Original article
Application of model of incremental haemodialysis, based on residual renal function, at the initiation of renal replacement therapy
Aplicación de una pauta de hemodiálisis incremental, basada en la función renal residual, al inicio del tratamiento renal sustitutivo
Read
7969
Timeswas read the article
2504
Total PDF
5465
Total HTML
Share statistics
array:25 [ "pii" => "S2013251417300470" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2017.02.005" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "316" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2017;37:39-46" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3493 "formatos" => array:3 [ "EPUB" => 333 "HTML" => 2473 "PDF" => 687 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0211699516302107" "issn" => "02116995" "doi" => "10.1016/j.nefro.2016.11.015" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "316" "copyright" => "Sociedad Española de Nefrología" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2017;37:39-46" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 6283 "formatos" => array:3 [ "EPUB" => 399 "HTML" => 4916 "PDF" => 968 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Aplicación de una pauta de hemodiálisis incremental, basada en la función renal residual, al inicio del tratamiento renal sustitutivo" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "39" "paginaFinal" => "46" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Application of model of incremental haemodialysis, based on residual renal function, at the initiation of renal replacement therapy" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1779 "Ancho" => 2207 "Tamanyo" => 150457 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribución de los pacientes incidentes en la Unidad de Hemodiálisis del Hospital Universitario del Henares en el periodo comprendido desde julio de 2008 hasta septiembre de 2015.</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">FRR: función renal residual; TRS: tratamiento renal sustitutivo.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José L. Merino, Patricia Domínguez, Blanca Bueno, Yésika Amézquita, Beatriz Espejo, Vicente Paraíso" "autores" => array:6 [ 0 => array:2 [ "nombre" => "José L." "apellidos" => "Merino" ] 1 => array:2 [ "nombre" => "Patricia" "apellidos" => "Domínguez" ] 2 => array:2 [ "nombre" => "Blanca" "apellidos" => "Bueno" ] 3 => array:2 [ "nombre" => "Yésika" "apellidos" => "Amézquita" ] 4 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Espejo" ] 5 => array:2 [ "nombre" => "Vicente" "apellidos" => "Paraíso" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2013251417300470" "doi" => "10.1016/j.nefroe.2017.02.005" "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/S2013251417300470?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699516302107?idApp=UINPBA000064" "url" => "/02116995/0000003700000001/v3_201702240054/S0211699516302107/v3_201702240054/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2013251417300056" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2017.01.005" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "238" "copyright" => "Sociedad Española de Nefrología" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2017;37:47-53" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3158 "formatos" => array:3 [ "EPUB" => 336 "HTML" => 2246 "PDF" => 576 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Echocardiographic findings in haemodialysis patients according to their state of hydration" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "47" "paginaFinal" => "53" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hallazgos ecocardiográficos en pacientes en hemodiálisis según su estado de hidratación" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Cristina Di Gioia, Raul Gascuena, Paloma Gallar, Gabriela Cobo, Rosa Camacho, Nuria Acosta, Zsofia Baranyi, Isabel Rodriguez, Aniana Oliet, Olimpia Ortega, Inmaculada Fernandez, Carmen Mon, Milagros Ortiz, Mari C. Manzano, Juan C. Herrero, José I. Martinez, Joaquín Palma, Ana Vigil" "autores" => array:18 [ 0 => array:2 [ "nombre" => "María" "apellidos" => "Cristina Di Gioia" ] 1 => array:2 [ "nombre" => "Raul" "apellidos" => "Gascuena" ] 2 => array:2 [ "nombre" => "Paloma" "apellidos" => "Gallar" ] 3 => array:2 [ "nombre" => "Gabriela" "apellidos" => "Cobo" ] 4 => array:2 [ "nombre" => "Rosa" "apellidos" => "Camacho" ] 5 => array:2 [ "nombre" => "Nuria" "apellidos" => "Acosta" ] 6 => array:2 [ "nombre" => "Zsofia" "apellidos" => "Baranyi" ] 7 => array:2 [ "nombre" => "Isabel" "apellidos" => "Rodriguez" ] 8 => array:2 [ "nombre" => "Aniana" "apellidos" => "Oliet" ] 9 => array:2 [ "nombre" => "Olimpia" "apellidos" => "Ortega" ] 10 => array:2 [ "nombre" => "Inmaculada" "apellidos" => "Fernandez" ] 11 => array:2 [ "nombre" => "Carmen" "apellidos" => "Mon" ] 12 => array:2 [ "nombre" => "Milagros" "apellidos" => "Ortiz" ] 13 => array:2 [ "nombre" => "Mari C." "apellidos" => "Manzano" ] 14 => array:2 [ "nombre" => "Juan C." "apellidos" => "Herrero" ] 15 => array:2 [ "nombre" => "José I." "apellidos" => "Martinez" ] 16 => array:2 [ "nombre" => "Joaquín" "apellidos" => "Palma" ] 17 => array:2 [ "nombre" => "Ana" "apellidos" => "Vigil" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0211699516300893" "doi" => "10.1016/j.nefro.2016.06.003" "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/S0211699516300893?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417300056?idApp=UINPBA000064" "url" => "/20132514/0000003700000001/v1_201703230033/S2013251417300056/v1_201703230033/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2013251417300160" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2017.01.013" "estado" => "S300" "fechaPublicacion" => "2017-01-01" "aid" => "209" "copyright" => "Sociedad Española de Nefrología" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "ssu" "cita" => "Nefrologia (English Version). 2017;37:34-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3836 "formatos" => array:3 [ "EPUB" => 360 "HTML" => 2855 "PDF" => 621 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Notes on techniques</span>" "titulo" => "Follow a recipe to prescribe phosphate during hemodialysis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "34" "paginaFinal" => "38" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Receta para prescribir fósforo durante hemodiálisis" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "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" => 1552 "Ancho" => 1637 "Tamanyo" => 95993 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The figure shows the concentrations of P achieved in the dialysis fluid for each calculation.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Marta Albalate, Ma Jesús Ruiz-Alvarez, Patricia de Sequera, Rafael Perez-Garcia, Patricia Arribas, Elena Corchete, Caridad Ruiz Caro, Tamar Talaván Zanón, Roberto Alcazar, Mayra Ortega, Marta Puerta" "autores" => array:11 [ 0 => array:2 [ "nombre" => "Marta" "apellidos" => "Albalate" ] 1 => array:2 [ "nombre" => "Ma Jesús" "apellidos" => "Ruiz-Alvarez" ] 2 => array:2 [ "nombre" => "Patricia" "apellidos" => "de Sequera" ] 3 => array:2 [ "nombre" => "Rafael" "apellidos" => "Perez-Garcia" ] 4 => array:2 [ "nombre" => "Patricia" "apellidos" => "Arribas" ] 5 => array:2 [ "nombre" => "Elena" "apellidos" => "Corchete" ] 6 => array:2 [ "nombre" => "Caridad" "apellidos" => "Ruiz Caro" ] 7 => array:2 [ "nombre" => "Tamar" "apellidos" => "Talaván Zanón" ] 8 => array:2 [ "nombre" => "Roberto" "apellidos" => "Alcazar" ] 9 => array:2 [ "nombre" => "Mayra" "apellidos" => "Ortega" ] 10 => array:2 [ "nombre" => "Marta" "apellidos" => "Puerta" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0211699516300418" "doi" => "10.1016/j.nefro.2016.04.005" "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/S0211699516300418?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417300160?idApp=UINPBA000064" "url" => "/20132514/0000003700000001/v1_201703230033/S2013251417300160/v1_201703230033/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Application of model of incremental haemodialysis, based on residual renal function, at the initiation of renal replacement therapy" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "39" "paginaFinal" => "46" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "José L. Merino, Patricia Domínguez, Blanca Bueno, Yésika Amézquita, Beatriz Espejo, Vicente Paraíso" "autores" => array:6 [ 0 => array:4 [ "nombre" => "José L." "apellidos" => "Merino" "email" => array:1 [ 0 => "jluis.merino@salud.madrid.org" ] "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" => "Patricia" "apellidos" => "Domínguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Blanca" "apellidos" => "Bueno" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Yésika" "apellidos" => "Amézquita" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Beatriz" "apellidos" => "Espejo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Vicente" "apellidos" => "Paraíso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Sección de Nefrología, Hospital Universitario del Henares, Coslada, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Sección de Nefrología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aplicación de una pauta de hemodiálisis incremental, basada en la función renal residual, al inicio del tratamiento renal sustitutivo" ] ] "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" => 1779 "Ancho" => 2207 "Tamanyo" => 155706 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribution of incident patients treated in the haemodialysis unit of the Hospital Universitario del Henares from July 2008 to September 2015. RRF: residual renal function; RRT: renal replacement therapy.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Residual renal function (RRF) is associated with increased survival inpatients with advanced renal disease.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> Numerous studies have shown that it is important to maintain RRF in peritoneal dialysis.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2,3</span></a> Some studies in haemodialysis (HD) have highlighted the benefits of RRF, however its role has received only limited attention.<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1,4</span></a> Recent studies, have shown improved survival of patients with preserved RRF, and have also enphasized the difficulty involved in the management of RRF in routine clinical practice.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">5–8</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Preserving RRF is associated with better survival and also results in a better tolerance of haemodialysis, improved control of calcium–phosphorus metabolism, better nutritional status, as well as a beneficial effect on anemia and perceived quality of life in patients receiving renal replacement therapy (RRT).<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">9–11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The loss of RRF during the first few months of RRT is well described. This loss of RRF is associated with several factors: episodes of hypotension, volume depletion, activation of inflammatory mediators, biocompatibility of dialyzers and dialysis fluid, and the use of nephrotoxic treatments and contrast media.<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">12,13</span></a> Incremental dialysis, starting with twice-weekly sessions and gradually adjusting the length of dialysis under close medical supervision, is well tolerated and the residual urine output is preserved without complications.<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1,6,7,14</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In our center, we decided to introduce incremental HD at the commencement of RRT. To do so we followed the kinetic model developed by Gotch in 1985, in which adequate dialysis is achieved provided if urea clearance does not fall below 2.5<span class="elsevierStyleHsp" style=""></span>ml/min.<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">15,16</span></a> In the present study, we describe how we have implemented this strategy in our hospital over the past 7 years. Our objective is to analyze the evolution of patients with incremental HD particularly their residual urine output, the clinical features and analytical parameters.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">This is a retrospective study of a number of case series without a control group. All patients starting incremental RRT since 2008 were considered for inclusion. Patients already on dialysis transferred from other centers, and patients who were subsequently included in the peritoneal dialysis program were analyzed.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Inclusion criteria were: 24<span class="elsevierStyleHsp" style=""></span>h residual urine output of at least 1000<span class="elsevierStyleHsp" style=""></span>ml, clinically stable, no evidence of volume overload or edema. Exclusion criteria were: unstable clinical status, 24<span class="elsevierStyleHsp" style=""></span>h diuresis of less than 1000<span class="elsevierStyleHsp" style=""></span>ml or the presence of laboratory abnormalities such as serum phosphate concentration persistently above 6<span class="elsevierStyleHsp" style=""></span>mg/dl or serum potassium level above 6.5<span class="elsevierStyleHsp" style=""></span>mEq/l. Other exclusion criteria were: non-compliance or being unable to follow instructions and nephrotic proteinuria at the start of RRT. Data from patients who received incremental HD for less than 6 months were not included in the final analysis.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In our center, the criteria for starting RRT with HD are: asymptomatic patient with estimated glomerular filtration rate (GFR) of <6<span class="elsevierStyleHsp" style=""></span>ml/min, calculated using the MDRD or patients with higher GFR with symptoms that do not respond to medical treatment, uremic symptoms or poor control of analytical parameters. Patients starting RRT on an outpatient basis begin on twice-weekly incremental dialysis sessions (Monday and Friday or Tuesday and Saturday) lasting at least 180<span class="elsevierStyleHsp" style=""></span>min por session if the weight is less than 60<span class="elsevierStyleHsp" style=""></span>kg and 210<span class="elsevierStyleHsp" style=""></span>min if they are above 60<span class="elsevierStyleHsp" style=""></span>kg. Following 2006 KDOQI guidelines, after 2–3 weeks the RRF is reassessed together with the determination of residual urine output, conventional analytical parameters along and a physical exam.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">17</span></a> Patients starting RRT due to hospitalization follow the regime recommended by the nephrologist based on their clinical situation. Once the clinical situation has been stable for 2–3 weeks, they are re-evaluated following the same protocol applied to non-hospitalised patients. Provided they meet the inclusion criteria, they are changed to twice-weekly HD with corresponding follow-up.</p><p id="par0040" class="elsevierStylePara elsevierViewall">To considered a patient from our outpatient advanced chronic kidney disease (ACKD) the patient had to be followed for at least 3 months independently of whether the patient had a permanent vascular access.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Once RRT has started, residual urine output was re-evaluated every 2 months, using the 24<span class="elsevierStyleHsp" style=""></span>h urine output from the day preceding the first weekly dialysis. In addition, analytical parameters were monitored every month, the dialysis dose was calculated bi-monthly using the simplified single-pool Kt/V Daugirdas formula, the urea reduction ratio (URR) was calculated every two months, and dialysis adequacy was monitored daily using the standardized formula for urea clearance (Kt and Kt/V). Twice-weekly HD was maintained provided that residual urine output was greater than 1000<span class="elsevierStyleHsp" style=""></span>ml/24<span class="elsevierStyleHsp" style=""></span>h, urea clearance above 2.5<span class="elsevierStyleHsp" style=""></span>ml/min, no evidence of edema or volume overload, and no analytical parameters are persistently outside the recommended range. Blood pressure was measured at the beginning of the dialysis session.</p><p id="par0050" class="elsevierStylePara elsevierViewall">To prevent hypotension the maximum ultrafiltration (UF) rate was set at 1500–2000<span class="elsevierStyleHsp" style=""></span>cc per session, and it was re-evaluated on the basis of edema or volume overload. The “dry” weight was evaluated every week based on physical examination and estimated UF. All patients were advised on fluid intake and dietary salt and potassium intake. As a rule, furosemide was not started at the commencement of incremental HD but it was continued in patients previously receiving furosemide. All patients were dialysed with ultrapure dialysis fluid and high-flux biocompatible membranes. They initially received dialysate with calcium 2.5<span class="elsevierStyleHsp" style=""></span>mEq/l and potassium 1.5<span class="elsevierStyleHsp" style=""></span>mEq/l, at a temperature of 35.5<span class="elsevierStyleHsp" style=""></span>°C, if well tolerated.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The analysis of baseline, 6 month and 1 year parameters included data from patients who started on twice-weekly dialysis, irrespective of whether they were eventually changed to thrice-weekly HD within the year.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0060" class="elsevierStylePara elsevierViewall">Results are shown as mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation, or as median and range when required. All the data analyzed were normally distributed, so parametric tests were used. Means were compared using the Student's <span class="elsevierStyleItalic">t</span>-test for paired data. A <span class="elsevierStyleItalic">p</span> value <0.05 was considered statistically significant.</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">Data from all incident HD patients treated since the inauguration of the Haemodialysis Unit in March 2008 were reviewed. As of September 2015, a total of 34 patients had started incremental twice-weekly HD. Ten patients were excluded because did not remain on incremental HD for at least 6 months. Six patients remained on incremental HD for less than 6 months due to volume overload, poorly controlled clinical parameters, or excessive weight gain. In 4 patients, there was an increase in RRF after starting incremental HD and allowed a temporal discontinuation of RRT was temporarily discontinued (at the end of the study, 3 of these patients had CKD stage 4–5 with no need for RRT, and the fourth patient remained dialysis-free for 18 months, but he had to resumed thrice-weekly HD after a myocardial infarction).</p><p id="par0070" class="elsevierStylePara elsevierViewall">Patients analyzed were those that remained on incremental HD for at least 6 months and on RRT for at least 12 months by the end of the data collection period (1 September 2015). Ten patients had been on incremental HD for at least 1 year, and another 5 had completed more than 6 months (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Of the 24 patients enrolled, 9 receiving twice-weekly HD were ultimately excluded from the analysis because they received less than 12 months by the end of study. Finally, data from 15 patients who had received at least 12 months of RRT, 10 men and 5 women with a mean age at onset of RRT of 60 (15 years), were included in the analysis. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows patient demographics and origin of kidney disease.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Two patients started RRT without previous follow-up as an outpatient, and were placed on twice-weekly HD after admission. Nine patients began RRT with an arteriovenous fistula (AVF), while the other 6 patients needed a tunneled catheter.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Mean time on incremental HD was 19 months (18 months) (median: 13; range: 7–80), and patients remained on RRT for 31 months (23 months) (median: 20; range: 12–86).</p><p id="par0085" class="elsevierStylePara elsevierViewall">Two patients came from the kidney transplant unit with chronic graft dysfunction. In these patients, decreased residual urine output and worsening of analytical parameters required conversion to thrice-weekly HD at 10 and 12 months respectively.</p><p id="par0090" class="elsevierStylePara elsevierViewall">The reasons for changing HD regimen are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Six patients required conversion to thrice-weekly HD due to abnormal analytical parameters and 2 due to episodes of heart failure (one due to myocardial ischemia and another due to a respiratory infection) that required more strict UF and had a concomitant loss of residual urine output. In 1 case, non-compliance with the pharmacological therapy leading to persistently high levels of phosphorus and potassium called for conversion to thrice-weekly HD. In 3 cases, incremental HD was discontinued due to kidney transplant after 12, 18 and 14 months on this regime.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Two patients died during follow-up, both after discontinuation of incremental HD; one of them due to infection several months after receiving a kidney transplant, and in the other one the cause of death brain hemorrhage that occurred after 7 months of thrice-weekly and a total of 17 months on RRT.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Analytical data and dialysis parameters are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. Average initial residual urine output was 2106<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>606<span class="elsevierStyleHsp" style=""></span>ml/day that gradually declined over the first year but the average urine output remained over 1<span class="elsevierStyleHsp" style=""></span>l at 12 months, 1545<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>558<span class="elsevierStyleHsp" style=""></span>ml/day (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.07). This observation was consistent with the parallel decrease in urea clearance, from 5.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.5 vs to 3.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.9<span class="elsevierStyleHsp" style=""></span>ml/min at 12 months (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.01). The reduction in reduction was also related to a loss of RRF (ml/min), from 8.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.4 at baseline to 6.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.3 after 1 year (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.28). We also observed that this occurred in parallel with the increased duration of each HD session, 172<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>26<span class="elsevierStyleHsp" style=""></span>min vs 203<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>24<span class="elsevierStyleHsp" style=""></span>min at 1 year of follow-up (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001); together with an increased in the dose of dialysis based on Kt/V Daugirdas and URR; the respective calculated dose of dialysis were, 1.09<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.25 and 66<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.8 at baseline vs 1.33<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.28 and 68.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.3 at 12 months, (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.03 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.23, respectively).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">At the beginning of the study, 7 patients were receiving loop diuretics (80–40<span class="elsevierStyleHsp" style=""></span>mg furosemide); at 1 year, 5 patients with preserved residual urine output received the diuretic.</p><p id="par0110" class="elsevierStylePara elsevierViewall">Average baseline weight (kg) at pre- dialysis session was 69.6 (17), no significant change was observed after 12 months 68.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>18<span class="elsevierStyleHsp" style=""></span>kg (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.096). Average interdialyctic weight gain (kg) increased significantly during the first year from was 866<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>308 to 1313<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>741 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.033). Serum total protein levels did not change, although serum albumin concentration increased significantly at 12 months.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Blood pressure was similar at baseline as compared with 12 months; average baseline systolic blood pressure (mmHg) was 145<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>mmHg vs 151<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>14 after 12 months (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.165) and the average baseline diastolic at baseline and one year were 72<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13 vs and 67<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>20 respectively (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.243).</p><p id="par0120" class="elsevierStylePara elsevierViewall">The hemoglobin and haematocrit improved after 1 year, with no significant increase in mean dose of erythropoiesis stimulating factors (ESF), that in our case was darbepoetin (mcg/week), 27<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>21 and 30<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>22<span class="elsevierStyleHsp" style=""></span>mcg/semana; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.725.</p><p id="par0125" class="elsevierStylePara elsevierViewall">The control of seric phosphate and PTH levels improved after 1 year, but the differences were not statistically significant.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0130" class="elsevierStylePara elsevierViewall">Thrice-weekly hemodialysis sessions are generally recommended by the guidelines. In some countries, incremental twice-weekly HD regimens are considered suboptimal, while in others, with limited resources, is the only option.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">5,18,19</span></a> Preserving residual urine output is an important goal in peritoneal dialysis, however this concern is not common in haemodialysis.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">2,3,20</span></a> Both Vilar et al. and Fernández-Lucas et al. showed that patients starting on twice-weekly incremental HD had better survival and higher residual urine output than patients starting with a thrice-weekly regimen.<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1,7</span></a> Our study does not allow conclusion of patients survival. However, even with the limitation of the present work: small sample size, short follow-up, patient selection bias and absence of control group, we found that twice weekly HD helps to maintain acceptable residual kidney function for one year at least which is beneficial for patients in RRT patients.</p><p id="par0135" class="elsevierStylePara elsevierViewall">In HD patients significant RRF is associated with lower mortality irrespective of other conventional risk factors.<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">4,21</span></a> Strategies aimed at preserving RRF, such as incremental dialysis, should be consider as an option at the beginning of RRT. Lin et al., in 2009, found that patients with relatively high urine output on a twice-weekly HD regime maintained adequate dialysis parameters and the RRF is preserved for longer than those on three times a week HD.<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">14</span></a> However, there are still questions about the benefit of this strategy, particularly if it carries other potential risks, such as volume overload or infradialysis.<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">22,23</span></a> Some authors suggest the need for randomized studies comparing HD regimens, conducting trials that are large enough to support conclusions would be both complex and costly.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">5</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">There is no uniformity in how to monitor patient response to incremental HD. We rely on clinical criteria, with particular emphasis on physical examination to detect volume overload and the most widely accepted analytical parameters, such as urea clearance and residual urine output.<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1,7,24</span></a> As shown by Teruel et al.,<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">8</span></a> careful application and monitoring of incremental HD may preserve RRF as efficiently as peritoneal dialysis. In this 2013 study, the authors reported that preservation of RRF in patients undergoing incremental HD was comparable to that of patients receiving peritoneal dialysis. Recently, Kalantar-Zadeh et al. proposed a set of clinical and laboratory criteria for twice-weekly HD patients, based mainly on urine output.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">5</span></a> Although control of urine output is important, other parameters should also be considered; we, like other authors, monitor the urea clearance.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">8</span></a> We also evaluated other conventional parameters used for dialysis monitoring, and although the ultimate aim is to preserve RRF, the presence of parameters the limit explain the gradual increase the dialysis dose which is associated to a decline in RRF. Some studies have weighed up the benefits of preservation of RRF against conventional dialysis adequacy as a factor to take into account in incremental HD.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">5,25</span></a> We use conventional parameters including residual urine output to ensure dialysis dosage, even at the risk of loss of RRF.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">26</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">In our series, unlike others, furosemide is not routinely added to the treatment in patients starting on incremental HD particularly if they were already polymedicated unless if they were already taking this medication.<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">7,27</span></a> Although furosemide can improve fluid balance, some authors have shown that it does not improve RRF.<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">28</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Other aspects that should be taking into consideration to prevent loss of RRF are: improved biocompatibility of dialysis membranes, the availability of ultrapure dialysis fluids and advances made in the technology used to control dialysis sessions. All these improve dialysis tolerance and prevent factors that are potentially damaging to RRF.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">13,29,30</span></a> In 2002, McKane et al., achieved an identical decline in RRF using high-flux biocompatible dialysis vs peritoneal dialysis.<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">31</span></a> In our series, all patients were dialysed using high-flux membranes and ultrapure fluids.</p><p id="par0155" class="elsevierStylePara elsevierViewall">Instability during dialysis and episodes of hypotension can also accelerate the decline of RRF. For this reason, we limit the rate of UF to a maximum per session provided this is tolerated by the patient (no edema or other signs of volume overload). In the absence of bioimpedance measurements, even though dialysis machines are equipped with automatic volume measurement systems, we established that a persistent poorly controlled “dry” weight is a criteria for conversion to thrice-weekly HD. This limitation may have prevented us from achieving the more objective dry weight adjustment achieved by other authors, and also probably prevented us from maximizing the potential of incremental HD.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">7</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Anemia is another parameter to be considered in incremental HD. We achieved better control of hemoglobin levels, albeit using similar doses of ESF, other authors have reported lower dose requirements.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">7</span></a> Similarly, serum phosphate and PTH levels were well controlled but the difference was not statistically significant. There was a mean 1.3<span class="elsevierStyleHsp" style=""></span>kg reduction in “dry” weight over 12 months, although this was not statistically significant. Nevertheless, we did observe a slight, though significant, improvement in serum albumin levels. This could be related with a better nutritional status resulting from preserved RRF, as reported in other series.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">32</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Finally, 5 patients from our series underwent kidney transplantation; 3 were on an incremental HD regimen at the time of transplant, and although the other 2 had been changed to thrice-weekly HD, they had preserved residual urine output. Several studies have showed that residual urine output is associated with better graft survival and less graft-related urological complications, suggesting the preserving RRF could be beneficial in transplant patients. Incremental HD could predict a favorable outcome in kidney transplant patients.<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">33,34</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Limitations</span><p id="par0170" class="elsevierStylePara elsevierViewall">Retrospective design and small sample size are the main limitations. Evolution was biased by our selection of patients that met criteria for a favorable outcome, and this prevents us from extrapolating our results to other RRT populations undergoing 3 or more HD sessions per week.</p><p id="par0175" class="elsevierStylePara elsevierViewall">The characteristics of our series also prevented us from evaluating certain aspects, such as β2-microglobulin removal, or from obtaining more accurate weight calculations using methods such as bioimpedance or automated control systems. As this was not possible in our center, the lack of data on the removal of medium-sized molecules has limited the number of analysable parameters. Nevertheless, we believe that the satisfactory evolution of our patients, the generation of a clinical protocol and the experience obtained after 7 years using incremental HD provides valuable insight into this dialysis regimen.</p><p id="par0180" class="elsevierStylePara elsevierViewall">In conclusion, twice-weekly HD can preserve residual urine output, at least over the first year of treatment. RRF may contribute to better survival in kidney patients, and may also be beneficial in other contexts. The conventional criteria for dose of dialysis may not be the best for twice-weekly HD, however they should be used as there is no evidence to support the use of alternative parameters. Twice-weekly HD at the commencement of RRT demands close, careful monitoring, but certainly is a valid option in a select group of patients.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicts of interest</span><p id="par0185" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres818628" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec815678" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres818629" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec815677" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Limitations" ] 9 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-05-09" "fechaAceptado" => "2016-11-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec815678" "palabras" => array:4 [ 0 => "Incremental dialysis" 1 => "Residual diuresis" 2 => "Mortality" 3 => "Haemodialysis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec815677" "palabras" => array:4 [ 0 => "Diálisis incremental" 1 => "Diuresis residual" 2 => "Mortalidad" 3 => "Hemodiálisis" ] ] ] ] "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">The interest in the preservation of residual kidney function on starting renal replacement therapy (RRT) is very common in techniques such as peritoneal dialysis but less so in haemodialysis (HD). In our center the pattern of incremental dialysis (2<span class="elsevierStyleHsp" style=""></span>HD/week) has been an option for a group of patients. Here we share our experience with this regimen from March 2008.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We included incident patients with residual diuresis >1000<span class="elsevierStyleHsp" style=""></span>ml/24<span class="elsevierStyleHsp" style=""></span>h, clinical stability, absence of edema, absence of hyperkalaemia >6.5<span class="elsevierStyleHsp" style=""></span>mEq/l and phosphoremia >6<span class="elsevierStyleHsp" style=""></span>mg/dl, with acceptable comprehension of dietetic care. Exclusion criteria were: clinical instability, no dietary or medical compliance and the afore mentioned laboratory abnormalities.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 24 patients were included in incremental technique. The mean age at start of RRT was 60<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>15 years. The average time on incremental technique was 19<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>18 months (range: 7–80), with a mean time on dialysis of 31<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>23 months (range: 12–86). The reasons for transfer to thrice-weekly HD were: in 6 patients due to laboratory tests, in 2 patients for heart failure events, one for poor compliance and 3 for receiving a kidney graft. The residual diuresis decreased in the first year from 2106<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>606<span class="elsevierStyleHsp" style=""></span>ml/day to 1545<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>558 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.17) with the urea clearance and calculated residual renal function, basal 5.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.5 vs 3.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.9<span class="elsevierStyleHsp" style=""></span>ml/min per year (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.01) and basal 8.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.4 vs 6.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.3 per year (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.28), respectively.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Incremental HD treatment, with twice-weekly HD, may be an alternative in selected patients. This approach can largely preserve residual renal function at least for the first year. Although this pattern probably is not applicable to all patients starting RRT, it can and should be an initial alternative to consider.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El interés por preservar la función renal residual una vez iniciado un tratamiento renal sustitutivo (TRS) es notorio en técnicas como la diálisis peritoneal pero es menor en hemodiálisis (HD). En nuestro centro la pauta de diálisis incremental (2<span class="elsevierStyleHsp" style=""></span>HD/semana) ha sido una opción posible para un grupo de pacientes. Mostramos nuestra experiencia con dicha pauta desde marzo de 2008.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Incluimos a pacientes incidentes con diuresis residual >1.000<span class="elsevierStyleHsp" style=""></span>ml/24<span class="elsevierStyleHsp" style=""></span>h, estabilidad clínica, ausencia de edemas, ausencia de hiperpotasemia >6,5<span class="elsevierStyleHsp" style=""></span>mEq/l y de fosforemia >6<span class="elsevierStyleHsp" style=""></span>mg/dl, con aceptable comprensión de los cuidados dietéticos. Fueron criterios de exclusión: la inestabilidad clínica, el no cumplimiento dietético ni médico y las alteraciones analíticas referidas.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Veinticuatro pacientes han sido incluidos en la técnica incremental. La edad media al inicio de TRS fue de 60<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>15 años. El tiempo medio en técnica incremental fue de 19<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>18 meses (rango: 7-80), con una permanencia media en TRS de 31<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>23 meses (rango: 12-86). Los motivos de cambio a 3<span class="elsevierStyleHsp" style=""></span>HD/semana fueron: 6<span class="elsevierStyleHsp" style=""></span>pacientes por parámetros analíticos, 2<span class="elsevierStyleHsp" style=""></span>por episodios de insuficiencia cardiaca, uno por mal cumplimiento terapéutico y 3<span class="elsevierStyleHsp" style=""></span>por recibir un injerto renal. La diuresis residual desciende en el primer año de 2.106<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>606<span class="elsevierStyleHsp" style=""></span>ml/día a 1.545<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>558 (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,07) junto con el aclaramiento de urea y la función renal residual calculada, basal de 5,7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1,5 vs. 3,8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1,9<span class="elsevierStyleHsp" style=""></span>ml/min al año (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,01) y basal de 8,9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2,4<span class="elsevierStyleHsp" style=""></span>vs. 6,9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4,3 al año (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,28), respectivamente.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La HD incremental, con 2 sesiones de HD/semana, puede ser una alternativa en un grupo seleccionado de pacientes. Esta modalidad puede preservar la función renal residual en buena medida, al menos durante el primer año. Aunque probablemente no sea aplicable a todos los pacientes que inician TRS, puede y debe ser una alternativa inicial que considerar.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Please cite this article as: Merino JL, Domínguez P, Bueno B, Amézquita Y, Espejo B, Paraíso V. Aplicación de una pauta de hemodiálisis incremental, basada en la función renal residual, al inicio del tratamiento renal sustitutivo. Nefrologia. 2017;37:39–46.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1779 "Ancho" => 2207 "Tamanyo" => 155706 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribution of incident patients treated in the haemodialysis unit of the Hospital Universitario del Henares from July 2008 to September 2015. RRF: residual renal function; RRT: renal replacement therapy.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">AVF: arteriovenous fistula; CHF: congestive heart failure; CKD: chronic kidney disease; DM: diabetes mellitus; GN: glomerulonephritis; HD: haemodialysis; IN: interstitial nephritis; NS: nephrosclerosis; PKD: polycystic kidney disease; RRT: renal replacement therapy; VA: vascular access.</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="left" valign="top" scope="col" style="border-bottom: 2px solid black">No. \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">Age at start of RRT \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">Gender \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">Etiology of CKD \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">Initial vascular access \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">Referred from \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">Status as of September 2015 \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">Time on twice-weekly HD (weeks) \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">Time of renal replacement therapy with HD (months) \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">Reason for change of regimen \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="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Myeloma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catheter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Thrice-weekly HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Laboratory parameters \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AVF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Kidney transplant \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">IN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catheter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Thrice-weekly HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-compliance \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">DM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catheter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hospitalization \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Thrice-weekly HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CCI \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">DM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AVF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Thrice-weekly HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Laboratory parameters \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">DM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AVF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CCI \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AVF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Transplant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Kidney transplant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Laboratory parameters \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AVF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Kidney transplant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Laboratory parameters \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Unknown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AVF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Kidney transplant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Kidney transplant \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AVF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Transplant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Thrice-weekly HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Laboratory parameters \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catheter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Twice-weekly HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Continues<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</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="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PKD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AVF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Kidney transplant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Kidney transplant \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Unknown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catheter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hospitalization \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Thrice-weekly HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Laboratory parameters \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PKD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AVF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Twice-weekly HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Continues<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</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="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">DM \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Catheter \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Twice-weekly HD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Continues<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1375956.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">As of September 2015 continues on twice-weekly HD.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Characteristics and evolution of patients receiving incremental HD.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">BP: blood pressure; ESF: erythropoiesis stimulating factors; URR: urea reduction ratio; RRF: calculated residual renal function (CrCl<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>UreaC)/2.</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 \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>15 \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">p</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> \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>15 \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">p</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hemoglobin (g/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 (1.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (1.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.02</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.2 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Haematocrit (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37 (3.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.02</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37 (4.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (1.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (2.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (3.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.02</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Urea (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">203 (84) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">155 (43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">163 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.04</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Urea clearance (ml/min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.7 (1.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.2 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.8 (1.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Residual urine output (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="char" valign="top">2106 (606) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1750 (364) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1545 (558) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine clearance (ml/min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.4 (4.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.5 (4.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.3 (6.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.62 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">RRF (ml/min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.9 (2.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.5 (2.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.9 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.28 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Calcium (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.2 (0.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.6 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.6 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.06 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Phosphorus (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.9 (1.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.9 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.97 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.6 (1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.27 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total protein (g/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.3 (0.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.4 (0.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.97 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.4 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.80 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Albumin (g/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.4 (0.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.8 (0.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.05</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.8 (0.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.05</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Parathyroid hormone (pg/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">386 (224) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">440 (444) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">290 (181) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.17 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sodium (mEq/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">141 (2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">139 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">139 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.03</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Potassium (mEq/l) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.5 (0.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (0.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Kt/V Daugirdas \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.09 (0.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.24 (0.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.33 (0.28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">URR (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66 (9.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.8 (4.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68.5 (7.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.23 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dry weight (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69.6 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69.7 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.91 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68.3 (18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.09 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Duration of dialysis session (min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">172 (26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">206 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">203 (24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold"><0.01</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean systolic BP (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">145 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">153 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">151 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.16 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean diastolic BP (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.24 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean interdialytic weight gain (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">866 (308) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1306 (779) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.04</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1313 (741) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><span class="elsevierStyleBold">0.03</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ESF dose (mcg/week) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 (22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.72 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1375957.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">6-month follow-up vs baseline.</p>" ] 1 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">12-month follow-up vs baseline.</p> <p class="elsevierStyleNotepara" id="npar0020">Bold, statistical significance <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>0.05.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Dialysis and analytical parameters at baseline, 6 months and 1 year of renal replacement therapy.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib0175" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Residual renal function improves outcome in incremental haemodialysis despite reduced dialysis dose" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Vilar" 1 => "D. Wellsted" 2 => "S.M. Chandna" 3 => "R.N. Greenwood" 4 => "K. Farrington" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transpl" "fecha" => "2009" "volumen" => "24" "paginaInicial" => "2502" "paginaFinal" => "2510" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0180" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Independent effects of renal and peritoneal clearances on the mortality of peritoneal dialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.C. Szeto" 1 => "T.Y. Wong" 2 => "K.M. Chow" 3 => "C.B. Leung" 4 => "M.C. Law" 5 => "P.K. Li" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Perit Dial Int" "fecha" => "2004" "volumen" => "24" "paginaInicial" => "58" "paginaFinal" => "64" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15104337" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0185" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis: a reanalysis of the CANUSA study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.M. Bargman" 1 => "K.E. Thorpe" 2 => "D.N. Churchill" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "2001" "volumen" => "12" "paginaInicial" => "2158" "paginaFinal" => "2162" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11562415" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0190" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Residual renal function and mortality risk in hemodialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Shemin" 1 => "A.G. Bostom" 2 => "P. Laliberty" 3 => "L.D. Dworkin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/ajkd.2001.25198" "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2001" "volumen" => "38" "paginaInicial" => "85" "paginaFinal" => "90" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11431186" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0195" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Twice-weekly and incremental hemodialysis treatment for initiation of kidney replacement therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Kalantar-Zadeh" 1 => "M. Unruh" 2 => "P.G. Zager" 3 => "C.P. Kovesdy" 4 => "J.M. Bargman" 5 => "J. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.ajkd.2014.04.019" "Revista" => array:7 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2014" "volumen" => "64" "paginaInicial" => "181" "paginaFinal" => "186" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24840669" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109714023390" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0200" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of initial twice-weekly hemodialysis treatment with preservation of residual kidney function in ESRD patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Zhang" 1 => "M. Wang" 2 => "H. Li" 3 => "P. Yu" 4 => "L. Yuan" 5 => "C. Hao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000365819" "Revista" => array:6 [ "tituloSerie" => "Am J Nephrol" "fecha" => "2014" "volumen" => "40" "paginaInicial" => "140" "paginaFinal" => "150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25171342" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0205" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Maintaining residual renal function in patients on haemodialysis: 5-year experience using a progressively increasing dialysis regimen" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Fernández-Lucas" 1 => "J.L. Teruel-Briones" 2 => "A. Gomis-Couto" 3 => "J. Villacorta-Pérez" 4 => "C. Quereda-Rodríguez-Navarro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2012.Jul.11517" "Revista" => array:6 [ "tituloSerie" => "Nefrologia" "fecha" => "2012" "volumen" => "32" "paginaInicial" => "767" "paginaFinal" => "776" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23169359" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0210" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Progression of residual renal function with an increase in dialysis: haemodialysis versus peritoneal dialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Teruel-Briones" 1 => "M. Fernández-Lucas" 2 => "M. Rivera-Gorrin" 3 => "G. Ruiz-Roso" 4 => "M. Díaz-Domínguez" 5 => "N. Rodríguez-Mendiola" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2013.May.12038" "Revista" => array:6 [ "tituloSerie" => "Nefrologia" "fecha" => "2013" "volumen" => "33" "paginaInicial" => "640" "paginaFinal" => "649" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24089155" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0215" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Residual renal function: the delicate balance between benefits and risks" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B. Canaud" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transpl" "fecha" => "2008" "volumen" => "23" "paginaInicial" => "1801" "paginaFinal" => "1805" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0220" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Emerging importance of residual renal function in end-stage renal failure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Vilar" 1 => "K. Farrington" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1525-139X.2011.00968.x" "Revista" => array:6 [ "tituloSerie" => "Semin Dial" "fecha" => "2011" "volumen" => "24" "paginaInicial" => "487" "paginaFinal" => "494" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21999737" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0225" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Let us give twice-weekly hemodialysis a chance: revisiting the taboo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. Kalantar-Zadeh" 1 => "F.G. Casino" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transpl" "fecha" => "2014" "volumen" => "29" "paginaInicial" => "1618" "paginaFinal" => "1620" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0230" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of loss of residual renal function among new dialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.M. Moist" 1 => "F.K. Port" 2 => "S.M. Orzol" 3 => "E.W. Young" 4 => "T. Ostbye" 5 => "R.A. Wolfe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "2000" "volumen" => "11" "paginaInicial" => "556" "paginaFinal" => "564" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10703680" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109711021814" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0235" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of the rate of decline of residual renal function in incident dialysis patients" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "NECOSAD Study Group" "etal" => false "autores" => array:6 [ 0 => "M.A. Jansen" 1 => "A.A. Hart" 2 => "J.C. Korevaar" 3 => "F.W. Dekker" 4 => "E.W. Boeschoten" 5 => "R.T. Krediet" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1523-1755.2002.00505.x" "Revista" => array:6 [ "tituloSerie" => "Kidney Int" "fecha" => "2002" "volumen" => "62" "paginaInicial" => "1046" "paginaFinal" => "1053" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12164889" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0240" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of residual renal function in patients undergoing twice-weekly versus three-times-weekly haemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y.F. Lin" 1 => "J.W. Huang" 2 => "M.S. Wu" 3 => "T.S. Chu" 4 => "S.L. Lin" 5 => "Y.M. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrology (Carlton)" "fecha" => "2009" "volumen" => "14" "paginaInicial" => "59" "paginaFinal" => "64" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0245" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Care of the patient on hemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F.A. Gotch" 1 => "M.L. Keen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Introduction to dialysis" "paginaInicial" => "73" "paginaFinal" => "143" "serieFecha" => "1985" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0250" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Kinetic modeling in hemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F.A. Gotch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Clinical dialysis" "paginaInicial" => "118" "paginaFinal" => "146" "serieFecha" => "1992" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0255" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "National Kidney Foundation" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "titulo" => "K/DOQI clinical practice recommendations for hemodialysis adequacy. Guideline 6: preservation of residual kidney function" "tituloSerie" => "Am J Kidney Dis" "fecha" => "2006" "volumen" => "48" "numero" => "Suppl. 1" "paginaInicial" => "S68" "paginaFinal" => "S70" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0260" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infrequent dialysis: a new paradigm for hemodialysis initiation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.M. Rhee" 1 => "M. Unruh" 2 => "J. Chen" 3 => "C.P. Kovesdy" 4 => "P. Zager" 5 => "K. Kalantar-Zadeh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/sdi.12133" "Revista" => array:6 [ "tituloSerie" => "Semin Dial" "fecha" => "2013" "volumen" => "26" "paginaInicial" => "720" "paginaFinal" => "727" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24016197" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0265" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prescription of twice-weekly hemodialysis in the USA" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.A. Hanson" 1 => "T.E. Hulbert-Shearon" 2 => "A.O. Ojo" 3 => "F.K. Port" 4 => "R.A. Wolfe" 5 => "L.Y. Agodoa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "13533" "Revista" => array:6 [ "tituloSerie" => "Am J Nephrol" "fecha" => "1999" "volumen" => "19" "paginaInicial" => "625" "paginaFinal" => "633" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10592355" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0270" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Strategies for preserving residual renal function in peritoneal dialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Nongnuch" 1 => "M. Assanatham" 2 => "K. Panorchan" 3 => "A. Davenport" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ckj/sfu140" "Revista" => array:6 [ "tituloSerie" => "Clin Kidney J" "fecha" => "2015" "volumen" => "8" "paginaInicial" => "202" "paginaFinal" => "211" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25815178" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0275" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Full loss of residual renal function causes higher mortality in dialysis patients; findings from a marginal structural model" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.M. van der Wal" 1 => "M. Noordzij" 2 => "F.W. Dekker" 3 => "E.W. Boeschoten" 4 => "R.T. Krediet" 5 => "J.C. Korevaar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transpl" "fecha" => "2011" "volumen" => "26" "paginaInicial" => "2978" "paginaFinal" => "2983" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0280" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Should the preservation of residual renal function cost volume overload and its consequence left ventricular hypertrophy in new hemodialysis patients?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.I. Gunal" 1 => "E. Kirciman" 2 => "M. Guler" 3 => "M. Yavuzkir" 4 => "H. Celiker" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ren Fail" "fecha" => "2004" "volumen" => "26" "paginaInicial" => "405" "paginaFinal" => "409" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15462109" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0285" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is starting hemodialysis on a twice-weekly regimen a valid option?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Vanholder" 1 => "W. Van Biesen" 2 => "N. Lameire" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.ajkd.2014.06.003" "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2014" "volumen" => "64" "paginaInicial" => "165" "paginaFinal" => "167" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25060001" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0290" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incremental haemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Wong" 1 => "E. Vilar" 2 => "A. Davenport" 3 => "K. Farrington" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transpl" "fecha" => "2015" "volumen" => "30" "paginaInicial" => "1639" "paginaFinal" => "1648" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0295" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Equivalent continuous clearances EKR and stdK in incremental haemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Vartia" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transpl" "fecha" => "2012" "volumen" => "27" "paginaInicial" => "777" "paginaFinal" => "784" "itemHostRev" => array:3 [ "pii" => "S0735109701017272" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0300" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The equivalent renal urea clearance: a new parameter to assess dialysis dose" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F.G. Casino" 1 => "T. Lopez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transpl" "fecha" => "1996" "volumen" => "11" "paginaInicial" => "1574" "paginaFinal" => "1581" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0305" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diuretic use, residual renal function, and mortality among hemodialysis patients in the Dialysis Outcomes and Practice Pattern Study (DOPPS)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.L. Bragg-Gresham" 1 => "R.B. Fissell" 2 => "N.A. Mason" 3 => "G.R. Bailie" 4 => "B.W. Gillespie" 5 => "V. Wizemann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.ajkd.2006.12.012" "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2007" "volumen" => "49" "paginaInicial" => "426" "paginaFinal" => "431" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17336704" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0310" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Residual renal function: considerations on its importance and preservation in dialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.M. Chandna" 1 => "K. Farrington" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.0894-0959.2004.17306.x" "Revista" => array:6 [ "tituloSerie" => "Semin Dial" "fecha" => "2004" "volumen" => "17" "paginaInicial" => "196" "paginaFinal" => "201" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15144545" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0315" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "ii42-6" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How to preserve residual renal function in patients with chronic kidney disease and on dialysis?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.T. Krediet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Nephrol Dial Transpl" "fecha" => "2006" "volumen" => "21" "numero" => "Suppl. 2" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0320" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Importance of the residual renal function in hemodialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Rodríguez-Benítez" 1 => "F.J. Gómez-Campderá" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nefrologia" "fecha" => "2002" "volumen" => "22" "paginaInicial" => "98" "paginaFinal" => "103" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12085429" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0325" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identical decline of residual renal function in high-flux biocompatible hemodialysis and CAPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W. McKane" 1 => "S.M. Chandna" 2 => "J.E. Tattersall" 3 => "R.N. Greenwood" 4 => "K. Farrington" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1523-1755.2002.00098.x" "Revista" => array:7 [ "tituloSerie" => "Kidney Int" "fecha" => "2002" "volumen" => "61" "paginaInicial" => "256" "paginaFinal" => "265" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11786108" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S073510971500217X" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0330" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The contribution of residual renal function to overall nutritional status in chronic haemodialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Suda" 1 => "K. Hiroshige" 2 => "T. Ohta" 3 => "Y. Watanabe" 4 => "M. Iwamoto" 5 => "K. Kanegae" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transpl" "fecha" => "2000" "volumen" => "15" "paginaInicial" => "396" "paginaFinal" => "401" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0335" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Does daily urine output really matter in renal transplantation?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "X. Tillou" 1 => "A. Lee-Bion" 2 => "B. Hurault de Ligny" 3 => "C. Orczyk" 4 => "S. Le Gal" 5 => "A. Desmonts" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Transpl" "fecha" => "2013" "volumen" => "18" "paginaInicial" => "716" "paginaFinal" => "720" ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0340" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dialysis modality and outcomes in kidney transplant recipients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.Z. Molnar" 1 => "R. Mehrotra" 2 => "U. Duong" 3 => "S. Bunnapradist" 4 => "L.R. Lukowsky" 5 => "M. Krishnan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2215/CJN.07110711" "Revista" => array:6 [ "tituloSerie" => "Clin J Am Soc Nephrol" "fecha" => "2012" "volumen" => "7" "paginaInicial" => "332" "paginaFinal" => "341" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22156753" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003700000001/v1_201703230033/S2013251417300470/v1_201703230033/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/20132514/0000003700000001/v1_201703230033/S2013251417300470/v1_201703230033/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417300470?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 8 | 18 |
| 2024 October | 63 | 39 | 102 |
| 2024 September | 54 | 20 | 74 |
| 2024 August | 71 | 63 | 134 |
| 2024 July | 93 | 27 | 120 |
| 2024 June | 63 | 39 | 102 |
| 2024 May | 65 | 30 | 95 |
| 2024 April | 41 | 42 | 83 |
| 2024 March | 66 | 31 | 97 |
| 2024 February | 57 | 43 | 100 |
| 2024 January | 38 | 22 | 60 |
| 2023 December | 29 | 20 | 49 |
| 2023 November | 58 | 35 | 93 |
| 2023 October | 66 | 28 | 94 |
| 2023 September | 62 | 33 | 95 |
| 2023 August | 35 | 15 | 50 |
| 2023 July | 44 | 31 | 75 |
| 2023 June | 43 | 15 | 58 |
| 2023 May | 58 | 27 | 85 |
| 2023 April | 26 | 16 | 42 |
| 2023 March | 58 | 27 | 85 |
| 2023 February | 51 | 13 | 64 |
| 2023 January | 43 | 16 | 59 |
| 2022 December | 53 | 25 | 78 |
| 2022 November | 72 | 34 | 106 |
| 2022 October | 54 | 26 | 80 |
| 2022 September | 59 | 30 | 89 |
| 2022 August | 77 | 42 | 119 |
| 2022 July | 79 | 44 | 123 |
| 2022 June | 49 | 48 | 97 |
| 2022 May | 42 | 46 | 88 |
| 2022 April | 50 | 50 | 100 |
| 2022 March | 43 | 57 | 100 |
| 2022 February | 48 | 43 | 91 |
| 2022 January | 36 | 40 | 76 |
| 2021 December | 54 | 30 | 84 |
| 2021 November | 55 | 31 | 86 |
| 2021 October | 73 | 34 | 107 |
| 2021 September | 51 | 36 | 87 |
| 2021 August | 43 | 46 | 89 |
| 2021 July | 50 | 39 | 89 |
| 2021 June | 52 | 27 | 79 |
| 2021 May | 61 | 55 | 116 |
| 2021 April | 92 | 112 | 204 |
| 2021 March | 91 | 42 | 133 |
| 2021 February | 71 | 30 | 101 |
| 2021 January | 51 | 28 | 79 |
| 2020 December | 42 | 14 | 56 |
| 2020 November | 35 | 17 | 52 |
| 2020 October | 29 | 27 | 56 |
| 2020 September | 31 | 22 | 53 |
| 2020 August | 45 | 14 | 59 |
| 2020 July | 33 | 13 | 46 |
| 2020 June | 29 | 24 | 53 |
| 2020 May | 45 | 12 | 57 |
| 2020 April | 44 | 16 | 60 |
| 2020 March | 35 | 15 | 50 |
| 2020 February | 39 | 21 | 60 |
| 2020 January | 48 | 26 | 74 |
| 2019 December | 51 | 30 | 81 |
| 2019 November | 38 | 23 | 61 |
| 2019 October | 28 | 15 | 43 |
| 2019 September | 46 | 11 | 57 |
| 2019 August | 24 | 17 | 41 |
| 2019 July | 24 | 25 | 49 |
| 2019 June | 29 | 23 | 52 |
| 2019 May | 32 | 30 | 62 |
| 2019 April | 69 | 41 | 110 |
| 2019 March | 59 | 23 | 82 |
| 2019 February | 36 | 17 | 53 |
| 2019 January | 30 | 26 | 56 |
| 2018 December | 212 | 52 | 264 |
| 2018 November | 399 | 34 | 433 |
| 2018 October | 188 | 18 | 206 |
| 2018 September | 68 | 28 | 96 |
| 2018 August | 50 | 24 | 74 |
| 2018 July | 49 | 19 | 68 |
| 2018 June | 56 | 16 | 72 |
| 2018 May | 91 | 20 | 111 |
| 2018 April | 91 | 19 | 110 |
| 2018 March | 66 | 11 | 77 |
| 2018 February | 46 | 7 | 53 |
| 2018 January | 57 | 7 | 64 |
| 2017 December | 53 | 7 | 60 |
| 2017 November | 60 | 31 | 91 |
| 2017 October | 50 | 18 | 68 |
| 2017 September | 50 | 8 | 58 |
| 2017 August | 72 | 10 | 82 |
| 2017 July | 63 | 11 | 74 |
| 2017 June | 52 | 2 | 54 |
| 2017 May | 80 | 14 | 94 |
| 2017 April | 48 | 5 | 53 |
| 2017 March | 43 | 6 | 49 |
Show all
