array:24 [
  "pii" => "S2013251417300810"
  "issn" => "20132514"
  "doi" => "10.1016/j.nefroe.2017.04.009"
  "estado" => "S300"
  "fechaPublicacion" => "2017-03-01"
  "aid" => "272"
  "copyright" => "Sociedad Española de Nefrología"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "sco"
  "cita" => "Nefrologia (English Version). 2017;37:115-7"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 5327
    "formatos" => array:3 [
      "EPUB" => 354
      "HTML" => 4115
      "PDF" => 858
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S0211699516301527"
      "issn" => "02116995"
      "doi" => "10.1016/j.nefro.2016.10.001"
      "estado" => "S300"
      "fechaPublicacion" => "2017-03-01"
      "aid" => "272"
      "copyright" => "Sociedad Española de Nefrología"
      "documento" => "article"
      "crossmark" => 0
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "sco"
      "cita" => "Nefrologia. 2017;37:115-7"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 6762
        "formatos" => array:3 [
          "EPUB" => 402
          "HTML" => 5388
          "PDF" => 972
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
        "titulo" => "Alfabetizaci&#243;n en salud y enfermedad renal cr&#243;nica"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "115"
            "paginaFinal" => "117"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Health literacy and chronic kidney disease"
          ]
        ]
        "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" => 1410
                "Ancho" => 3209
                "Tamanyo" => 336160
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Modelo del concepto alfabetizaci&#243;n en salud propuesto por HLS-EU &#40;2012&#41;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a>&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Gema Costa-Requena, Francesc Moreso, M&#46; Carmen Cantarell, Daniel Ser&#243;n"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Gema"
                "apellidos" => "Costa-Requena"
              ]
              1 => array:2 [
                "nombre" => "Francesc"
                "apellidos" => "Moreso"
              ]
              2 => array:2 [
                "nombre" => "M&#46; Carmen"
                "apellidos" => "Cantarell"
              ]
              3 => array:2 [
                "nombre" => "Daniel"
                "apellidos" => "Ser&#243;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2013251417300810"
          "doi" => "10.1016/j.nefroe.2017.04.009"
          "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/S2013251417300810?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699516301527?idApp=UINPBA000064"
      "url" => "/02116995/0000003700000002/v1_201704211146/S0211699516301527/v1_201704211146/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S201325141730072X"
    "issn" => "20132514"
    "doi" => "10.1016/j.nefroe.2017.03.006"
    "estado" => "S300"
    "fechaPublicacion" => "2017-03-01"
    "aid" => "233"
    "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "ssu"
    "cita" => "Nefrologia &#40;English Version&#41;. 2017;37:118-25"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5666
      "formatos" => array:3 [
        "EPUB" => 350
        "HTML" => 4696
        "PDF" => 620
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
      "titulo" => "Role of TWEAK&#47;Fn14 signalling pathway in lupus nephritis and other clinical settings"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "118"
          "paginaFinal" => "125"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Papel de la v&#237;a de se&#241;alizaci&#243;n del TWEAK&#47;Fn14 en la nefritis l&#250;pica y otros escenarios cl&#237;nicos"
        ]
      ]
      "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" => "fig0010"
          "etiqueta" => "Fig&#46; 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1791
              "Ancho" => 3333
              "Tamanyo" => 311176
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Role of TWEAK&#47;Fn14 in lupus nephritis&#46; The binding of TWEAK to the Fn14 receptor encourages the activation of one of the 3 effector pathways&#44; depending on the type of cell stimulated&#44; the cellular microenvironment and the intracellular signalling generated&#46; IP-10&#58; interferon-gamma-inducible protein 10&#59; MAPK&#58; mitogen-activated protein kinase&#59; MCP-1&#58; monocyte chemoattractant protein type 1&#59; NF-kB&#58; nuclear factor kappa B&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Diego A&#46; Gonz&#225;lez-S&#225;nchez, Cristian M&#46; &#193;lvarez, Gloria V&#225;squez, Jos&#233; Alfredo G&#243;mez-Puerta"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Diego A&#46;"
              "apellidos" => "Gonz&#225;lez-S&#225;nchez"
            ]
            1 => array:2 [
              "nombre" => "Cristian M&#46;"
              "apellidos" => "&#193;lvarez"
            ]
            2 => array:2 [
              "nombre" => "Gloria"
              "apellidos" => "V&#225;squez"
            ]
            3 => array:2 [
              "nombre" => "Jos&#233; Alfredo"
              "apellidos" => "G&#243;mez-Puerta"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0211699516300844"
        "doi" => "10.1016/j.nefro.2016.05.020"
        "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/S0211699516300844?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S201325141730072X?idApp=UINPBA000064"
    "url" => "/20132514/0000003700000002/v1_201705250045/S201325141730072X/v1_201705250045/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Health literacy and chronic kidney disease"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "115"
        "paginaFinal" => "117"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Gema Costa-Requena, Francesc Moreso, M&#46; Carmen Cantarell, Daniel Ser&#243;n"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Gema"
            "apellidos" => "Costa-Requena"
            "email" => array:2 [
              0 => "gcosta&#64;vhebron&#46;net"
              1 => "gecostare&#64;gmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Francesc"
            "apellidos" => "Moreso"
          ]
          2 => array:2 [
            "nombre" => "M&#46;"
            "apellidos" => "Carmen Cantarell"
          ]
          3 => array:2 [
            "nombre" => "Daniel"
            "apellidos" => "Ser&#243;n"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Unidad de Psiquiatr&#237;a&#44; Hospital Universitari Vall d&#8217;Hebron&#44; Barcelona&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Alfabetizaci&#243;n en salud y enfermedad renal cr&#243;nica"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1418
            "Ancho" => 3209
            "Tamanyo" => 318654
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Model of the health literacy concept proposed by HLS-EU &#40;2012&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a></p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Around the 1970s in Canada&#44; policies to promote health began to take shape when the Ministry of Health and Welfare&#44; led by Marc Lalonde&#44; noted the public health system&#39;s inability to ensure the health of the population on its own&#44; taking into account the high costs involved and the limited results obtained with lifestyle changes&#46; Subsequently&#44; these conclusions were gathered at the First International Conference on Health Promotion &#40;1986&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">1</span></a> where the Ottawa Charter was drafted&#44; which impacted on the development of the concept of health promotion&#59; this concept &#8220;is the process of enabling people to increase control over&#44; and to improve their health&#59; considering that to reach a state of adequate physical&#44; mental and social well-being&#44; an individual or group should be able to identify and to accomplish their aspirations&#44; to satisfy needs&#44; and to change or cope with the environment&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Subsequent conferences in Adelaide &#40;1988&#41;&#44; Sundsvall &#40;1991&#41;&#44; Jakarta &#40;1997&#41;&#44; Mexico City &#40;2000&#41;&#44; Bangkok &#40;2005&#41; and Nairobi &#40;2009&#41; continued to emphasise the need to develop public policies to strengthen action and strategies aimed at making people to increase control over their health&#44; and with equity in the access to health&#44; and provide the means to enable the entire population to maximise their health potential&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Finally&#44; at the 8th Global Conference on Health Promotion held in Helsinki &#40;2013&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">2</span></a> the promotion of health was said to be a fundamental right of every human being&#44; as well as a factor that determines quality of life&#44; which encompasses physical and emotional well-being in the face of transmissible or non transmissible diseases or any other health threat&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Within this context&#44; the concept of health literacy was developed&#46; The WHO &#40;2013&#41;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">3</span></a> adopts the following definition&#44; developed by Health Literacy Europe&#39;s working group&#58; &#8220;Health literacy is based on general literacy and encompasses people&#39;s knowledge&#44; motivation and competences to access&#44; understand&#44; evaluate and apply information on health in order to make judgements and make decisions concerning healthcare&#44; disease prevention and promotion of health to maintain and improve quality of life during their life time&#46;&#8221;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Health literacy is a concept that is closely related to the capacity for effective acquisition of knowledge&#44; skills and abilities originated from health education&#44; and the autonomy to apply what has been acquired to one&#39;s own care and the care of those close to them&#46; Literacy therefore represents a new concept that refers to education on healthy behaviours&#44; and is a step prior to patient empowerment for making decisions on the management of one&#39;s own health and illness&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Considered by the WHO as a social determinant&#44; health literacy does not depend exclusively on individual capacities&#44; but on the interaction between demands on the health system and individual abilities&#44; which affect healthy habits and the effective use of the health system&#46; As a result of the project funded by the European Commission&#44; the European Health Literacy Survey &#40;HLS-EU&#44; 2012&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">4</span></a> and following a comprehensive systematic review of the use of the term literacy and related descriptions&#44; a model was proposed to define the concept of health literacy throughout life&#44; which considers three levels of action&#58; care&#44; disease prevention&#44; and health promotion&#44; to which four methods of processing relevant health information must be applied &#40;accessing&#44; understanding&#44; appraising and applying&#41;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">4&#44;6</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Thus&#44; in addition to improving patients&#8217; individual capacities&#44; it is necessary to create a physical and social environment in healthcare facilities that is accessible and easy to use&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">7</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Health literacy has a direct impact that is evident in vulnerable groups such as the elderly&#44; polymedicated patients&#44; immigrants and the chronically ill&#46; A low level of health literacy may lead to a poor understanding of information about treatments&#44; poor knowledge about chronicity and late detection of diseases&#44; as well as medication errors&#44; misuse of healthcare services and a higher rate of morbidity and hospital admissions&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">8&#8211;10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">It would therefore be worth improving the quality and accessibility of information&#44; eliminating structural barriers to provide healthcare and promoting communication skills among professionals that enhance&#44; rather than inhibit&#44; community and patient-association involvement in healthy behaviours&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">7</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Health literacy and advanced chronic kidney disease</span><p id="par0045" class="elsevierStylePara elsevierViewall">In moderate or severe renal disease&#44; the prevalence of inadequate health literacy ranges from 5&#37; to 60&#37; depending on the studies and socio-demographic variables considered&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">11&#8211;14</span></a> A systematic review&#44; which identified six studies that met the inclusion criteria &#40;a validated measurement of literacy and glomerular filtration&#41;&#44; found a combined prevalence of 23&#37; as regards inadequate health literacy in patients with advanced chronic kidney disease &#40;ACKD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">15</span></a> Low health literacy scores are associated with torpid outcomes and disease progression&#44;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">16&#44;17</span></a> with low glomerular filtration rate<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">11&#44;14</span></a> and increased likelihood of a prior clinical history of cardiovascular disorders associated with hypertension and diabetes&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">14</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In dialysis patients&#44; the highest scores in health literacy are associated with behaviours that promote adherence and lower treatment costs&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">18</span></a> The relationship between health literacy and treatment adherence is modulated by the patient&#39;s knowledge of the disease&#44; i&#46;e&#46; adequate health literacy promotes greater knowledge of kidney disease and favours adherence-to the treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">9&#44;19</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In this regard&#44; the doctor&#8211;patient relationship is both significant and relevant&#46; Some studies indicate that the knowledge about kidney failure and treatment options increases as kidney disease progresses as the number the patient&#39;s visits to his&#47;her nephrologist increase&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">20</span></a> The same study shows that integrated ACKD care systems that include psychosocial and multi-professional support &#40;Canada&#41; provide a better level of literacy than non-integrated systems &#40;USA&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In kidney transplantation&#44; between 60&#37; and 90&#37; of patients show adequate levels of health literacy&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">8&#44;21&#44;22</span></a> Improving health literacy in kidney transplant patients leads to parallel improvements in graft function&#44; while lower rates of post-transplant health literacy have been associated with higher levels of serum creatinine&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">22</span></a> Moreover&#44; patients with low levels of health literacy are less often assessed for placement on a transplant list&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">12&#44;23</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Improving health literacy in transplant patients helps to promote healthy behaviours&#44; such as adherence to immunosuppressive therapy and increased physical activity&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">16</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">In patients with chronic kidney disease&#44; interventions aimed at increasing health literacy should consider the use psychoeducation programmes that provide feedback on what has been learned&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">22</span></a> Among these programmes&#44; educational materials must be developed and disseminated to patients in relation to cardiovascular disorders and risk factors for diabetes&#44; adapted to the stage of renal disease&#46; Likewise&#44; nephrologists and healthcare professionals should be trained to detect signs of poor health literacy in patients&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">8</span></a> Particularly in patients with advanced stage of the disease literacy will help to gain knowledge on the treatment options for ACKD&#44; types of dialysis&#44; and actions to be taken before a kidney transplant&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">16&#44;22</span></a> Increasing knowledge about chronic kidney disease in relation to health literacy may improve patients&#8217; self-care capacities&#44; lead to an effective use of the health system&#44; and improve the quality of doctor-patient relationships&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">15</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">It should also be noted that health literacy depends not only on individual capacities but also on interaction with the healthcare environment&#46; This requires an interdisciplinary and multi-sector approach&#44; with interventions on patients and the general population to increase their health literacy&#44; thereby simplifying accessibility to the healthcare system in a manner that is suitable to all cultural and social contexts&#44; improving the quality of the information transmitted&#44; and surpassing the traditional schemes of health education&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">6</span></a></p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Health literacy and advanced chronic kidney disease"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Costa-Requena G&#44; Moreso F&#44; Carmen Cantarell M&#44; Ser&#243;n D&#46; Alfabetizaci&#243;n en salud y enfermedad renal cr&#243;nica&#46; Nefrolog&#237;a&#46; 2017&#59;37&#58;115&#8211;117&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1418
            "Ancho" => 3209
            "Tamanyo" => 318654
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Model of the health literacy concept proposed by HLS-EU &#40;2012&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a></p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:23 [
            0 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available in&#58; <span class="elsevierStyleInterRef" id="intr0010" href="http://www1.paho.org/spanish/HPP/OttawaCharterSp.pdf">http&#58;&#47;&#47;www1&#46;paho&#46;org&#47;spanish&#47;HPP&#47;OttawaCharterSp&#46;pdf</span> &#91;accessed 08&#46;07&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Conferencia Internacional auspiciada por la OMS y la Asociaci&#243;n Canadiense de Salud P&#250;blica&#46; Canad&#225;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Carta de Ottawa para la promoci&#243;n de salud"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "1986"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available in&#58; <span class="elsevierStyleInterRef" id="intr0015" href="http://www.healthpromotion2013.org/images/8GCHP%20_Helsinki_Statement.pdf">http&#58;&#47;&#47;www&#46;healthpromotion2013&#46;org&#47;images&#47;8GCHP &#95;Helsinki&#95;Statement&#46;pdf</span> &#91;accessed 08&#46;07&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "8&#170; Conferencia Mundial de Promoci&#243;n de la Salud&#46; Helsinki"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Organizaci&#243;n Mundial de la Salud"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Organizaci&#243;n Mundial de la Salud"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "Health literacy&#58; the solid facts"
                        "serieFecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HLS-EU Consortium Health Literacy Project European&#46; Health literacy and public health&#58; a systematic review and integration of definitions and models"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46; S&#248;rensen"
                            1 => "S&#46; van den Broucke"
                            2 => "J&#46; Fullam"
                            3 => "G&#46; Doyle"
                            4 => "J&#46; Pelikan"
                            5 => "Z&#46; Slonska"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2458-12-80"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2012"
                        "volumen" => "12"
                        "paginaInicial" => "80"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22276600"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available in&#58; <span class="elsevierStyleInterRef" id="intr0020" href="http://www.salupedia.org/alfabetizacion">http&#58;&#47;&#47;www&#46;salupedia&#46;org&#47;alfabetizacion</span> &#91;accessed 11&#46;07&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alfabetizaci&#243;n en salud&#46; De la informaci&#243;n a la acci&#243;n"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "I&#46; Basagoiti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "El paciente y la alfabetizaci&#243;n en salud"
                        "paginaInicial" => "65"
                        "paginaFinal" => "96"
                        "serieFecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alfabetizaci&#243;n en salud&#59; concepto y dimensiones&#46; Proyecto Europeo de Alfabetizaci&#243;n en Salud"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Falc&#243;n"
                            1 => "A&#46; Luna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "RCyS"
                        "fecha" => "2012"
                        "volumen" => "2"
                        "paginaInicial" => "91"
                        "paginaFinal" => "98"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "On health literacy and health outcomes&#58; background&#44; impact and future directions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;E&#46; Rudd"
                            1 => "O&#46;R&#46; Groene"
                            2 => "M&#46;D&#46; Navarro-Rubio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cali.2013.03.003"
                      "Revista" => array:7 [
                        "tituloSerie" => "Rev Calid Asist"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "188"
                        "paginaFinal" => "192"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23684050"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674908019210"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing health literacy in renal failure and kidney transplant patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46; Escobedo"
                            1 => "P&#46; Weismuller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7182/pit2013473"
                      "Revista" => array:6 [
                        "tituloSerie" => "Prog Transplant"
                        "fecha" => "2013"
                        "volumen" => "23"
                        "paginaInicial" => "47"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23448820"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy and knowledge of chronic disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;A&#46; Gazmararian"
                            1 => "M&#46;V&#46; Williams"
                            2 => "J&#46; Peel"
                            3 => "D&#46;W&#46; Baker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Patient Educ Couns"
                        "fecha" => "2003"
                        "volumen" => "51"
                        "paginaInicial" => "267"
                        "paginaFinal" => "275"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14630383"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low health literacy and health outcomes&#58; an updated systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "N&#46;D&#46; Berkman"
                            1 => "S&#46;L&#46; Sheridan"
                            2 => "K&#46;E&#46; Donahue"
                            3 => "D&#46;J&#46; Halpem"
                            4 => "K&#46; Crotty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7326/0003-4819-155-2-201107190-00005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2011"
                        "volumen" => "155"
                        "paginaInicial" => "97"
                        "paginaFinal" => "107"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21768583"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship between health literacy and kidney function"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Devraj"
                            1 => "M&#46; Borrego"
                            2 => "A&#46;M&#46; Vilay"
                            3 => "E&#46;J&#46; Gordon"
                            4 => "J&#46; Pailden"
                            5 => "B&#46; Horowitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/nep.12425"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrology &#40;Carlton&#41;"
                        "fecha" => "2015"
                        "volumen" => "20"
                        "paginaInicial" => "360"
                        "paginaFinal" => "367"
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674910018555"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy and access to kidney transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46; Grubbs"
                            1 => "S&#46;E&#46; Gregorich"
                            2 => "E&#46;J&#46; Perez-Stable"
                            3 => "C&#46;Y&#46; Hsu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2215/CJN.03290708"
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin J Am Soc Nephrol"
                        "fecha" => "2009"
                        "volumen" => "4"
                        "paginaInicial" => "195"
                        "paginaFinal" => "200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19056617"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1081120613009034"
                          "estado" => "S300"
                          "issn" => "10811206"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A cross-sectional comparison of health literacy deficits among patients with chronic disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Lambert"
                            1 => "J&#46; Mullan"
                            2 => "K&#46; Mansfield"
                            3 => "M&#46; Lonergan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/10810730.2015.1080329"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Health Commun"
                        "fecha" => "2015"
                        "volumen" => "20"
                        "paginaInicial" => "16"
                        "paginaFinal" => "23"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26513027"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Limited health literacy is associated with low glomerular filtration in the Chronic Renal Insufficiency Cohort &#40;CRIC&#41; study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;C&#46; Ricardo"
                            1 => "W&#46; Yang"
                            2 => "C&#46;M&#46; Lora"
                            3 => "E&#46;J&#46; Gordon"
                            4 => "C&#46;J&#46; Diamantidis"
                            5 => "V&#46; Ford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5414/CN108062"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nephrol"
                        "fecha" => "2014"
                        "volumen" => "81"
                        "paginaInicial" => "30"
                        "paginaFinal" => "37"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24219913"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and associations of limited health literacy in chronic kidney disease&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;D&#46;S&#46; Frasen"
                            1 => "P&#46;J&#46; Roderick"
                            2 => "M&#46; Casey"
                            3 => "M&#46;W&#46; Taal"
                            4 => "H&#46;M&#46; Yuen"
                            5 => "D&#46; Nuthbeam"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ndt/gfs371"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrol Dial Transplant"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "129"
                        "paginaFinal" => "137"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23222414"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy and kidney disease&#58; toward a new line of research"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Devraj"
                            1 => "E&#46;J&#46; Gordon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.ajkd.2008.12.028"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Kidney Dis"
                        "fecha" => "2009"
                        "volumen" => "53"
                        "paginaInicial" => "884"
                        "paginaFinal" => "889"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19324481"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0022347608010342"
                          "estado" => "S300"
                          "issn" => "00223476"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy in kidney disease&#58; review of the literature and implications for clinical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Jan"
                            1 => "J&#46;A&#46; Green"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5527/wjn.v5.i2.147"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Nephrol"
                        "fecha" => "2016"
                        "volumen" => "5"
                        "paginaInicial" => "147"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26981438"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Associations of health literacy with dialysis adherence and health resource utilization in patients receiving maintenance hemodialysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Green"
                            1 => "M&#46;K&#46; Mor"
                            2 => "A&#46;M&#46; Shields"
                            3 => "M&#46;A&#46; Sevick"
                            4 => "R&#46;M&#46; Arnold"
                            5 => "P&#46;M&#46; Palevsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.ajkd.2012.12.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Kidney Dis"
                        "fecha" => "2013"
                        "volumen" => "62"
                        "paginaInicial" => "73"
                        "paginaFinal" => "80"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23352380"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health Literacy and medical adherence in hemodialysis patients&#58; the mediating role of disease-specific knowledge"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Quobadi"
                            1 => "M&#46;A&#46; Besharat"
                            2 => "R&#46; Rostami"
                            3 => "A&#46; Rahiminezhad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5812/thrita.26195"
                      "Revista" => array:5 [
                        "tituloSerie" => "Thrita"
                        "fecha" => "2015"
                        "volumen" => "4"
                        "paginaInicial" => "e26195"
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674913005289"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perceived knowledge among patients cared for by nephrologists about chronic kidney disease and end-stage renal disease therapies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;O&#46; Finkelstein"
                            1 => "K&#46; Story"
                            2 => "C&#46; Firanek"
                            3 => "P&#46; Barre"
                            4 => "T&#46; Takano"
                            5 => "S&#46; Soroka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ki.2008.376"
                      "Revista" => array:7 [
                        "tituloSerie" => "Kidney Int"
                        "fecha" => "2008"
                        "volumen" => "74"
                        "paginaInicial" => "1178"
                        "paginaFinal" => "1184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18668024"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674913003230"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Understanding patients barriers to kidney transplant evaluation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;A&#46; Dageforde"
                            1 => "A&#46; Box"
                            2 => "I&#46;D&#46; Feurer"
                            3 => "K&#46;L&#46; Cavanaugh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Transplantation"
                        "fecha" => "2015"
                        "volumen" => "29"
                        "paginaInicial" => "1463"
                        "paginaFinal" => "1469"
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674911029423"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy skills of kidney transplant recipients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;J&#46; Gordon"
                            1 => "M&#46;S&#46; Wolf"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7182/prtr.19.1.qnj8621040488u52"
                      "Revista" => array:6 [
                        "tituloSerie" => "Prog Transplant"
                        "fecha" => "2009"
                        "volumen" => "19"
                        "paginaInicial" => "25"
                        "paginaFinal" => "34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19341060"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy and kidney transplant outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;S&#46; Kazley"
                            1 => "J&#46;J&#46; Hund"
                            2 => "K&#46;N&#46; Simpson"
                            3 => "K&#46; Chavin"
                            4 => "P&#46; Baliga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7182/pit2015463"
                      "Revista" => array:6 [
                        "tituloSerie" => "Prog Transplant"
                        "fecha" => "2015"
                        "volumen" => "25"
                        "paginaInicial" => "85"
                        "paginaFinal" => "90"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25758806"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003700000002/v1_201705250045/S2013251417300810/v1_201705250045/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "38706"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Editorial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003700000002/v1_201705250045/S2013251417300810/v1_201705250045/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417300810?idApp=UINPBA000064"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Editorial
Health literacy and chronic kidney disease
Alfabetización en salud y enfermedad renal crónica
Gema Costa-Requena
Corresponding author
, Francesc Moreso, M. Carmen Cantarell, Daniel Serón
Unidad de Psiquiatría, Hospital Universitari Vall d’Hebron, Barcelona, Spain
Read
10401
Times
was read the article
2889
Total PDF
7512
Total HTML
Share statistics
 array:24 [
  "pii" => "S2013251417300810"
  "issn" => "20132514"
  "doi" => "10.1016/j.nefroe.2017.04.009"
  "estado" => "S300"
  "fechaPublicacion" => "2017-03-01"
  "aid" => "272"
  "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "sco"
  "cita" => "Nefrologia &#40;English Version&#41;. 2017;37:115-7"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 5327
    "formatos" => array:3 [
      "EPUB" => 354
      "HTML" => 4115
      "PDF" => 858
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S0211699516301527"
      "issn" => "02116995"
      "doi" => "10.1016/j.nefro.2016.10.001"
      "estado" => "S300"
      "fechaPublicacion" => "2017-03-01"
      "aid" => "272"
      "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
      "documento" => "article"
      "crossmark" => 0
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "sco"
      "cita" => "Nefrologia. 2017;37:115-7"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 6762
        "formatos" => array:3 [
          "EPUB" => 402
          "HTML" => 5388
          "PDF" => 972
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
        "titulo" => "Alfabetizaci&#243;n en salud y enfermedad renal cr&#243;nica"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "115"
            "paginaFinal" => "117"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Health literacy and chronic kidney disease"
          ]
        ]
        "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" => 1410
                "Ancho" => 3209
                "Tamanyo" => 336160
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Modelo del concepto alfabetizaci&#243;n en salud propuesto por HLS-EU &#40;2012&#41;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a>&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Gema Costa-Requena, Francesc Moreso, M&#46; Carmen Cantarell, Daniel Ser&#243;n"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Gema"
                "apellidos" => "Costa-Requena"
              ]
              1 => array:2 [
                "nombre" => "Francesc"
                "apellidos" => "Moreso"
              ]
              2 => array:2 [
                "nombre" => "M&#46; Carmen"
                "apellidos" => "Cantarell"
              ]
              3 => array:2 [
                "nombre" => "Daniel"
                "apellidos" => "Ser&#243;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2013251417300810"
          "doi" => "10.1016/j.nefroe.2017.04.009"
          "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/S2013251417300810?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699516301527?idApp=UINPBA000064"
      "url" => "/02116995/0000003700000002/v1_201704211146/S0211699516301527/v1_201704211146/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S201325141730072X"
    "issn" => "20132514"
    "doi" => "10.1016/j.nefroe.2017.03.006"
    "estado" => "S300"
    "fechaPublicacion" => "2017-03-01"
    "aid" => "233"
    "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "ssu"
    "cita" => "Nefrologia &#40;English Version&#41;. 2017;37:118-25"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5666
      "formatos" => array:3 [
        "EPUB" => 350
        "HTML" => 4696
        "PDF" => 620
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
      "titulo" => "Role of TWEAK&#47;Fn14 signalling pathway in lupus nephritis and other clinical settings"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "118"
          "paginaFinal" => "125"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Papel de la v&#237;a de se&#241;alizaci&#243;n del TWEAK&#47;Fn14 en la nefritis l&#250;pica y otros escenarios cl&#237;nicos"
        ]
      ]
      "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" => "fig0010"
          "etiqueta" => "Fig&#46; 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1791
              "Ancho" => 3333
              "Tamanyo" => 311176
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Role of TWEAK&#47;Fn14 in lupus nephritis&#46; The binding of TWEAK to the Fn14 receptor encourages the activation of one of the 3 effector pathways&#44; depending on the type of cell stimulated&#44; the cellular microenvironment and the intracellular signalling generated&#46; IP-10&#58; interferon-gamma-inducible protein 10&#59; MAPK&#58; mitogen-activated protein kinase&#59; MCP-1&#58; monocyte chemoattractant protein type 1&#59; NF-kB&#58; nuclear factor kappa B&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Diego A&#46; Gonz&#225;lez-S&#225;nchez, Cristian M&#46; &#193;lvarez, Gloria V&#225;squez, Jos&#233; Alfredo G&#243;mez-Puerta"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Diego A&#46;"
              "apellidos" => "Gonz&#225;lez-S&#225;nchez"
            ]
            1 => array:2 [
              "nombre" => "Cristian M&#46;"
              "apellidos" => "&#193;lvarez"
            ]
            2 => array:2 [
              "nombre" => "Gloria"
              "apellidos" => "V&#225;squez"
            ]
            3 => array:2 [
              "nombre" => "Jos&#233; Alfredo"
              "apellidos" => "G&#243;mez-Puerta"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0211699516300844"
        "doi" => "10.1016/j.nefro.2016.05.020"
        "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/S0211699516300844?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S201325141730072X?idApp=UINPBA000064"
    "url" => "/20132514/0000003700000002/v1_201705250045/S201325141730072X/v1_201705250045/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Health literacy and chronic kidney disease"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "115"
        "paginaFinal" => "117"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Gema Costa-Requena, Francesc Moreso, M&#46; Carmen Cantarell, Daniel Ser&#243;n"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Gema"
            "apellidos" => "Costa-Requena"
            "email" => array:2 [
              0 => "gcosta&#64;vhebron&#46;net"
              1 => "gecostare&#64;gmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Francesc"
            "apellidos" => "Moreso"
          ]
          2 => array:2 [
            "nombre" => "M&#46;"
            "apellidos" => "Carmen Cantarell"
          ]
          3 => array:2 [
            "nombre" => "Daniel"
            "apellidos" => "Ser&#243;n"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Unidad de Psiquiatr&#237;a&#44; Hospital Universitari Vall d&#8217;Hebron&#44; Barcelona&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Alfabetizaci&#243;n en salud y enfermedad renal cr&#243;nica"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1418
            "Ancho" => 3209
            "Tamanyo" => 318654
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Model of the health literacy concept proposed by HLS-EU &#40;2012&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a></p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Around the 1970s in Canada&#44; policies to promote health began to take shape when the Ministry of Health and Welfare&#44; led by Marc Lalonde&#44; noted the public health system&#39;s inability to ensure the health of the population on its own&#44; taking into account the high costs involved and the limited results obtained with lifestyle changes&#46; Subsequently&#44; these conclusions were gathered at the First International Conference on Health Promotion &#40;1986&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">1</span></a> where the Ottawa Charter was drafted&#44; which impacted on the development of the concept of health promotion&#59; this concept &#8220;is the process of enabling people to increase control over&#44; and to improve their health&#59; considering that to reach a state of adequate physical&#44; mental and social well-being&#44; an individual or group should be able to identify and to accomplish their aspirations&#44; to satisfy needs&#44; and to change or cope with the environment&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Subsequent conferences in Adelaide &#40;1988&#41;&#44; Sundsvall &#40;1991&#41;&#44; Jakarta &#40;1997&#41;&#44; Mexico City &#40;2000&#41;&#44; Bangkok &#40;2005&#41; and Nairobi &#40;2009&#41; continued to emphasise the need to develop public policies to strengthen action and strategies aimed at making people to increase control over their health&#44; and with equity in the access to health&#44; and provide the means to enable the entire population to maximise their health potential&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Finally&#44; at the 8th Global Conference on Health Promotion held in Helsinki &#40;2013&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">2</span></a> the promotion of health was said to be a fundamental right of every human being&#44; as well as a factor that determines quality of life&#44; which encompasses physical and emotional well-being in the face of transmissible or non transmissible diseases or any other health threat&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Within this context&#44; the concept of health literacy was developed&#46; The WHO &#40;2013&#41;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">3</span></a> adopts the following definition&#44; developed by Health Literacy Europe&#39;s working group&#58; &#8220;Health literacy is based on general literacy and encompasses people&#39;s knowledge&#44; motivation and competences to access&#44; understand&#44; evaluate and apply information on health in order to make judgements and make decisions concerning healthcare&#44; disease prevention and promotion of health to maintain and improve quality of life during their life time&#46;&#8221;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Health literacy is a concept that is closely related to the capacity for effective acquisition of knowledge&#44; skills and abilities originated from health education&#44; and the autonomy to apply what has been acquired to one&#39;s own care and the care of those close to them&#46; Literacy therefore represents a new concept that refers to education on healthy behaviours&#44; and is a step prior to patient empowerment for making decisions on the management of one&#39;s own health and illness&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Considered by the WHO as a social determinant&#44; health literacy does not depend exclusively on individual capacities&#44; but on the interaction between demands on the health system and individual abilities&#44; which affect healthy habits and the effective use of the health system&#46; As a result of the project funded by the European Commission&#44; the European Health Literacy Survey &#40;HLS-EU&#44; 2012&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">4</span></a> and following a comprehensive systematic review of the use of the term literacy and related descriptions&#44; a model was proposed to define the concept of health literacy throughout life&#44; which considers three levels of action&#58; care&#44; disease prevention&#44; and health promotion&#44; to which four methods of processing relevant health information must be applied &#40;accessing&#44; understanding&#44; appraising and applying&#41;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">4&#44;6</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Thus&#44; in addition to improving patients&#8217; individual capacities&#44; it is necessary to create a physical and social environment in healthcare facilities that is accessible and easy to use&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">7</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Health literacy has a direct impact that is evident in vulnerable groups such as the elderly&#44; polymedicated patients&#44; immigrants and the chronically ill&#46; A low level of health literacy may lead to a poor understanding of information about treatments&#44; poor knowledge about chronicity and late detection of diseases&#44; as well as medication errors&#44; misuse of healthcare services and a higher rate of morbidity and hospital admissions&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">8&#8211;10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">It would therefore be worth improving the quality and accessibility of information&#44; eliminating structural barriers to provide healthcare and promoting communication skills among professionals that enhance&#44; rather than inhibit&#44; community and patient-association involvement in healthy behaviours&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">7</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Health literacy and advanced chronic kidney disease</span><p id="par0045" class="elsevierStylePara elsevierViewall">In moderate or severe renal disease&#44; the prevalence of inadequate health literacy ranges from 5&#37; to 60&#37; depending on the studies and socio-demographic variables considered&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">11&#8211;14</span></a> A systematic review&#44; which identified six studies that met the inclusion criteria &#40;a validated measurement of literacy and glomerular filtration&#41;&#44; found a combined prevalence of 23&#37; as regards inadequate health literacy in patients with advanced chronic kidney disease &#40;ACKD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">15</span></a> Low health literacy scores are associated with torpid outcomes and disease progression&#44;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">16&#44;17</span></a> with low glomerular filtration rate<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">11&#44;14</span></a> and increased likelihood of a prior clinical history of cardiovascular disorders associated with hypertension and diabetes&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">14</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In dialysis patients&#44; the highest scores in health literacy are associated with behaviours that promote adherence and lower treatment costs&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">18</span></a> The relationship between health literacy and treatment adherence is modulated by the patient&#39;s knowledge of the disease&#44; i&#46;e&#46; adequate health literacy promotes greater knowledge of kidney disease and favours adherence-to the treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">9&#44;19</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In this regard&#44; the doctor&#8211;patient relationship is both significant and relevant&#46; Some studies indicate that the knowledge about kidney failure and treatment options increases as kidney disease progresses as the number the patient&#39;s visits to his&#47;her nephrologist increase&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">20</span></a> The same study shows that integrated ACKD care systems that include psychosocial and multi-professional support &#40;Canada&#41; provide a better level of literacy than non-integrated systems &#40;USA&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In kidney transplantation&#44; between 60&#37; and 90&#37; of patients show adequate levels of health literacy&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">8&#44;21&#44;22</span></a> Improving health literacy in kidney transplant patients leads to parallel improvements in graft function&#44; while lower rates of post-transplant health literacy have been associated with higher levels of serum creatinine&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">22</span></a> Moreover&#44; patients with low levels of health literacy are less often assessed for placement on a transplant list&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">12&#44;23</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Improving health literacy in transplant patients helps to promote healthy behaviours&#44; such as adherence to immunosuppressive therapy and increased physical activity&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">16</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">In patients with chronic kidney disease&#44; interventions aimed at increasing health literacy should consider the use psychoeducation programmes that provide feedback on what has been learned&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">22</span></a> Among these programmes&#44; educational materials must be developed and disseminated to patients in relation to cardiovascular disorders and risk factors for diabetes&#44; adapted to the stage of renal disease&#46; Likewise&#44; nephrologists and healthcare professionals should be trained to detect signs of poor health literacy in patients&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">8</span></a> Particularly in patients with advanced stage of the disease literacy will help to gain knowledge on the treatment options for ACKD&#44; types of dialysis&#44; and actions to be taken before a kidney transplant&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">16&#44;22</span></a> Increasing knowledge about chronic kidney disease in relation to health literacy may improve patients&#8217; self-care capacities&#44; lead to an effective use of the health system&#44; and improve the quality of doctor-patient relationships&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">15</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">It should also be noted that health literacy depends not only on individual capacities but also on interaction with the healthcare environment&#46; This requires an interdisciplinary and multi-sector approach&#44; with interventions on patients and the general population to increase their health literacy&#44; thereby simplifying accessibility to the healthcare system in a manner that is suitable to all cultural and social contexts&#44; improving the quality of the information transmitted&#44; and surpassing the traditional schemes of health education&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">6</span></a></p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Health literacy and advanced chronic kidney disease"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Costa-Requena G&#44; Moreso F&#44; Carmen Cantarell M&#44; Ser&#243;n D&#46; Alfabetizaci&#243;n en salud y enfermedad renal cr&#243;nica&#46; Nefrolog&#237;a&#46; 2017&#59;37&#58;115&#8211;117&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1418
            "Ancho" => 3209
            "Tamanyo" => 318654
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Model of the health literacy concept proposed by HLS-EU &#40;2012&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a></p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:23 [
            0 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available in&#58; <span class="elsevierStyleInterRef" id="intr0010" href="http://www1.paho.org/spanish/HPP/OttawaCharterSp.pdf">http&#58;&#47;&#47;www1&#46;paho&#46;org&#47;spanish&#47;HPP&#47;OttawaCharterSp&#46;pdf</span> &#91;accessed 08&#46;07&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Conferencia Internacional auspiciada por la OMS y la Asociaci&#243;n Canadiense de Salud P&#250;blica&#46; Canad&#225;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Carta de Ottawa para la promoci&#243;n de salud"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "1986"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available in&#58; <span class="elsevierStyleInterRef" id="intr0015" href="http://www.healthpromotion2013.org/images/8GCHP%20_Helsinki_Statement.pdf">http&#58;&#47;&#47;www&#46;healthpromotion2013&#46;org&#47;images&#47;8GCHP &#95;Helsinki&#95;Statement&#46;pdf</span> &#91;accessed 08&#46;07&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "8&#170; Conferencia Mundial de Promoci&#243;n de la Salud&#46; Helsinki"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Organizaci&#243;n Mundial de la Salud"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Organizaci&#243;n Mundial de la Salud"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "Health literacy&#58; the solid facts"
                        "serieFecha" => "2013"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HLS-EU Consortium Health Literacy Project European&#46; Health literacy and public health&#58; a systematic review and integration of definitions and models"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46; S&#248;rensen"
                            1 => "S&#46; van den Broucke"
                            2 => "J&#46; Fullam"
                            3 => "G&#46; Doyle"
                            4 => "J&#46; Pelikan"
                            5 => "Z&#46; Slonska"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2458-12-80"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Public Health"
                        "fecha" => "2012"
                        "volumen" => "12"
                        "paginaInicial" => "80"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22276600"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available in&#58; <span class="elsevierStyleInterRef" id="intr0020" href="http://www.salupedia.org/alfabetizacion">http&#58;&#47;&#47;www&#46;salupedia&#46;org&#47;alfabetizacion</span> &#91;accessed 11&#46;07&#46;16&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alfabetizaci&#243;n en salud&#46; De la informaci&#243;n a la acci&#243;n"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "I&#46; Basagoiti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "El paciente y la alfabetizaci&#243;n en salud"
                        "paginaInicial" => "65"
                        "paginaFinal" => "96"
                        "serieFecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alfabetizaci&#243;n en salud&#59; concepto y dimensiones&#46; Proyecto Europeo de Alfabetizaci&#243;n en Salud"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Falc&#243;n"
                            1 => "A&#46; Luna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "RCyS"
                        "fecha" => "2012"
                        "volumen" => "2"
                        "paginaInicial" => "91"
                        "paginaFinal" => "98"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "On health literacy and health outcomes&#58; background&#44; impact and future directions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;E&#46; Rudd"
                            1 => "O&#46;R&#46; Groene"
                            2 => "M&#46;D&#46; Navarro-Rubio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.cali.2013.03.003"
                      "Revista" => array:7 [
                        "tituloSerie" => "Rev Calid Asist"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "188"
                        "paginaFinal" => "192"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23684050"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674908019210"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing health literacy in renal failure and kidney transplant patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46; Escobedo"
                            1 => "P&#46; Weismuller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7182/pit2013473"
                      "Revista" => array:6 [
                        "tituloSerie" => "Prog Transplant"
                        "fecha" => "2013"
                        "volumen" => "23"
                        "paginaInicial" => "47"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23448820"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy and knowledge of chronic disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;A&#46; Gazmararian"
                            1 => "M&#46;V&#46; Williams"
                            2 => "J&#46; Peel"
                            3 => "D&#46;W&#46; Baker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Patient Educ Couns"
                        "fecha" => "2003"
                        "volumen" => "51"
                        "paginaInicial" => "267"
                        "paginaFinal" => "275"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14630383"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low health literacy and health outcomes&#58; an updated systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "N&#46;D&#46; Berkman"
                            1 => "S&#46;L&#46; Sheridan"
                            2 => "K&#46;E&#46; Donahue"
                            3 => "D&#46;J&#46; Halpem"
                            4 => "K&#46; Crotty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7326/0003-4819-155-2-201107190-00005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2011"
                        "volumen" => "155"
                        "paginaInicial" => "97"
                        "paginaFinal" => "107"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21768583"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship between health literacy and kidney function"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Devraj"
                            1 => "M&#46; Borrego"
                            2 => "A&#46;M&#46; Vilay"
                            3 => "E&#46;J&#46; Gordon"
                            4 => "J&#46; Pailden"
                            5 => "B&#46; Horowitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/nep.12425"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrology &#40;Carlton&#41;"
                        "fecha" => "2015"
                        "volumen" => "20"
                        "paginaInicial" => "360"
                        "paginaFinal" => "367"
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674910018555"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy and access to kidney transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46; Grubbs"
                            1 => "S&#46;E&#46; Gregorich"
                            2 => "E&#46;J&#46; Perez-Stable"
                            3 => "C&#46;Y&#46; Hsu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2215/CJN.03290708"
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin J Am Soc Nephrol"
                        "fecha" => "2009"
                        "volumen" => "4"
                        "paginaInicial" => "195"
                        "paginaFinal" => "200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19056617"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1081120613009034"
                          "estado" => "S300"
                          "issn" => "10811206"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A cross-sectional comparison of health literacy deficits among patients with chronic disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Lambert"
                            1 => "J&#46; Mullan"
                            2 => "K&#46; Mansfield"
                            3 => "M&#46; Lonergan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/10810730.2015.1080329"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Health Commun"
                        "fecha" => "2015"
                        "volumen" => "20"
                        "paginaInicial" => "16"
                        "paginaFinal" => "23"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26513027"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Limited health literacy is associated with low glomerular filtration in the Chronic Renal Insufficiency Cohort &#40;CRIC&#41; study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;C&#46; Ricardo"
                            1 => "W&#46; Yang"
                            2 => "C&#46;M&#46; Lora"
                            3 => "E&#46;J&#46; Gordon"
                            4 => "C&#46;J&#46; Diamantidis"
                            5 => "V&#46; Ford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5414/CN108062"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Nephrol"
                        "fecha" => "2014"
                        "volumen" => "81"
                        "paginaInicial" => "30"
                        "paginaFinal" => "37"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24219913"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and associations of limited health literacy in chronic kidney disease&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;D&#46;S&#46; Frasen"
                            1 => "P&#46;J&#46; Roderick"
                            2 => "M&#46; Casey"
                            3 => "M&#46;W&#46; Taal"
                            4 => "H&#46;M&#46; Yuen"
                            5 => "D&#46; Nuthbeam"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ndt/gfs371"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrol Dial Transplant"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "129"
                        "paginaFinal" => "137"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23222414"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy and kidney disease&#58; toward a new line of research"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Devraj"
                            1 => "E&#46;J&#46; Gordon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.ajkd.2008.12.028"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Kidney Dis"
                        "fecha" => "2009"
                        "volumen" => "53"
                        "paginaInicial" => "884"
                        "paginaFinal" => "889"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19324481"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0022347608010342"
                          "estado" => "S300"
                          "issn" => "00223476"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy in kidney disease&#58; review of the literature and implications for clinical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Jan"
                            1 => "J&#46;A&#46; Green"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5527/wjn.v5.i2.147"
                      "Revista" => array:6 [
                        "tituloSerie" => "World J Nephrol"
                        "fecha" => "2016"
                        "volumen" => "5"
                        "paginaInicial" => "147"
                        "paginaFinal" => "151"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26981438"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Associations of health literacy with dialysis adherence and health resource utilization in patients receiving maintenance hemodialysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Green"
                            1 => "M&#46;K&#46; Mor"
                            2 => "A&#46;M&#46; Shields"
                            3 => "M&#46;A&#46; Sevick"
                            4 => "R&#46;M&#46; Arnold"
                            5 => "P&#46;M&#46; Palevsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.ajkd.2012.12.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Kidney Dis"
                        "fecha" => "2013"
                        "volumen" => "62"
                        "paginaInicial" => "73"
                        "paginaFinal" => "80"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23352380"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health Literacy and medical adherence in hemodialysis patients&#58; the mediating role of disease-specific knowledge"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Quobadi"
                            1 => "M&#46;A&#46; Besharat"
                            2 => "R&#46; Rostami"
                            3 => "A&#46; Rahiminezhad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5812/thrita.26195"
                      "Revista" => array:5 [
                        "tituloSerie" => "Thrita"
                        "fecha" => "2015"
                        "volumen" => "4"
                        "paginaInicial" => "e26195"
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674913005289"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perceived knowledge among patients cared for by nephrologists about chronic kidney disease and end-stage renal disease therapies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;O&#46; Finkelstein"
                            1 => "K&#46; Story"
                            2 => "C&#46; Firanek"
                            3 => "P&#46; Barre"
                            4 => "T&#46; Takano"
                            5 => "S&#46; Soroka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/ki.2008.376"
                      "Revista" => array:7 [
                        "tituloSerie" => "Kidney Int"
                        "fecha" => "2008"
                        "volumen" => "74"
                        "paginaInicial" => "1178"
                        "paginaFinal" => "1184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18668024"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674913003230"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Understanding patients barriers to kidney transplant evaluation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;A&#46; Dageforde"
                            1 => "A&#46; Box"
                            2 => "I&#46;D&#46; Feurer"
                            3 => "K&#46;L&#46; Cavanaugh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Transplantation"
                        "fecha" => "2015"
                        "volumen" => "29"
                        "paginaInicial" => "1463"
                        "paginaFinal" => "1469"
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674911029423"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy skills of kidney transplant recipients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;J&#46; Gordon"
                            1 => "M&#46;S&#46; Wolf"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7182/prtr.19.1.qnj8621040488u52"
                      "Revista" => array:6 [
                        "tituloSerie" => "Prog Transplant"
                        "fecha" => "2009"
                        "volumen" => "19"
                        "paginaInicial" => "25"
                        "paginaFinal" => "34"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19341060"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Health literacy and kidney transplant outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;S&#46; Kazley"
                            1 => "J&#46;J&#46; Hund"
                            2 => "K&#46;N&#46; Simpson"
                            3 => "K&#46; Chavin"
                            4 => "P&#46; Baliga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7182/pit2015463"
                      "Revista" => array:6 [
                        "tituloSerie" => "Prog Transplant"
                        "fecha" => "2015"
                        "volumen" => "25"
                        "paginaInicial" => "85"
                        "paginaFinal" => "90"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25758806"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003700000002/v1_201705250045/S2013251417300810/v1_201705250045/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "38706"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Editorial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003700000002/v1_201705250045/S2013251417300810/v1_201705250045/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417300810?idApp=UINPBA000064"
]
Article information
ISSN: 20132514
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 15 4 19
2024 October 55 46 101
2024 September 63 34 97
2024 August 80 75 155
2024 July 39 26 65
2024 June 69 45 114
2024 May 70 34 104
2024 April 75 40 115
2024 March 56 33 89
2024 February 57 42 99
2024 January 42 23 65
2023 December 38 21 59
2023 November 56 33 89
2023 October 95 39 134
2023 September 96 27 123
2023 August 129 31 160
2023 July 63 23 86
2023 June 46 32 78
2023 May 73 32 105
2023 April 50 22 72
2023 March 80 27 107
2023 February 69 20 89
2023 January 40 28 68
2022 December 69 25 94
2022 November 65 34 99
2022 October 70 48 118
2022 September 49 30 79
2022 August 66 54 120
2022 July 39 42 81
2022 June 52 37 89
2022 May 45 37 82
2022 April 60 72 132
2022 March 77 55 132
2022 February 97 49 146
2022 January 62 49 111
2021 December 66 33 99
2021 November 42 41 83
2021 October 39 45 84
2021 September 49 45 94
2021 August 42 42 84
2021 July 44 37 81
2021 June 44 34 78
2021 May 37 55 92
2021 April 119 63 182
2021 March 72 57 129
2021 February 90 37 127
2021 January 50 33 83
2020 December 35 22 57
2020 November 44 18 62
2020 October 36 24 60
2020 September 42 31 73
2020 August 53 18 71
2020 July 43 22 65
2020 June 77 29 106
2020 May 51 23 74
2020 April 43 29 72
2020 March 49 15 64
2020 February 65 28 93
2020 January 69 31 100
2019 December 60 43 103
2019 November 61 34 95
2019 October 104 29 133
2019 September 176 26 202
2019 August 72 31 103
2019 July 61 25 86
2019 June 61 43 104
2019 May 58 28 86
2019 April 94 51 145
2019 March 71 40 111
2019 February 60 23 83
2019 January 94 49 143
2018 December 202 47 249
2018 November 379 44 423
2018 October 336 27 363
2018 September 219 37 256
2018 August 114 18 132
2018 July 123 17 140
2018 June 142 17 159
2018 May 196 20 216
2018 April 228 22 250
2018 March 185 17 202
2018 February 155 6 161
2018 January 115 17 132
2017 December 154 15 169
2017 November 75 13 88
2017 October 40 16 56
2017 September 59 9 68
2017 August 99 9 108
2017 July 77 10 87
2017 June 58 12 70
2017 May 66 11 77
2017 April 10 2 12
Show all

Follow this link to access the full text of the article

Idiomas
Nefrología (English Edition)