Letter to the Editor
Blood transfusion during haemodialysis improves systemic tissue oxygenation: A case report
La transfusión de sangre durante la hemodiálisis mejora la oxigenación sistémica del tejido: un reporte de un caso
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array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Susumu" "apellidos" => "Ookawara" "email" => array:1 [ 0 => "su-ooka@hb.tp1.jp" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Yuichiro" "apellidos" => "Ueda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Takayuki" "apellidos" => "Uchida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Masaya" "apellidos" => "Kofuji" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Hideyuki" "apellidos" => "Hayasaka" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "Taro" "apellidos" => "Hoshino" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 7 => array:3 [ "nombre" => "Kaoru" "apellidos" => "Tabei" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 8 => array:3 [ "nombre" => "Yoshiyuki" "apellidos" => "Morishita" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Clinical Engineering, Saitama Medical Center, Jichi Medical University, Saitama, Japan" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Minami-Uonuma City Hospital, Niigata, Japan" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La transfusión de sangre durante la hemodiálisis mejora la oxigenación sistémica del tejido: un reporte de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1479 "Ancho" => 1677 "Tamanyo" => 172258 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Changes in regional oxygen saturation (rSO<span class="elsevierStyleInf">2</span>) of the forehead (A), liver (B), and lower leg (C) as per the oxygenation values of cerebral, hepatic, and muscle tissue, respectively, under hemodialysis (HD) with or without blood transfusion. rSO<span class="elsevierStyleInf">2</span> ratio is defined as the ratio of rSO<span class="elsevierStyleInf">2</span> value at <span class="elsevierStyleItalic">t</span> (min) during HD and the initial rSO<span class="elsevierStyleInf">2</span> value before HD (rSO<span class="elsevierStyleInf">2</span> at <span class="elsevierStyleItalic">t</span> (min) during HD/initial rSO<span class="elsevierStyleInf">2</span> before HD).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Tissue oxygenation is maintained through various mechanisms, including blood pressure, circulating blood volume, and hemoglobin (Hb) concentration. In particular, Hb itself is considered an important factor because of its oxygen transportation function to systemic organs. Therefore, it is evident that oxygen supply would decrease in a severe anemic state.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Recent reports have demonstrated the measurement of regional oxygen saturation (rSO<span class="elsevierStyleInf">2</span>), a real-time marker of tissue oxygenation using near-infrared spectroscopy (NIRS).<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a> Measurement of rSO<span class="elsevierStyleInf">2</span> by using NIRS is a straightforward non-invasive procedure, which can be performed continuously. Nevertheless, only a few studies have investigated the association between systemic tissue oxygenation and the increase in Hb levels after blood transfusion in hemodialysis (HD) patients. In the current case study, we were able to monitor changes in the rSO<span class="elsevierStyleInf">2</span> of brain, liver, and lower-limb muscles during HD with and without blood transfusion.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 79-year-old woman undergoing HD was admitted to our hospital with acute obstructive suppurative cholangitis. Upon admission, we administered intravenous antibiotics and performed endoscopic biliary drainage, which resulted in a gradual improvement of her symptoms. Her anemia had been previously managed with an erythropoietin-beta (3000<span class="elsevierStyleHsp" style=""></span>IU/session, 3 times/week); however, her Hb levels decreased to 6.8<span class="elsevierStyleHsp" style=""></span>g/dL. Therefore, blood transfusion during HD was performed. She provided written informed consent to participate in monitoring of her systemic rSO<span class="elsevierStyleInf">2</span> during HD with or without blood transfusion. The rSO<span class="elsevierStyleInf">2</span> levels were monitored at the forehead, right hypochondriac region above the liver, and lower leg above the gastrocnemii muscles by using the INVOS 5100c (Covidien Japan). She received a transfusion of 560<span class="elsevierStyleHsp" style=""></span>mL of concentrated red blood cells during HD and her Hb levels increased from 6.8 to 10.0<span class="elsevierStyleHsp" style=""></span>g/dL after HD (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Furthermore, we compared the time course of rSO<span class="elsevierStyleInf">2</span> ratio in each organ, with and without blood transfusion. The rSO<span class="elsevierStyleInf">2</span> ratio was defined as the ratio of rSO<span class="elsevierStyleInf">2</span> values at <span class="elsevierStyleItalic">t</span> (min) during HD and initial rSO<span class="elsevierStyleInf">2</span> value before HD. As shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, the changes in rSO<span class="elsevierStyleInf">2</span> ratio during HD without blood transfusion were modest in each organ, whereas the rSO<span class="elsevierStyleInf">2</span> ratio at each organ increased with blood transfusion, particularly in cerebral and hepatic regions.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In the world including United States, Europe, and Japan in around 1990, the use of erythropoiesis stimulating agents (ESA) in clinical settings was approved, which dramatically improved the Hb levels in patients with HD. However, even in the present day, blood transfusion during HD is still necessary for improving Hb levels in HD patients with severe anemia. Indeed, in comparison of blood transfusion frequency between ESA responsive and hyporesponsive HD patients, hyporesponsive patients had approximately 5 to 7-fold higher burden of blood transfusion than those with responsiveness.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> In addition, changes in systemic oxygenation induced by blood transfusion during HD have not been investigated extensively.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The brain has an auto-regulatory mechanism to maintain cerebral oxygenation. In HD patients, normalization of hematocrit by ESA did not increase cerebral oxygenation.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Moreover, cerebral oxygenation in these patients was well-maintained when compared to pre-dialysis patients,<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> and cerebral rSO<span class="elsevierStyleInf">2</span> values did not change by ultrafiltration under well-managed Hb levels.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> In the present case, rSO<span class="elsevierStyleInf">2</span> values did not change in any organ during HD without blood transfusion, which is similar to a previous report.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> On the other hand, each rSO<span class="elsevierStyleInf">2</span> values improved with an increase in Hb levels after blood transfusion. Particularly in the brain, oxygen supply decreases in patients with severe anemia<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>; furthermore, acute anemia by phlebotomy induces the deterioration of intracellular oxygen reactions in mice.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Thus, presence of severe anemia may lead to a decrease in cerebral oxygenation despite the auto-regulatory mechanism of the brain. Therefore, the improvement of cerebral oxygenation after blood transfusion could be explained by the increase of oxygen-carrying capacity, which is associated with the increase in Hb levels.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Regarding the changes in rSO<span class="elsevierStyleInf">2</span> of each organ after blood transfusion, the improvement of lower-limb muscular rSO<span class="elsevierStyleInf">2</span> was relatively lower than that of cerebral and hepatic rSO<span class="elsevierStyleInf">2</span> even in this case without peripheral artery disease. In HD patients, the prevalence of subclinical peripheral artery disease reached around 20–25%,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> and its presence may directly influence the lower-limb muscular rSO<span class="elsevierStyleInf">2</span> via a decrease in oxygen supply induced by the dysfunction of macro- and micro-circulation. Furthermore, the skeletal muscle index has been reported to be lower in HD patients than in healthy subjects.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Therefore, the changes in lower-limb muscular rSO<span class="elsevierStyleInf">2</span> value during HD might be influenced by the circulatory impairment and skeletal muscle weakness. However, the mechanism responsible for the differences in rSO<span class="elsevierStyleInf">2</span> improvement between different organs, induced by blood transfusion during HD, remains unclear and requires further investigation.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Our study suggests that blood transfusion during HD could be an effective method to improve tissue oxygenation, particularly cerebral and hepatic oxygenation in HD patients with severe anemia.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financing</span><p id="par0035" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest statement</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have declared that no conflict of interest exists.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financing" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest statement" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1479 "Ancho" => 1677 "Tamanyo" => 172258 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Changes in regional oxygen saturation (rSO<span class="elsevierStyleInf">2</span>) of the forehead (A), liver (B), and lower leg (C) as per the oxygenation values of cerebral, hepatic, and muscle tissue, respectively, under hemodialysis (HD) with or without blood transfusion. rSO<span class="elsevierStyleInf">2</span> ratio is defined as the ratio of rSO<span class="elsevierStyleInf">2</span> value at <span class="elsevierStyleItalic">t</span> (min) during HD and the initial rSO<span class="elsevierStyleInf">2</span> value before HD (rSO<span class="elsevierStyleInf">2</span> at <span class="elsevierStyleItalic">t</span> (min) during HD/initial rSO<span class="elsevierStyleInf">2</span> before HD).</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">BP, blood pressure; BUN, blood urea nitrogen; Cr, creatinine; Hb, hemoglobin; HD, hemodialysis.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HD without blood transfusion \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">HD with blood transfusion \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Body weight, kg</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Before \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">59.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">58.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>After \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">57.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">57.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">BP, mmHg</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Before \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">147/71 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">118/93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>After \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">149/74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">173/75 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Pulse, beats/min</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Before \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">85 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>After \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">75 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Hb, g/dL</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Before \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>After \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">BUN, mg/dL</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Before \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>After \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Cr, mg/dL</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Before \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>After \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Albumin, g/dL</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Before \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>After \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1502169.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Vital signs and laboratory findings under HD with or without blood transfusion.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cerebral blood flow and vasodilatory capacity in anemia secondary to chronic renal failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Kuwabara" 1 => "M. Sasaki" 2 => "H. Hirakata" 3 => "H. Koga" 4 => "M. Nakagawa" 5 => "T. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1523-1755.2002.00142.x" "Revista" => array:6 [ "tituloSerie" => "Kidney Int" "fecha" => "2002" "volumen" => "61" "paginaInicial" => "564" "paginaFinal" => "569" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11849397" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factors affecting cerebral oxygenation in hemodialysis patients: cerebral oxygenation associates with pH, hemodialysis duration, serum albumin concentration, and diabetes mellitus" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Ito" 1 => "S. Ookawara" 2 => "Y. Ueda" 3 => "S. Goto" 4 => "H. Miyazawa" 5 => "H. Yamada" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0117474" "Revista" => array:5 [ "tituloSerie" => "PLOS ONE" "fecha" => "2015" "volumen" => "10" "paginaInicial" => "e0117474" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25706868" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Regional cerebral oxygen saturation monitoring for predicting interventional outcomes in patients following out-of-hospital cardiac arrest of presumed cardiac cause: a prospective, observational, multicentre study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Nishiyama" 1 => "N. Ito" 2 => "T. Orita" 3 => "K. Hayashida" 4 => "H. Arimoto" 5 => "S. Beppu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.resuscitation.2015.07.049" "Revista" => array:6 [ "tituloSerie" => "Resuscitation" "fecha" => "2015" "volumen" => "96" "paginaInicial" => "135" "paginaFinal" => "141" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26291387" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Characterization of chronic and acute ESA hyporesponse: a retrospective cohort study of hemodialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.P. Sibbel" 1 => "C.E. Koro" 2 => "S.M. Brunelli" 3 => "A.R. Cobitz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12882-015-0138-x" "Revista" => array:5 [ "tituloSerie" => "BMC Nephrol" "fecha" => "2015" "volumen" => "16" "paginaInicial" => "144" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26283069" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of normalization of hematocrit on brain circulation and metabolism in hemodialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Metry" 1 => "B. Wikstrom" 2 => "S. Valind" 3 => "B. Sandhagen" 4 => "T. Linde" 5 => "S. Beshara" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "1999" "volumen" => "10" "paginaInicial" => "854" "paginaFinal" => "863" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10203371" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Depressed cerebral oxygen metabolism in patients with chronic renal failure: a positron emission tomography study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Kanai" 1 => "H. Hirakata" 2 => "H. Nakane" 3 => "K. Fujii" 4 => "E. Hirakata" 5 => "S. Ibayashi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2001" "volumen" => "38" "paginaInicial" => "S129" "paginaFinal" => "S133" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11576938" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of cerebral oxygenation in patients undergoing long-term hemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Hoshino" 1 => "S. Ookawara" 2 => "S. Goto" 3 => "H. Miyazawa" 4 => "K. Ito" 5 => "Y. Ueda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephron Clin Prac" "fecha" => "2014" "volumen" => "126" "paginaInicial" => "57" "paginaFinal" => "61" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantitating intracellular oxygen tension in vivo by phosphorescence lifetime measurement" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Hirakawa" 1 => "T. Yoshihara" 2 => "M. Kamiya" 3 => "I. Mimura" 4 => "D. Fujikura" 5 => "T. Masuda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/srep17838" "Revista" => array:5 [ "tituloSerie" => "Sci Rep" "fecha" => "2015" "volumen" => "5" "paginaInicial" => "17838" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26644023" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparing survival between peritoneal dialysis and hemodialysis patients with subclinical peripheral artery disease: a 6-year follow up" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.H. Liu" 1 => "J.Y. Chen" 2 => "S.Y. Lin" 3 => "H.H. Lin" 4 => "I.W. Ting" 5 => "C.C. Liang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7150/ijms.5091" "Revista" => array:6 [ "tituloSerie" => "Int J Med Sci" "fecha" => "2013" "volumen" => "10" "paginaInicial" => "434" "paginaFinal" => "440" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23471522" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Positive association of vigorous and moderate physical activity volumes with skeletal muscle mass but not bone density or metabolism markers in hemodialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Y. Morishita" 1 => "K. Kubo" 2 => "A. Miki" 3 => "K. Ishibashi" 4 => "E. Kusano" 5 => "D. Nagata" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11255-014-0662-9" "Revista" => array:6 [ "tituloSerie" => "Int Urol Nephrol" "fecha" => "2014" "volumen" => "46" "paginaInicial" => "633" "paginaFinal" => "639" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24526334" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003700000004/v1_201708310023/S2013251417301049/v1_201708310023/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003700000004/v1_201708310023/S2013251417301049/v1_201708310023/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417301049?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
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| 2022 March | 216 | 48 | 264 |
| 2022 February | 223 | 57 | 280 |
| 2022 January | 210 | 42 | 252 |
| 2021 December | 188 | 61 | 249 |
| 2021 November | 199 | 40 | 239 |
| 2021 October | 144 | 41 | 185 |
| 2021 September | 165 | 42 | 207 |
| 2021 August | 147 | 35 | 182 |
| 2021 July | 156 | 47 | 203 |
| 2021 June | 145 | 30 | 175 |
| 2021 May | 147 | 55 | 202 |
| 2021 April | 223 | 63 | 286 |
| 2021 March | 223 | 27 | 250 |
| 2021 February | 175 | 26 | 201 |
| 2021 January | 148 | 26 | 174 |
| 2020 December | 127 | 29 | 156 |
| 2020 November | 86 | 21 | 107 |
| 2020 October | 97 | 25 | 122 |
| 2020 September | 133 | 13 | 146 |
| 2020 August | 130 | 18 | 148 |
| 2020 July | 81 | 13 | 94 |
| 2020 June | 77 | 23 | 100 |
| 2020 May | 23 | 9 | 32 |
| 2020 April | 26 | 15 | 41 |
| 2020 March | 20 | 16 | 36 |
| 2020 February | 66 | 16 | 82 |
| 2020 January | 97 | 26 | 123 |
| 2019 December | 128 | 35 | 163 |
| 2019 November | 43 | 19 | 62 |
| 2019 October | 39 | 10 | 49 |
| 2019 September | 38 | 14 | 52 |
| 2019 August | 22 | 13 | 35 |
| 2019 July | 36 | 20 | 56 |
| 2019 June | 34 | 24 | 58 |
| 2019 May | 29 | 21 | 50 |
| 2019 April | 70 | 20 | 90 |
| 2019 March | 40 | 26 | 66 |
| 2019 February | 34 | 18 | 52 |
| 2019 January | 28 | 21 | 49 |
| 2018 December | 111 | 39 | 150 |
| 2018 November | 173 | 12 | 185 |
| 2018 October | 157 | 18 | 175 |
| 2018 September | 89 | 14 | 103 |
| 2018 August | 63 | 12 | 75 |
| 2018 July | 47 | 15 | 62 |
| 2018 June | 50 | 9 | 59 |
| 2018 May | 68 | 14 | 82 |
| 2018 April | 139 | 16 | 155 |
| 2018 March | 113 | 13 | 126 |
| 2018 February | 114 | 8 | 122 |
| 2018 January | 101 | 10 | 111 |
| 2017 December | 50 | 5 | 55 |
| 2017 November | 36 | 9 | 45 |
| 2017 October | 33 | 4 | 37 |
| 2017 September | 53 | 16 | 69 |
| 2017 August | 2 | 1 | 3 |
Show all
