Letter to the Editor
Amyloid angiopathy in the context of hemodialysis: An unknown field
Angiopatía amiloide en el contexto de hemodiálisis: un terreno desconocido
Read
9446
Timeswas read the article
2291
Total PDF
7155
Total HTML
Share statistics
array:25 [ "pii" => "S2013251416300724" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2016.08.003" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "178" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2016;36:571-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4038 "formatos" => array:3 [ "EPUB" => 323 "HTML" => 3118 "PDF" => 597 ] ] "Traduccion" => array:1 [ "en" => array:20 [ "pii" => "S0211699516300108" "issn" => "02116995" "doi" => "10.1016/j.nefro.2016.03.007" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "178" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2016;36:571-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5572 "formatos" => array:3 [ "EPUB" => 376 "HTML" => 4361 "PDF" => 835 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Amyloid angiopathy in the context of hemodialysis: An unknown field" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "571" "paginaFinal" => "572" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Angiopatía amiloide en el contexto de hemodiálisis: un terreno desconocido" ] ] "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" => 900 "Ancho" => 900 "Tamanyo" => 73187 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">FLAIR MRI (December 2011) which showed hyperintense lesions compatible with microhemorrhages.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos Jesús Cabezas-Reina, Elvira Esquivias-de-Motta, José Carlos Estévez-María, Marina Sánchez-Agesta-Martínez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Carlos Jesús" "apellidos" => "Cabezas-Reina" ] 1 => array:2 [ "nombre" => "Elvira" "apellidos" => "Esquivias-de-Motta" ] 2 => array:2 [ "nombre" => "José Carlos" "apellidos" => "Estévez-María" ] 3 => array:2 [ "nombre" => "Marina" "apellidos" => "Sánchez-Agesta-Martínez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2013251416300724" "doi" => "10.1016/j.nefroe.2016.08.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251416300724?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699516300108?idApp=UINPBA000064" "url" => "/02116995/0000003600000005/v3_201705130058/S0211699516300108/v3_201705130058/en/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2013251416301249" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2016.11.012" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "241" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2016;36:573-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5359 "formatos" => array:3 [ "EPUB" => 319 "HTML" => 4438 "PDF" => 602 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Ecthyma gangrenosum in a renal transplant recipient" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "573" "paginaFinal" => "574" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ectima gangrenoso en paciente portadora de trasplante renal" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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" => 743 "Ancho" => 990 "Tamanyo" => 102192 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cutaneous lesions on the arm (A) and on the back of the leg (B), corresponding to ecthyma gangrenosum.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Begoña Santos, Marta Sanz, Almudena Nuñez, Lech Onofre Mayor, Borja Quiroga" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Begoña" "apellidos" => "Santos" ] 1 => array:2 [ "nombre" => "Marta" "apellidos" => "Sanz" ] 2 => array:2 [ "nombre" => "Almudena" "apellidos" => "Nuñez" ] 3 => array:2 [ "nombre" => "Lech Onofre" "apellidos" => "Mayor" ] 4 => array:2 [ "nombre" => "Borja" "apellidos" => "Quiroga" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0211699516301060" "doi" => "10.1016/j.nefro.2016.06.005" "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/S0211699516301060?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251416301249?idApp=UINPBA000064" "url" => "/20132514/0000003600000005/v1_201612260003/S2013251416301249/v1_201612260003/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2013251416300967" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2016.10.008" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "176" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2016;36:569-71" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3827 "formatos" => array:3 [ "EPUB" => 375 "HTML" => 2890 "PDF" => 562 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Regression of vascular calcification in a patient with calciphylaxis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "569" "paginaFinal" => "571" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Regresión de calcificaciones vasculares en paciente con calcifilaxia" ] ] "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" => 1094 "Ancho" => 1808 "Tamanyo" => 258423 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Right (above) and left (below) mammograms in 2011 (A), in 2013 (B) and in 2015 (C).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rosa M. Ruiz-Calero, Lilia M. Azevedo, Miguel A. Bayo, Boris Gonzales, Juan J. Cubero" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Rosa M." "apellidos" => "Ruiz-Calero" ] 1 => array:2 [ "nombre" => "Lilia M." "apellidos" => "Azevedo" ] 2 => array:2 [ "nombre" => "Miguel A." "apellidos" => "Bayo" ] 3 => array:2 [ "nombre" => "Boris" "apellidos" => "Gonzales" ] 4 => array:2 [ "nombre" => "Juan J." "apellidos" => "Cubero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S021169951630008X" "doi" => "10.1016/j.nefro.2016.03.005" "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/S021169951630008X?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251416300967?idApp=UINPBA000064" "url" => "/20132514/0000003600000005/v1_201612260003/S2013251416300967/v1_201612260003/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Amyloid angiopathy in the context of hemodialysis: An unknown field" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "571" "paginaFinal" => "572" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carlos Jesús Cabezas-Reina, Elvira Esquivias-de-Motta, José Carlos Estévez-María, Marina Sánchez-Agesta-Martínez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Carlos Jesús" "apellidos" => "Cabezas-Reina" "email" => array:1 [ 0 => "carlos.cabezas.14@outlook.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" => "Elvira" "apellidos" => "Esquivias-de-Motta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "José Carlos" "apellidos" => "Estévez-María" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Marina" "apellidos" => "Sánchez-Agesta-Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Grado Medicina, Facultad de Medicina y Enfermería, UCO, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Área de Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Área de Neurología, Hospital Universitario Reina Sofía, Córdoba, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Residencia de Nefrología, Hospital Universitario Reina Sofía, Córdoba, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Angiopatía amiloide en el contexto de hemodiálisis: un terreno desconocido" ] ] "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" => 906 "Ancho" => 905 "Tamanyo" => 80826 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">FLAIR MRI (December 2011) which showed hyperintense lesions compatible with microhemorrhages.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">It is known that cerebral amyloid angiopathy (CAA) is due to amyloid beta peptide (Aβ) accumulation in the middle and outer coats of small cerebral arteries and arterioles. CAA irrupts as a intracranial hemorrhage, which can be a cerebral hematoma or multifocal microhemorrhages. It is difficult to estimate its real incidence because diagnosis confirmation requires an anatomopathological study, but it is rated that almost 57% of non-traumatic intracranial hemorrhages in patients between 71 and 80 years old might be caused by CAA.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The spectrum of disease due to Aβ includes several disorders. In 1985, β2 microglobulin was identified as the responsible of hemodialysis-associated amyloidosis.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> In the 1980 decade, CAA was considered an Alzheimer's disease subtype,<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4</span></a> and they have been proposed as different conditions since the 1990 early decade.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Therefore, CAA is a disease with its own entity, but it lacks diagnosis, prevention and treatment protocols.</p><p id="par0010" class="elsevierStylePara elsevierViewall">There is evidence that uremic environment and glomerular filtration rate decline in patients with chronic kidney disease, aggravate cognitive functions and are related to microhemorrhages occurrence.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Both, it is necessary to clarify to what extent anticoagulant or antiplatelet treatments worsen CAA evolution. In this regard, it is interesting the case of an 82 years old patient with chronic kidney disease and hemodialysis for four years, who was evaluated due to a 48<span class="elsevierStyleHsp" style=""></span>hours disorientation state. His antecedents included memory impairment for nine years and an episode of multiple microangiopathic infarcts eight years ago. Non-contrast head CT showed a right frontal hematoma with perilesional edema, and hypodense lesions located in periventricular and subcortical white matter and left cerebellar hemisphere. That supported former infarcts or hemorrhages. According to the Boston criteria,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> the patient diagnosis was probable CAA.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The deficiency of standardized strategies to detect CAA and the bleeding risk that the disease entails, complicate the management of concomitant pathologies with antithrombotic therapy requirement. This is particularly important in patients under hemodialysis, who need anticoagulation treatment during sessions. In regard to antiplatelet treatment, retrospective researches show different outcomes respecting bleeding risk,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> although acetylsalicylic acid is generally avoided and replaced by clopidogrel. Anticoagulation with heparin is also controversial. On the one hand, a case report of CAA-related inflammation treated with enoxaparin 4000<span class="elsevierStyleHsp" style=""></span>IU/12<span class="elsevierStyleHsp" style=""></span>h due to venous thrombosis, described a subsequent big cerebral hematoma which caused death.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> On the other hand, low-molecular-weight heparin (LMWH) is recommended despite cerebral hemorrhage if immobilization extends beyond 3–4 days.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> In the exposed case of the patient, LMWH treatment was kept during hemodialysis sessions, and he continued his previous therapy with clopidogrel. Six days later, a control non-contrast head TC showed the resolution of acute hemorrhage, and due to the remarkable clinical improvement, the patient was discharged from the hospital showing a normal orientation state (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Because of its significance for hemodialysis patients, CAA is an important disease in Nephrology sphere. It is already known the importance of controlling parameters like arterial pressure, anemia, or hydroelectrolytic equilibrium in those patients in order to prevent microhemorrhages onset. However, prospective researches should focus on the bleeding risk stratification in CAA patients undergoing hemodialysis, the impact of different antithrombotic treatments in those patients, and emphasize diagnostic methods for CAA, like gradient echo sequences MRI.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "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" => 816 "Ancho" => 901 "Tamanyo" => 88180 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Non-contrast head CT along hospitalization (September 2015).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 906 "Ancho" => 905 "Tamanyo" => 80826 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">FLAIR MRI (December 2011) which showed hyperintense lesions compatible with microhemorrhages.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <a class="elsevierStyleInterRef" id="intr0005" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+amyloid+angiopathy-associated+intracerebral+hemorrhage%3A+pathology+and+management">http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+amyloid+angiopathy-associated+intracerebral+hemorrhage%3A+pathology+and+management</a>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cerebral amyloid angiopathy-associated intracerebral hemorrhage: pathology and management [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Mehndiratta" 1 => "S. Manjila" 2 => "T. Ostergard" 3 => "S. Eisele" 4 => "M.L. Cohen" 5 => "C. Sila" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/2012.1.FOCUS11370" "Revista" => array:6 [ "tituloSerie" => "Neurosurg Focus" "fecha" => "2012" "volumen" => "32" "numero" => "4" "paginaInicial" => "E7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22655696" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <a class="elsevierStyleInterRef" id="intr0010" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=A+new+form+of+amyloid+protein+associated+with+chronic+hemodialysis+was+identified+as+beta+2-microglobulin">http://www.ncbi.nlm.nih.gov/pubmed/?term=A+new+form+of+amyloid+protein+associated+with+chronic+hemodialysis+was+identified+as+beta+2-microglobulin</a>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new form of amyloid protein associated with chronic hemodialysis was identified as beta 2-microglobulin [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Gejyo" 1 => "T. Yamada" 2 => "S. Odani" 3 => "Y. Nakagawa" 4 => "M. Arakawa" 5 => "T. Kunitomo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Biochem Biophys Res Commun" "fecha" => "1985" "volumen" => "129" "numero" => "3" "paginaInicial" => "701" "paginaFinal" => "706" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3893430" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <a class="elsevierStyleInterRef" id="intr0015" href="http://www.ncbi.nlm.nih.gov/pubmed/6169353">http://www.ncbi.nlm.nih.gov/pubmed/6169353</a>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congophilic angiopathy in the pathogenesis of Alzheimer's degeneration [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.G. Glenner" 1 => "J.H. Henry" 2 => "S. Fujihara" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Ann Pathol" "fecha" => "1981" "volumen" => "1" "numero" => "2" "paginaInicial" => "120" "paginaFinal" => "129" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6169353" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <a class="elsevierStyleInterRef" id="intr0020" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=The+significance+of+clinically+defined+subgroups+of+Alzheimer%25C2%25B4s+disease">http://www.ncbi.nlm.nih.gov/pubmed/?term=The+significance+of+clinically+defined+subgroups+of+Alzheimer%C2%B4s+disease</a>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The significance of clinically defined subgroups of Alzheimer's disease [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H.C. Chui" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neural Transm Suppl" "fecha" => "1987" "volumen" => "24" "paginaInicial" => "57" "paginaFinal" => "68" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3316501" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <a class="elsevierStyleInterRef" id="intr0025" href="http://www.ncbi.nlm.nih.gov/pubmed/1469419">http://www.ncbi.nlm.nih.gov/pubmed/1469419</a>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cerebral amyloid angiopathy and Alzheimer's disease: two entities or one? [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H.V. Vinters" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Neurol Sci" "fecha" => "1992" "volumen" => "112" "numero" => "1" "paginaInicial" => "1" "paginaFinal" => "3" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1469419" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <a class="elsevierStyleInterRef" id="intr0030" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+microbleeds+and+cognitive+decline+in+a+hemodialysis+patient%3A+case+report+and+review+of+literature">http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+microbleeds+and+cognitive+decline+in+a+hemodialysis+patient%3A+case+report+and+review+of+literature</a>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cerebral microbleeds and cognitive decline in a hemodialysis patient: case report and review of literature [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Li" 1 => "M. Fisher" 2 => "W. Lau" 3 => "H. Moradi" 4 => "A. Cheung" 5 => "G. Thai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/hdi.12275" "Revista" => array:7 [ "tituloSerie" => "Hemodial Int" "fecha" => "2015" "volumen" => "19" "numero" => "3" "paginaInicial" => "E1" "paginaFinal" => "E7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25649895" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <a class="elsevierStyleInterRef" id="intr0035" href="http://www.ncbi.nlm.nih.gov/pubmed/11222803">http://www.ncbi.nlm.nih.gov/pubmed/11222803</a>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.A. Knudsen" 1 => "J. Rosand" 2 => "D. Karluk" 3 => "S.M. Greenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Neurology" "fecha" => "2001" "volumen" => "56" "numero" => "4" "paginaInicial" => "537" "paginaFinal" => "539" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11222803" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <a class="elsevierStyleInterRef" id="intr0040" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Elderly+and+forgetful%3A+is+aspirin+safe+for+you?">http://www.ncbi.nlm.nih.gov/pubmed/?term=Elderly+and+forgetful%3A+is+aspirin+safe+for+you%3F</a>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Elderly and forgetful: is aspirin safe for you? [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.H. Selim" 1 => "C.A. Molina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/STROKEAHA.114.006620" "Revista" => array:7 [ "tituloSerie" => "Stroke" "fecha" => "2014" "volumen" => "45" "numero" => "10" "paginaInicial" => "3153" "paginaFinal" => "3154" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25205308" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <a class="elsevierStyleInterRef" id="intr0045" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+amyloid+angiopathy-related+inflammation%3A+report+of+a+case+with+very+difficult+therapeutic+management">http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+amyloid+angiopathy-related+inflammation%3A+report+of+a+case+with+very+difficult+therapeutic+management</a>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cerebral amyloid angiopathy-related inflammation: report of a case with very difficult therapeutic management [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Crosta" 1 => "B. Orlandi" 2 => "F. De Santis" 3 => "G. Passalacqua" 4 => "J.C. DiFrancesco" 5 => "F. Piazza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2015/483020" "Revista" => array:2 [ "tituloSerie" => "Case Rep Neurol Med" "fecha" => "2015" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <a class="elsevierStyleInterRef" id="intr0050" href="http://www.ncbi.nlm.nih.gov/pubmed/18601836">http://www.ncbi.nlm.nih.gov/pubmed/18601836</a>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Actualización en hemorragia cerebral espontánea [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Escudero Augusto" 1 => "L. Marqués Álvarez" 2 => "F. Taboada Costa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Med Intensiva" "fecha" => "2008" "volumen" => "32" "numero" => "6" "paginaInicial" => "282" "paginaFinal" => "295" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18601836" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003600000005/v1_201612260003/S2013251416300724/v1_201612260003/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003600000005/v1_201612260003/S2013251416300724/v1_201612260003/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251416300724?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 6 | 11 |
| 2024 October | 83 | 31 | 114 |
| 2024 September | 64 | 23 | 87 |
| 2024 August | 86 | 65 | 151 |
| 2024 July | 65 | 25 | 90 |
| 2024 June | 94 | 44 | 138 |
| 2024 May | 106 | 34 | 140 |
| 2024 April | 98 | 42 | 140 |
| 2024 March | 67 | 15 | 82 |
| 2024 February | 70 | 33 | 103 |
| 2024 January | 65 | 22 | 87 |
| 2023 December | 67 | 27 | 94 |
| 2023 November | 79 | 36 | 115 |
| 2023 October | 78 | 27 | 105 |
| 2023 September | 77 | 27 | 104 |
| 2023 August | 63 | 21 | 84 |
| 2023 July | 96 | 24 | 120 |
| 2023 June | 80 | 21 | 101 |
| 2023 May | 75 | 27 | 102 |
| 2023 April | 78 | 15 | 93 |
| 2023 March | 82 | 23 | 105 |
| 2023 February | 49 | 12 | 61 |
| 2023 January | 74 | 25 | 99 |
| 2022 December | 153 | 33 | 186 |
| 2022 November | 90 | 31 | 121 |
| 2022 October | 110 | 42 | 152 |
| 2022 September | 56 | 30 | 86 |
| 2022 August | 86 | 41 | 127 |
| 2022 July | 73 | 41 | 114 |
| 2022 June | 78 | 32 | 110 |
| 2022 May | 83 | 26 | 109 |
| 2022 April | 79 | 33 | 112 |
| 2022 March | 81 | 35 | 116 |
| 2022 February | 78 | 30 | 108 |
| 2022 January | 75 | 34 | 109 |
| 2021 December | 57 | 47 | 104 |
| 2021 November | 75 | 36 | 111 |
| 2021 October | 60 | 37 | 97 |
| 2021 September | 56 | 35 | 91 |
| 2021 August | 65 | 40 | 105 |
| 2021 July | 64 | 37 | 101 |
| 2021 June | 63 | 35 | 98 |
| 2021 May | 60 | 47 | 107 |
| 2021 April | 95 | 90 | 185 |
| 2021 March | 67 | 27 | 94 |
| 2021 February | 77 | 33 | 110 |
| 2021 January | 53 | 27 | 80 |
| 2020 December | 61 | 20 | 81 |
| 2020 November | 48 | 22 | 70 |
| 2020 October | 37 | 13 | 50 |
| 2020 September | 60 | 21 | 81 |
| 2020 August | 48 | 16 | 64 |
| 2020 July | 45 | 8 | 53 |
| 2020 June | 44 | 12 | 56 |
| 2020 May | 56 | 16 | 72 |
| 2020 April | 35 | 17 | 52 |
| 2020 March | 35 | 17 | 52 |
| 2020 February | 54 | 18 | 72 |
| 2020 January | 58 | 14 | 72 |
| 2019 December | 54 | 26 | 80 |
| 2019 November | 39 | 19 | 58 |
| 2019 October | 33 | 17 | 50 |
| 2019 September | 52 | 12 | 64 |
| 2019 August | 32 | 10 | 42 |
| 2019 July | 41 | 25 | 66 |
| 2019 June | 42 | 21 | 63 |
| 2019 May | 35 | 18 | 53 |
| 2019 April | 50 | 33 | 83 |
| 2019 March | 43 | 20 | 63 |
| 2019 February | 31 | 18 | 49 |
| 2019 January | 38 | 18 | 56 |
| 2018 December | 177 | 36 | 213 |
| 2018 November | 286 | 21 | 307 |
| 2018 October | 254 | 32 | 286 |
| 2018 September | 137 | 7 | 144 |
| 2018 August | 61 | 19 | 80 |
| 2018 July | 83 | 17 | 100 |
| 2018 June | 97 | 15 | 112 |
| 2018 May | 146 | 20 | 166 |
| 2018 April | 130 | 12 | 142 |
| 2018 March | 166 | 10 | 176 |
| 2018 February | 175 | 6 | 181 |
| 2018 January | 246 | 5 | 251 |
| 2017 December | 207 | 6 | 213 |
| 2017 November | 62 | 15 | 77 |
| 2017 October | 25 | 2 | 27 |
| 2017 September | 38 | 16 | 54 |
| 2017 August | 29 | 7 | 36 |
| 2017 July | 26 | 5 | 31 |
| 2017 June | 32 | 19 | 51 |
| 2017 May | 36 | 20 | 56 |
| 2017 April | 37 | 9 | 46 |
| 2017 March | 25 | 12 | 37 |
| 2017 February | 27 | 14 | 41 |
| 2017 January | 44 | 11 | 55 |
| 2016 December | 3 | 0 | 3 |
Show all
