br>(47/132) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Diabetes mellitus</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes/No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19.8/80.2<br>(42/170) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24/76<br>(44/139) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Death</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes/No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0/100<br>(0/224) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.6/97.4<br>(5/190) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Dialysis started</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes/No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0/100<br>(0/219) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1/99<br>(2/192) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1375542.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Comparison of attendance vs no attendance at hospital emergency department.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 8 | 12 |
| 2024 October | 55 | 58 | 113 |
| 2024 September | 61 | 35 | 96 |
| 2024 August | 66 | 60 | 126 |
| 2024 July | 53 | 26 | 79 |
| 2024 June | 71 | 31 | 102 |
| 2024 May | 59 | 44 | 103 |
| 2024 April | 58 | 25 | 83 |
| 2024 March | 58 | 30 | 88 |
| 2024 February | 52 | 34 | 86 |
| 2024 January | 41 | 22 | 63 |
| 2023 December | 37 | 25 | 62 |
| 2023 November | 63 | 27 | 90 |
| 2023 October | 83 | 31 | 114 |
| 2023 September | 75 | 23 | 98 |
| 2023 August | 46 | 28 | 74 |
| 2023 July | 58 | 19 | 77 |
| 2023 June | 41 | 22 | 63 |
| 2023 May | 75 | 35 | 110 |
| 2023 April | 31 | 14 | 45 |
| 2023 March | 60 | 21 | 81 |
| 2023 February | 46 | 27 | 73 |
| 2023 January | 34 | 21 | 55 |
| 2022 December | 80 | 37 | 117 |
| 2022 November | 54 | 33 | 87 |
| 2022 October | 38 | 26 | 64 |
| 2022 September | 44 | 27 | 71 |
| 2022 August | 63 | 37 | 100 |
| 2022 July | 36 | 49 | 85 |
| 2022 June | 44 | 24 | 68 |
| 2022 May | 40 | 40 | 80 |
| 2022 April | 38 | 55 | 93 |
| 2022 March | 65 | 48 | 113 |
| 2022 February | 45 | 35 | 80 |
| 2022 January | 54 | 50 | 104 |
| 2021 December | 52 | 42 | 94 |
| 2021 November | 84 | 50 | 134 |
| 2021 October | 108 | 43 | 151 |
| 2021 September | 75 | 30 | 105 |
| 2021 August | 81 | 53 | 134 |
| 2021 July | 58 | 36 | 94 |
| 2021 June | 31 | 21 | 52 |
| 2021 May | 67 | 37 | 104 |
| 2021 April | 115 | 19 | 134 |
| 2021 March | 69 | 33 | 102 |
| 2021 February | 61 | 20 | 81 |
| 2021 January | 39 | 11 | 50 |
| 2020 December | 38 | 23 | 61 |
| 2020 November | 51 | 15 | 66 |
| 2020 October | 35 | 18 | 53 |
| 2020 September | 37 | 15 | 52 |
| 2020 August | 59 | 9 | 68 |
| 2020 July | 44 | 10 | 54 |
| 2020 June | 45 | 17 | 62 |
| 2020 May | 57 | 9 | 66 |
| 2020 April | 35 | 25 | 60 |
| 2020 March | 52 | 10 | 62 |
| 2020 February | 65 | 32 | 97 |
| 2020 January | 57 | 13 | 70 |
| 2019 December | 82 | 30 | 112 |
| 2019 November | 63 | 23 | 86 |
| 2019 October | 288 | 20 | 308 |
| 2019 September | 58 | 25 | 83 |
| 2019 August | 39 | 26 | 65 |
| 2019 July | 29 | 23 | 52 |
| 2019 June | 34 | 14 | 48 |
| 2019 May | 32 | 12 | 44 |
| 2019 April | 67 | 30 | 97 |
| 2019 March | 40 | 21 | 61 |
| 2019 February | 28 | 16 | 44 |
| 2019 January | 33 | 18 | 51 |
| 2018 December | 147 | 37 | 184 |
| 2018 November | 246 | 12 | 258 |
| 2018 October | 206 | 15 | 221 |
| 2018 September | 139 | 15 | 154 |
| 2018 August | 123 | 13 | 136 |
| 2018 July | 72 | 13 | 85 |
| 2018 June | 65 | 11 | 76 |
| 2018 May | 92 | 10 | 102 |
| 2018 April | 98 | 8 | 106 |
| 2018 March | 92 | 10 | 102 |
| 2018 February | 86 | 8 | 94 |
| 2018 January | 46 | 4 | 50 |
| 2017 December | 70 | 8 | 78 |
| 2017 November | 48 | 7 | 55 |
| 2017 October | 47 | 7 | 54 |
| 2017 September | 31 | 7 | 38 |
| 2017 August | 43 | 5 | 48 |
| 2017 July | 44 | 12 | 56 |
| 2017 June | 49 | 7 | 56 |
| 2017 May | 42 | 7 | 49 |
| 2017 April | 34 | 8 | 42 |
| 2017 March | 30 | 5 | 35 |
| 2017 February | 39 | 9 | 48 |
| 2017 January | 31 | 9 | 40 |
| 2016 December | 74 | 8 | 82 |
| 2016 November | 68 | 11 | 79 |
| 2016 October | 86 | 12 | 98 |
| 2016 September | 129 | 3 | 132 |
| 2016 August | 169 | 5 | 174 |
| 2016 July | 177 | 5 | 182 |
| 2016 June | 111 | 0 | 111 |
| 2016 May | 118 | 0 | 118 |
| 2016 April | 113 | 0 | 113 |
| 2016 March | 88 | 0 | 88 |
| 2016 February | 102 | 0 | 102 |
| 2016 January | 108 | 0 | 108 |
| 2015 December | 79 | 0 | 79 |
| 2015 November | 61 | 0 | 61 |
| 2015 October | 57 | 0 | 57 |
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