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Incremental peritoneal dialysis: Clinical outcomes and residual kidney function preservation
Diálisis peritoneal incremental: resultados clínicos y preservación de la función renal residual
Mercè Borràs Sans
, Andrea Chacón Camacho, Carla Cerdá Vilaplana, Ana Usón Nuño, Elvira Fernández
Corresponding author
Servicio de Nefrología, Hospital Universitari Arnau de Vilanova, Lérida, Spain
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This is defined as starting PD with 3 or fewer peritoneal exchanges per day. The IPD modality is postulated as an option for patients who start dialysis before manifestations of severe uraemia are present.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">By performing fewer exchanges per day, patients on IPD would have a reduced risk of peritonitis and a better quality of life. Furthermore, by reducing peritoneal glucose exposure and absorption, the peritoneal membrane should be better preserved, with less chronic inflammation and alterations in carbohydrate metabolism. All this would contribute to preserve future vascular accesses,<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3–5</span></a> in case there is a need to switch to haemodialysis (HD). It has also been reported that acceptable levels of solute clearance are maintained in IPD and there is an adequate control of other biochemical parameters, while residual renal function (RRF) is preserved. It should be highlighted that one study shows that in IPD there is slowing-down in the rate of renal function loss as compared to that observed during the pre-dialysis period.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Another study compares the evolution of patients who received transplantation during the first 3 years on dialysis. As compared with HD patients, IPD patients have a lower incidence of delayed graft function and better long-term clinical results, both for the patient and the graft.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Lastly, the possibility of starting treatment with IPD encourages patients to choose the modality of PD more often, particularly continuous ambulatory peritoneal dialysis (CAPD).<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The increased number of patients starting a pre-scheduled renal replacement therapy (RRT) and the potential advantages of IPD have led many PD centres to choose this modality in recent years. Nevertheless, there is limited evidence on the benefits and on the clinical management of these patients. Few studies analysing IPD are available and most of them are retrospective with short number of patients, no control group and carried out in the same country, which means the results cannot be extrapolated to other populations on dialysis.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Therefore, the objective of this study is to analyse the clinical and analytical characteristics of patients during the 2 first years on IPD, as well as patients prognosis and outcomes.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Material and methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">Design: descriptive, longitudinal and retrospective study.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Patients</span><p id="par0040" class="elsevierStylePara elsevierViewall">We included all patients from the Lleida Hospital Arnau de Vilanova PD unit who started CAPD using IPD, that is, 3 or fewer exchanges per day. We excluded patients who started CAPD using conventional treatment (4 exchanges) or those on automated peritoneal dialysis (APD).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Data</span><p id="par0045" class="elsevierStylePara elsevierViewall">The study period started in August 2003 (date when the first IPD patient was included in the study) and ended in December 2012 (final data collection date).</p><p id="par0050" class="elsevierStylePara elsevierViewall">The data collected included variables on demographics, anthropometric and analytical data and dialysis and pharmacological treatment data (number of antihypertensives, number of phosphate chelating agents, use of ACE inhibitors or ARBs, diuretics, paricalcitol and cinacalcet and darbepoetin doses). Comorbidity was estimated using the Charlson index evaluated for PD unadjusted by age.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a> Adequacy was calculated using Kt/V (renal, peritoneal and total) and RRF using combined 24<span class="elsevierStyleHsp" style=""></span>h urinary urea and creatinine clearances. These data were collected at the start of IPD, and at 6, 12, 18 and 24 months of IPD treatment. In the case of RRF, progression was also recorded in the last predialysis year for stable patients with a minimum of 4 valid determinations. Peritoneal function was estimated using the peritoneal equilibration test at the start of the modality and it was repeated each year. The rate of peritonitis was also calculated for the first 2 years on IPD.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Regarding the evolution on this modality, we recorded time on PD, on IPD and reasons for suspension of IPD, renal transplant, deaths, switching to HD, clinical manifestations of uraemia, <span class="elsevierStyleItalic">Kt</span>/<span class="elsevierStyleItalic">V</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>2 without clinical manifestations of uraemia, fluid overload and switching to APD due to patient's choice.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Statistics</span><p id="par0060" class="elsevierStylePara elsevierViewall">The Kolmogorov–Smirnov test was used to determine normal distribution of continuous variables. We expressed quantitative variables as means with standard deviation. Bivariate comparisons were performed using the Student's <span class="elsevierStyleItalic">t</span>-test for paired samples. Comparisons between qualitative variables, expressed as frequency or percentage, were performed with the test <span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span>. Results were considered to be significant with a <span class="elsevierStyleItalic">p</span>-value <0.05 (95% confidence interval).</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">During the study period, 75 patients were included in the PD programme; of these, 28 patients were excluded for choosing APD and one patient for starting the conventional modality due to a medical history of severe heart disease. A total of 46 patients started the IPD, of whom 39 (84.8%) came from the multidisciplinary advanced kidney disease clinics (MAKDC), 4 (8.7%) came from hemodialysis HD and 3 (6.5%) had renal transplant with poor renal function. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the baseline characteristics of the patients (epidemiological, anthropometric, RRF and pharmacological treatment).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">All patients started IPD treatment with 3 exchanges per day, at a volume ranging from 1500 to 2000<span class="elsevierStyleHsp" style=""></span>ml per exchange. The treatment always included an icodextrin exchange (Extraneal<span class="elsevierStyleSup">®</span>) and in 18 (39.1%) of the patients an amino acid exchange (Nutrineal<span class="elsevierStyleSup">®</span>). The other exchanges were with the dialysis solution Physioneal<span class="elsevierStyleSup">®</span> at a glucose concentration of 1.36%.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The mean time on IPD was 22.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>14 months (range: 6–61). During follow-up, 11 (24%) patients received transplantation while they were on IPD, 3 patients were switched to HD (2 due to severe peritonitis and one due to an unresolved alteration in the abdominal wall), 2 patients died (due to terminal multiple myeloma and disseminated cancer with pneumonia) and 22 (47.8%) of the patients were switched to conventional PD. The mean time on IPD in the subgroup of patients switched to conventional PD was 24.5 months. The reasons for the switch to conventional PD were: fluid overload in 9 (40.9%) patients; <span class="elsevierStyleItalic">Kt</span>/<span class="elsevierStyleItalic">V</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>2 without clinical manifestations of uraemia in 7 (31.8%) patients; clinical manifestations of uraemia in 5 (22.7%) patients; and preference of APD in one patient. At the end of the study period, 8 (36.36%) patients continued on IPD.</p><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the progression of RRF, adequacy and peritoneal function parameters in the first 2 years of IPD follow-up. During this period there was a decrease in glomerular filtration rate (GFR) of around 1.5<span class="elsevierStyleHsp" style=""></span>ml/min/year, accompanied by a decrease in renal <span class="elsevierStyleItalic">Kt</span>/<span class="elsevierStyleItalic">V</span>. Total fluid loss also decreased due to a reduction of diuresis. Comparison of the annual loss of renal function during pre-dialysis period with the first 2 years of IPD showed that the rate of renal function deterioration slowed down when patients started PD: −7.06<span class="elsevierStyleHsp" style=""></span>ml/min/year before initiation of IPD vs. −1.58<span class="elsevierStyleHsp" style=""></span>ml/min/year in IPD; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0001. None of the patients who started IPD experienced anuria during the follow-up period. Regarding peritoneal function, an increase in solute transport was observed (D/P cr), which was significant in the second year, with no loss of UF capacity.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the outcome of clinical, analytical and pharmacological parameters. The mean weight increased non-significantly; blood pressure (BP) did not change except for the diastolic BP that was decreased at 2 years. There were no significant changes in the number of antihypertensive drugs prescribed. Regarding mineral metabolism parameters, the serum calcium and phosphorus levels were stable with a tendency for intact parathormone levels to decrease. This was controlled through a significant increase in phosphorus chelating agents from baseline and an increase in the number of patients on treatment with paricalcitol and cinacalcet. <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows the progression of haemoglobin levels and darbepoetin dose. Haemoglobin levels remained stable, within acceptable ranges. It should be highlighted that these levels were maintained in spite of a significant reduction of darbepoetin doses prescribed throughout the follow-up period.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Lastly, of the population studied, 10 (21.7%) patients presented an episode of peritonitis during the first 2 years on IPD. The rate of peritonitis was one episode every 99 months, which is comparable to the rate presented by the rest of the population on PD in our unit during the same period.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">This study shows that most patients starting IPD present considerable clinical and analytical stability during the first 2 years on this modality. Moreover, the loss of RRF slows down compared to the year prior to starting PD.</p><p id="par0100" class="elsevierStylePara elsevierViewall">The definition of IPD in CAPD has not been clearly established. In most studies, IPD is defined as patient on PD with 2 or fewer manual exchanges<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1,9</span></a>. However, in other studies,<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">6,10,11</span></a> the incremental modality includes patients with 3 or fewer exchanges prescribed according to glomerular filtration rate or Kt/V. We chose a definition for IPD as starting PD with 3 or fewer exchanges because the classic and standard description of CAPD is 4 peritoneal exchanges,<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a> and this framework has been used for several decades. In recent years, many PD units have adopted 3 or fewer peritoneal exchanges when the clinical condition allows as the standard initial modality. Two facts have contributed to this change: the decrease in adequacy objectives<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">13,14</span></a> and a greater number of patients with planned dialysis start thanks to MAKDC. Although it is a routine clinical practice, there is limited published data.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Our experience was largely positive. Firstly, because it shows that many patients starting PD can do it on IPD. Only in one case starting with only 3 exchanges was contraindicated due to, severe heart failure with several episodes of overhydration. Patients not included on IPD were those that chose APD as their starting modality. Nevertheless, there was a bias in the choice for APD because it was the modality of choice in a considerable number of patients who required a caregiver or who had been referred from HD or renal transplant. We do not have data on starting APD using an incremental modality, defined in general as fewer than 6 days of weekly treatment.</p><p id="par0110" class="elsevierStylePara elsevierViewall">Secondly, our experience was positive because during their time on IPD, the patients remained clinically and analytically stable, with low peritonitis rates and did not require increases in prescribed medication. In fact, haemoglobin remained stable while darbepoetin doses had significantly been reduced. Values of BP remained within normal ranges without the need to increase antihypertensive treatment; thus, the non-significant increase in weight should not be attributed to overhydration. Lastly, serum calcium and phosphate concentration were maintained throughout follow-up, with a decrease in parathormone levels. In this case there was an increase in the number of patients on phosphate-chelating agents and treated with paricalcitol and cinacalcet. Notwithstanding, no patients had to be switched to standard CAPD or HD due to poor control of mineral metabolism.</p><p id="par0115" class="elsevierStylePara elsevierViewall">A third aspect to be highlighted is the progression of RRF. Mean glomerular filtration rate (GFR) at the before initiation of IPD was 8<span class="elsevierStyleHsp" style=""></span>ml/min. It should be noted that during the length of the study the recommendation of relatively RRT start was followed, as indicated by guidelines. Currently, after the results from the IDEAL study<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a> and other publications, the indication was to reconsider an early initiation of replacement therapy. Nonetheless, it should be remembered that in the IDEAL study, the mean GFR for the late start group was 9.2<span class="elsevierStyleHsp" style=""></span>ml/ml, although it was calculated by estimating the creatinine clearance formula corrected for body surface. In any case, our patients did not start RRT with very high GFRs and, in any case, the loss of RRF slowed down from −7.06 to −1.58<span class="elsevierStyleHsp" style=""></span>ml/min/year. This is surely key to explaining IPD patient stability during the 24 months that they remained on this modality. Viglino et al.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a> also observed a reduction in the rate of renal function loss of 2.4<span class="elsevierStyleHsp" style=""></span>ml/min/year with IPD compared to the predialysis period. This reduction in the loss of RRF cannot be attributed to the incremental modality, given that Berlanga et al.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a> already reported this same effect with PD in general. However, it is important to demonstrate that the incremental modality also has this effect, given that the importance of preserving RRF in PD is beyond the clinical management; it is well known that this factor is also associated to lower morbidity and mortality in PD patients.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">17</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Lastly, it is worth noting that one quarter of patients received transplant while they were still on the incremental modality. Patients who switched to the conventional modality were maintained on IPD for an average of 2 years in good conditions, and fluid management was the main reason for switching to conventional PD. However, overhydration was not severe and there were no cases requiring hospitalization. Thirty-two per cent (32%) of patients were switched to conventional PD due to a <span class="elsevierStyleItalic">Kt</span>/<span class="elsevierStyleItalic">V</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>2, although they were entirely asymptomatic. This consideration should probably be reconsidered in light of the most recent results and publications; some of these patients could have been maintained on IPD without complications. In any case, individualised, case-by-case assessment and acquired experience will be crucial to optimise IPD and suitably switch to conventional PD.</p><p id="par0125" class="elsevierStylePara elsevierViewall">In summary, we had a positive experience at our centre by starting PD with 3 peritoneal exchanges. Most patients remained stable for the first 2 years and one quarter of them received transplant while on this modality. Moreover, we confirmed a slow-down of RRF compared to the predialysis period.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicts of interest</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres828242" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Material and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec824462" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres828243" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Material y métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec824461" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Data" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistics" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-02-02" "fechaAceptado" => "2016-01-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec824462" "palabras" => array:3 [ 0 => "Incremental peritoneal dialysis" 1 => "Residual kidney function" 2 => "Initiation of dialysis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec824461" "palabras" => array:3 [ 0 => "Diálisis peritoneal incremental" 1 => "Función renal residual" 2 => "Inicio de diálisis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Initiation of peritoneal dialysis (PD) with 3 exchanges has become common practice in recent years, despite the lack of published clinical data.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To describe experience with incremental peritoneal dialysis (IPD) at a single site.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 46 IPD patients undergoing 2-year clinical, laboratory, treatment and progression follow-up.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">To 25% of patients were transplanted on IPD. Mean time on IPD before transfer to conventional PD of 24 months, half of the patients because of fluid balance. Good clinical and biochemical results with a peritonitis rate of one episode per 99 months. There was an improvement in the loss of residual kidney function compared to the pre-dialysis period (−7.06 vs. −1.58<span class="elsevierStyleHsp" style=""></span>ml/min/year; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.0001).</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">IPD with 3 peritoneal exchanges offers good results. Most patients remain stable during the first 2 years and there is an improvement in the loss of residual kidney function compared to the pre-dialysis period.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Material and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducción</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En los últimos años el inicio de diálisis peritoneal (DP) con 3 recambios se ha convertido en una práctica habitual, aunque se dispone de pocos resultados clínicos publicados.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Descripción de la experiencia de inicio con DP incremental (DPI) en un centro.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Material y métodos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A 46 pacientes en DPI se les realizó seguimiento clínico, analítico y tratamiento, y se estudió su evolución a 2 años.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A un 25% de los pacientes se les trasplanta en DPI. Tiempo medio de transferencia a DP convencional de 24 meses. La mitad de los pacientes son transferidos por manejo de líquidos. Buena estabilidad clínica y analítica con tasa de peritonitis de un episodio cada 99 meses. Enlentecimiento de la pérdida de función renal residual respecto al período prediálisis (−7,06 vs. −1,58<span class="elsevierStyleHsp" style=""></span>ml/min/año; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,0001).</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La experiencia en DPI con 3 recambios de inicio es positiva. La mayoría de los pacientes se mantienen estables durante los 2 primeros años, con un enlentecimiento de la pérdida de función renal residual respecto el período prediálisis.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Material y métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Please cite this article as: Borràs Sans M, Chacón Camacho A, Cerdá Vilaplana C, Usón Nuño A, Fernández E. Diálisis peritoneal incremental: resultados clínicos y preservación de la función renal residual. Actas Urol Esp. 2016;36:299–303.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1259 "Ancho" => 1576 "Tamanyo" => 87916 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Progression of Hb levels and darbepoetin dose.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Values expressed as percentages or mean and (standard deviation).</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">SBP, systolic blood pressure; DBP, diastolic blood pressure; ACE inhibitors, angiotensin-converting enzyme inhibitors; ARBs, angiotensin II receptor blockers.</p>" "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" 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"><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>46 \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 " align="left" valign="top"><span class="elsevierStyleItalic">Age (years)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">62.0 (17.3) \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="elsevierStyleItalic">Men (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">65.2 \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="elsevierStyleItalic">Smokers or ex (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37.0 \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="elsevierStyleItalic">Diabetics (%)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30.4 \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="elsevierStyleItalic">BMI (kg/m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25.9 (4.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Primary kidney disease n (%)</span></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">26.1 \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>Diabetic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">23.9 \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">17.4 \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>Glomerular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15.2 \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">10.9 \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>Polycystic kidney disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.3 \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>Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Treatments</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ACE inhibitors and/or ARBs <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21 (45.7) \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>Diuretics <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">32 (69.6) \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>Paricalcitol (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">39.5 \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>Cinacalcet (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.3 \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>Number of antihypertensives \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.4 (1.2) \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>Number of phosphorus-chelating agents \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.6 \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>Darbepoetin (μg/kg/week) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.4 (0.5) \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>Charlson index \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.4 (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>SBP (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">138 (20) \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>DBP (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">72 (12) \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>Glomerular filtration rate, ml/min/1.73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.0 (3.2) \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>Diuresis volume, ml/24<span class="elsevierStyleHsp" style=""></span>h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1367 (598) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1393573.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Clinical data and baseline treatment.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Compared to baseline value:</p>" "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" 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">Baseline<br>(<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>46) \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">6 months<br>(<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>46) \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">12 months<br>(<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>36) \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">18 months<br>(<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26) \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">24 months<br>(<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>24) \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 " align="left" valign="top">GFR (ml/min/1.73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.0 (3.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.3 (2.9)<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.9 (3.2)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.5 (3.0)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.7 (3.1)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">**</span></a> \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">Diuresis volume (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1366 (598) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1324 (595) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1229 (611) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1210 (454)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1121 (409)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">**</span></a> \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">Total UF (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2305 (775) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2256 (701) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2215 (603) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2157 (580)<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2118 (523)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">**</span></a> \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">Renal <span class="elsevierStyleItalic">Kt</span>/<span class="elsevierStyleItalic">V</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.4 (0.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.3 (0.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.2 (0.6)<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.2 (0.5)<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.1 (0.6)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">**</span></a> \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">Peritoneal <span class="elsevierStyleItalic">Kt</span>/<span class="elsevierStyleItalic">V</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.1 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.2 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.2 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.2 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.2 (0.3) \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">D/P cr \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.68<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \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">PET UF Vol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2502 (334) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2569 (206) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2608 (226) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1393572.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "**" "nota" => "<p class="elsevierStyleNotepara" id="npar0010"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001.</p> <p class="elsevierStyleNotepara" id="npar0015">Values expressed as the mean and (standard deviation).</p> <p class="elsevierStyleNotepara" id="npar0020">RRF, residual renal function; PET, peritoneal equilibration test.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">RRF progression, adequacy and PET.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Compared to baseline value:</p>" "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" 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">Baseline<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>46 \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">6 months<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>45 \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">12 months<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>36 \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">18 months<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26 \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">24 months<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>24 \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 " align="left" valign="top">Weight (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67.2 (1.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67.9 (11.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">70.7 (11.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">70.6 (10.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">70.4 (10.6) \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">SBP (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">138 (19.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">134 (21.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">134 (19.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">135 (23.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">130 (22.6) \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">DBP (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72 (11.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 (10.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">71 (11.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66 (7.9)<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">*</span></a> \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">No. of antihypertensives \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.4 (1.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.3 (1.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.4 (1.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.4 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.3 (1.5) \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">Calcium (mmol/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.19 (0.17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.19 (0.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.22 (0.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.24 (0.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.24 (0.02) \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">Phosphorus (mmol/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.42 (0.22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.35 (0.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.42 (0.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.43 (0.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.42 (0.06) \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">PTH (pg/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">322 (170.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">290 (20.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">260 (20.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">223 (10.3)<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">240 (20) \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">No. of phosphorus-chelating agents \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.64 (0.61) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.78)<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.12 (0.79)<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.25 (0.73)<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.12 <span class="elsevierStyleUnderline">(</span>0.78)<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">*</span></a> \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">Paricalcitol <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 (60.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 (81) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (85) \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">Cinacalcet <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (14)<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (9) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1393574.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0025"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] 1 => array:3 [ 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"autores" => array:5 [ 0 => "A.F. De Vecchi" 1 => "A. Scalamogna" 2 => "S. Finazzi" 3 => "P. Colucci" 4 => "A. Ponticelli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Perit Dial Int" "fecha" => "2000" "volumen" => "20" "paginaInicial" => "412" "paginaFinal" => "417" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11007372" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0095" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rationale for early incremental dialysis with continuous ambulatory peritoneal dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K.D. Nolph" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant" "fecha" => "1998" "volumen" => "13" "numero" => "S6" "paginaInicial" => "S117" "paginaFinal" => "S119" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0100" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Integrated care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.J. Davies" 1 => "W. van Biesen" 2 => "J. Nicholas" 3 => "N. Lameire" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:8 [ "tituloSerie" => "Perit Dial Int" "fecha" => "2001" "volumen" => "21" "numero" => "S3" "paginaInicial" => "S269" "paginaFinal" => "S274" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11887834" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283805008389" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0105" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationship between dialysis modality and mortality" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.P. McDonald" 1 => "M.R. Marshall" 2 => "D.W. Johnson" 3 => "K.R. Polkinghorne" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1681/ASN.2007111188" "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "2009" "volumen" => "20" "paginaInicial" => "155" "paginaFinal" => "163" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19092128" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0110" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Integrated end-stage renal disease care: the role of peritoneal dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.G. Blake" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Nephrol Dial Transplant" "fecha" => "2001" "volumen" => "16" "numero" => "S5" "paginaInicial" => "61" "paginaFinal" => "66" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11590260" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0115" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects on the choice of dialysis modality, residual renal function and adequacy" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Incremental peritoneal dialysis" "etal" => false "autores" => array:3 [ 0 => "G. Viglino" 1 => "L. Neri" 2 => "S. Barbieri" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Kidney Int" "fecha" => "2008" "volumen" => "73" "paginaInicial" => "S52" "paginaFinal" => "S55" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0120" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incremental peritoneal dialysis favourably compares with hemodialysis as a bridge to renal transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Domenici" 1 => "M.C. Comunian" 2 => "L. Fazzari" 3 => "F. Sivo" 4 => "A. Dinnella" 5 => "B. Della Grotta" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Int J Nephrol" "fecha" => "2011" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0125" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Charlson comorbidity index as a predictor of outcomes in incident peritoneal dialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Fried" 1 => "J. Bernardini" 2 => "B. Piraino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/ajkd.2001.21300" "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2001" "volumen" => "37" "paginaInicial" => "337" "paginaFinal" => "342" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11157375" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0130" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Old and new perspectives on peritoneal dialysis study group census" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Marinangeli" 1 => "G. Cabiddu" 2 => "L. Neri" 3 => "G. Viglino" 4 => "R. Russo" 5 => "U. Teatini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3747/pdi.2011.00112" "Revista" => array:7 [ "tituloSerie" => "Perit Dial Int" "fecha" => "2012" "volumen" => "32" "paginaInicial" => "558" "paginaFinal" => "565" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22383633" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022534708021654" "estado" => "S300" "issn" => "00225347" ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0135" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of residual renal function on dietary protein and caloric intake in patients on incremental peritoneal dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Caravaca" 1 => "M. Arrobas" 2 => "C. Dominguez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Perit Dial Int" "fecha" => "1999" "volumen" => "19" "paginaInicial" => "350" "paginaFinal" => "356" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10507816" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0140" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incremental initiation of dialysis: one center's experience over a two-year period" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.M. Burkart" 1 => "S.G. Satko" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Perit Dial Int" "fecha" => "2000" "volumen" => "20" "paginaInicial" => "418" "paginaFinal" => "422" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11007373" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0145" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Continuous ambulatory peritoneal dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.P. Popovich" 1 => "J.W. Moncrief" 2 => "K.D. Nolph" 3 => "A.J. Ghods" 4 => "Z.J. Twardowski" 5 => "W.K. Pyle" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1978" "volumen" => "88" "paginaInicial" => "449" "paginaFinal" => "456" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/637423" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0150" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guideline on targets for solute and fluid removal in adult patients on chronic peritoneal dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.K. Lo" 1 => "J.M. Bargman" 2 => "J. Burkart" 3 => "R.T. Krediet" 4 => "C. Pollock" 5 => "H. Kawanishi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Perit Dial Int" "fecha" => "2006" "volumen" => "26" "paginaInicial" => "520" "paginaFinal" => "522" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16973505" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022534712044710" "estado" => "S300" "issn" => "00225347" ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0155" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Scientific-technical quality and ongoing quality improvement plan in peritoneal dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.A. Bajo" 1 => "R. Selgas" 2 => "C. Remón" 3 => "J. Arrieta" 4 => "F. Alvarez-Ude" 5 => "M.D. Arenas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2010.Jan.10205" "Revista" => array:6 [ "tituloSerie" => "Nefrologia" "fecha" => "2010" "volumen" => "30" "paginaInicial" => "28" "paginaFinal" => "45" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20098469" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0160" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A randomized, controlled trial of early versus late initiation of dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.A. Cooper" 1 => "P. Branley" 2 => "L. Bulfone" 3 => "J.F. Collins" 4 => "J.C. Craig" 5 => "M.B. Fraenkel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1000552" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2010" "volumen" => "363" "paginaInicial" => "609" "paginaFinal" => "619" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20581422" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0165" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peritoneal dialysis retardation of progression of advanced renal failure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.R. Berlanga" 1 => "B. Marrón" 2 => "A. Reyero" 3 => "C. Caramelo" 4 => "A. Ortiz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Perit Dial Int" "fecha" => "2002" "volumen" => "22" "paginaInicial" => "239" "paginaFinal" => "242" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11990410" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0170" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The importance of residual kidney function for patients on dialysis: a critical review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Perl" 1 => "J.M. Bargman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2009" "volumen" => "56" "paginaInicial" => "1068" "paginaFinal" => "1081" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003600000003/v3_201704140402/S2013251416300530/v3_201704140402/en/main.assets" "Apartado" => array:4 [ "identificador" => "42660" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003600000003/v3_201704140402/S2013251416300530/v3_201704140402/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251416300530?idApp=UINPBA000064" ]
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| 2020 October | 41 | 40 | 81 |
| 2020 September | 39 | 33 | 72 |
| 2020 August | 61 | 21 | 82 |
| 2020 July | 49 | 24 | 73 |
| 2020 June | 57 | 16 | 73 |
| 2020 May | 64 | 16 | 80 |
| 2020 April | 47 | 24 | 71 |
| 2020 March | 43 | 8 | 51 |
| 2020 February | 48 | 27 | 75 |
| 2020 January | 66 | 33 | 99 |
| 2019 December | 68 | 35 | 103 |
| 2019 November | 58 | 21 | 79 |
| 2019 October | 48 | 20 | 68 |
| 2019 September | 50 | 16 | 66 |
| 2019 August | 44 | 24 | 68 |
| 2019 July | 48 | 30 | 78 |
| 2019 June | 61 | 23 | 84 |
| 2019 May | 36 | 33 | 69 |
| 2019 April | 66 | 29 | 95 |
| 2019 March | 48 | 31 | 79 |
| 2019 February | 39 | 34 | 73 |
| 2019 January | 46 | 31 | 77 |
| 2018 December | 148 | 49 | 197 |
| 2018 November | 311 | 22 | 333 |
| 2018 October | 250 | 36 | 286 |
| 2018 September | 87 | 23 | 110 |
| 2018 August | 53 | 21 | 74 |
| 2018 July | 45 | 12 | 57 |
| 2018 June | 50 | 21 | 71 |
| 2018 May | 80 | 18 | 98 |
| 2018 April | 115 | 12 | 127 |
| 2018 March | 121 | 20 | 141 |
| 2018 February | 131 | 11 | 142 |
| 2018 January | 116 | 6 | 122 |
| 2017 December | 145 | 15 | 160 |
| 2017 November | 87 | 12 | 99 |
| 2017 October | 52 | 11 | 63 |
| 2017 September | 36 | 13 | 49 |
| 2017 August | 26 | 38 | 64 |
| 2017 July | 36 | 20 | 56 |
| 2017 June | 47 | 22 | 69 |
| 2017 May | 52 | 11 | 63 |
| 2017 April | 46 | 19 | 65 |
| 2017 March | 32 | 11 | 43 |
| 2017 February | 21 | 9 | 30 |
| 2017 January | 32 | 19 | 51 |
| 2016 December | 42 | 14 | 56 |
| 2016 November | 62 | 24 | 86 |
| 2016 October | 68 | 15 | 83 |
| 2016 September | 162 | 12 | 174 |
| 2016 August | 117 | 8 | 125 |
| 2016 July | 100 | 7 | 107 |
Show all
