Statins and antiplatelet agents are associated with changes in the circulatory markers of endothelial dysfunction in chronic kidney disease

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Se indica la significación estadística del test de tendencia K tau con 2asteriscos (**) y los valores outliers con este símbolo (o). Los gráficos de cajas indican mediana y rango intercuartílico. MVE: microvesículas endoteliales." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Estefanya García-Menéndez, María Marques Vidas, Matilde Alique, Julia Carracedo, Patricia de Sequera, Elena Corchete, Rafael Pérez García, Rafael Ramírez Chamond, José M. 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Portolés" "autores" => array:9 [ 0 => array:4 [ "nombre" => "Estefanya" "apellidos" => "García Menéndez" "email" => array:1 [ 0 => "estefanyagarciam@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "María" "apellidos" => "Marques Vidas" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] ] ] 2 => array:3 [ "nombre" => "Matilde" "apellidos" => "Alique" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Julia" "apellidos" => "Carracedo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Patricia" "apellidos" => "de Sequera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 5 => array:3 [ "nombre" => "Elena" "apellidos" => "Corchete" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 6 => array:3 [ "nombre" => "Rafael" "apellidos" => "Pérez García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 7 => array:3 [ "nombre" => "Rafael" "apellidos" => "Ramírez Chamond" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 8 => array:3 [ "nombre" => "José M." "apellidos" => "Portolés" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Departmento Biología de Sistemas, Alcalá de Henares, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "REDInREN ISCiii 016/0091009 RETYC, Madrid, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El uso de estatinas y antiagregantes se asocia con cambios en los marcadores de disfunción endotelial en la enfermedad renal crónica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 829 "Ancho" => 2345 "Tamanyo" => 85413 ] ] "descripcion" => array:1 [ "en" => "AOPP (a) and VEGF (b) values according to the treatment with statin or PA. Values of p<0.05 are indicated by an asterisk (*) and outlayer values with this symbol (o). AOPP: advanced protein oxidation products; VEGF: vascular endothelial growth factor; PA: platelet antiaggregants. Box plots indicate median and interquartile range." ] ] ] "textoCompleto" => "IntroductionPatients with chronic kidney disease (CKD) are more likely to develop cardiovascular disease (CVD), this is observed regardless of the rate of progression to advanced stages. It is a fact that the main cause of death in patients with CKD is cardiovascular.<a class="elsevierStyleCrossRef" href="#bib0145">1</a> The development of CVD in uremic patients involves complex processes of inflammation and endothelial dysfunction, whose final result is the atherosclerosis. In addition, the loss of arterial wall elasticity is a finding common in CKD and has been described as an independent predictor of cardiovascular events.<a class="elsevierStyleCrossRef" href="#bib0150">2</a>The microvesicles (MVs) are corpuscles that can be released from almost any eukaryotic cell during both activation and cellular apoptosis.<a class="elsevierStyleCrossRef" href="#bib0155">3</a> During the recent decades it has been shown that MVs derived from the endothelium (EMVs) are useful blood markers for different pathological situations such as vascular inflammation (acute or chronic) and endothelial dysfunction.<a class="elsevierStyleCrossRef" href="#bib0160">4</a> In addition, many studies have shown that circulating EMVs can interact a subsequent fusion with cell membrane of different cells, such as endothelial cells and leukocytes, this results in an effective delivery of components of its original cells to the target cells.<a class="elsevierStyleCrossRef" href="#bib0155">3</a> The measurement of EMVs plasma levels may provide relevant information in both healthy and patients. Normally, the EMVs count increases after the induction of acute or chronic endothelial dysfunction.<a class="elsevierStyleCrossRef" href="#bib0165">5</a> The mechanisms mediating the released these particles are not totally clear, and have been postulated as intermediate regulators of several growth factors and cytokines such as vascular endothelial growth factor (VEGF).<a class="elsevierStyleCrossRef" href="#bib0170">6</a>Several studies have reported the association between CKD and circulating MVs, showing changes in serum MV levels, according to the stage of CKD or the modalities of renal replacement therapy.<a class="elsevierStyleCrossRef" href="#bib0175">7</a> However, studies focused on circulating EMVs and CKD have led to nonuniform data.<a class="elsevierStyleCrossRefs" href="#bib0180">8,9</a> It has not been analyzed whether drugs commonly used in CKD that act on endothelial function (statins and antiplatelet agents) have some effect on the production of EMVs and other biomarkers.The advanced oxidation protein products (AOPP) are a family of oxidized proteins that contain dithyrosine, which are generated during stress oxidative and are measurable in plasma and that are useful as an early marker of oxidative tissue damage. They have also been described as active mediators of the inflammation associated with the uremic state.<a class="elsevierStyleCrossRef" href="#bib0190">10</a>The aim of this study was to analyze the effect of the use of statins and platelet antiaggregants (PA) on circulating EMVs and the expression of serum markers of endothelial dysfunction, oxidative stress and inflammation as AOPP and VEGF in a cohort of patients with CKD. Likewise, their relationship with other cardiovascular risk factors will be analyzed.MethodsA cross-sectional study was conducted on 41 patients with CKD. The patients with a history of autoimmune diseases such as Lupus, Vasculitis or Glomerulonephritis with active urinary sediment were excluded. The control group included 8 healthy volunteers.The study was approved by the Hospital Puerta de Hierro Ethics and Clinical research committee and before inclusion all participants provided written consent. Baseline demographics, clinical and laboratory data (total cholesterol level and fractions, uric acid, creatinine, etc.) and pharmacological treatment were recorded from structured electronic medical record-EMR (Nefrolink® and Selene®).Blood collection, isolation and analysis by flow cytometry of EMVsBlood samples were taken with a 21G gauge needle after applying a light tourniquet. The first 4ml were discarded, the blood was collected in tubes with 3.2% trisodium citrate (Becton Dickinson, Plymouth, UK)]. Twenty minutes after collection, the plasma was centrifuged at 1500×g, without brake, for 20min at room temperature. The plasma was centrifuged again for 2 more minutes at 13,000×g to obtain platelet-poor plasma, according to the method developed previously with minor modifications.<a class="elsevierStyleCrossRef" href="#bib0195">11</a> Aliquots of plasma were instantly frozen and stored at −80° C until use.The characterization of EMVs was obtained as previously described in other studies<a class="elsevierStyleCrossRef" href="#bib0195">11</a> using flow cytometry (Beckman Coulter Cytomic FC 500, CoulterInc, Fullerton, CA, USA) with CXP software (Beckman Coulter). According to the side scatter vs forward scatter dot-plot, MVs were considered those events gated in a size between 0.5 and 1.5μm. This system was previously established in a standardization experiment using size-calibrated fluorescent beads with sizes ranging from 0.1 to 1.9μm (SPHERO™ Flow Cytometry Nano Fluorescent Size Standard Kit, Spherotech, Lake Forest, IL USA). A triple-fluorescent labeling was performed for EMVs characterization. One hundred ml of platelet-poor plasma was incubated with fluorescein isothiocyanate-conjugated labeled monoclonal anti-CD31 (BD Pharmingen, San Diego, California, USA), Peridinin Chlorophyll Protein Complex monoclonal anti-CD42b (Abcam, Cambridge, MA), and phycoerythrin-annexin V kits (BD Pharmingen, San Diego, California, USA) in annexin V-binding buffer (10mM HEPES, 7.4 pH, 140mM NaCl, 2.5mM CaCl2) following the manufacturer's instructions of annexin V kit.To identify the cell-specific monoclonal antibodies of MVs, these were incubated with identical concentrations of isotype-matched control antibodies to set the threshold. As both platelets and endothelial cells express CD31, but CD42b occurs only on platelets, EMVs were CD31+/CD42− events. The absolute number of EMVs per microliter was quantified according to the manufacturer specification using Flow Count Calibrator beads (Beckman Coulter Inc, Fullerton, CA, US).AOPPs and VEGFThe plasma concentration of AOPP was measured in fasting plasma samples collected in tubes with ethylenediaminetetraacetic and kept frozen at −80°C. AOPP concentration was measured by Western Blot using the Oxy Blot™ Protein Oxidation Detection Kit, catalog no. S7150, Millipore.THeVEGF levels were analyzed in serum by ELISA using Quantikine VEGF ELISA kit (R&D Systems, Minneapolis, MN).Statistical analysisResults are expressed as percentage, median, range or interquartile range (IQR), unless indicated otherwise. Differences between groups were assessed by chi-square test, Fisher's exact test, Kruskal–Wallis test, Bonferroni correction or ANOVA according to the variables studied (post hoc analysis performed with Turkey's test). A linear regression analysis was performed to determine the level of EMVs according to treatment (statins or PA) adjusted for total cholesterol (TC) levels, indicating the β value and its 95% confidence interval (CI). The differences were considered significant if the p values <0.05. All tests were performed with software SSPS v 15.0 (Spss Inc., Chicago, IL, US) and Stata (StataCorp 2015. Stata Statistical Software: Release 14. College Station, TX: StataCorp LP).ResultsThe study included 41 patients with a median age of 51.5 years IQR [42.5–72.5]. A 39% of the patients were diabetic, 85.4% hypertensive and 9.8% had a history of ischemic heart disease.The most frequent cause of CKD was diabetic nephropathy in 39%, followed by a 19% of undiagnosed/other causes, 14.6% polycystic disease, 14.6% glomerular disease and 12.2%.vascular diseaseThe median estimated glomerular filtration rate (eGFR) using the CKD-EPI equation (Chronic Kidney Disease Epidemiology Collaboration) was 31.9ml/min (a 48.8% had eGFR<30ml/min).Respect to pharmacological treatment, most patients received angiotensin converting enzyme inhibitors (ACEIs) and/or Angiotensin Receptor Blocker (ARB) (78%), statins (48.8%) and PA (14.3%).Levels of EMVs in the ERCWe detected an increase in circulating EMVs in patients with CKD as compared with the control group (171.1 EMVs/μl vs 68.3 EMVs/μl, p<0.001), no significant correlation was observed between the eGFR and the amount of circulating EMVs.In our CKD patients, we did not find differences in the amount of EMVs according to the treatment received, for ACEIs/ARB, diuretics, beta-blockers, or erythropoietin.However the association of statin and PA significantly decreases the amount of EMVs. The results were: in patients without treatment, 225.55 EMVs/μl (119.11–304.88); Statin 169.33 EMVs/μl (86.9–271.56); AP 138.33 EMVs/μl (102.44–181.11); Statin plus PA 93.11 EMVs/μl (63.11–160.22) p<0.001 by Kruskall–Wallis test.The post hoc analysis with the Bonferroni correction indicates statistically significant differences only between statin plus PA vs no treatment p<0.001 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> describes the baseline characteristics according to the treatment. Patients on statins or PA were older, with higher proportion of diabetes mellitus (DM) and lower total serum cholesterol (TC) levels.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>A subanalysis in the diabetic population could not be performed because most of them were receiving statin or PA.We found a positive association between EMVs count and TC levels. In patients with a TC<200mg/dl treated with statins the EMVs levels were reduced (191.0 EMVs/μl vs 119.8 EMVs/μl, p=0.032). By linear regression, it was identified that patients on treatment with statins or PA had reduced circulating levels of EMVs, independently of the TC levels (β=−46.02, IC [−88.59 to −3.46]). Age correlated negatively with EMV levels (Spearman test p<0.05).To eliminate the bias produced by age, patients were stratified by tertiles of age and it was observed the use of statins and PA together significantly decreased EMVs levels only in the 2nd tertile (50–70 years) as shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> (K-tau trend test <0.05).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>VEGF and AOPPs in patients with CKD.No differences were observed in the serum levels of VEGF of CKD vs control groups. The treatment with statins and PA had an effect on the serum levels of VEGF that was similar to the observed in circulating EMVs (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>a) although without achieving statistical significance.<elsevierMultimedia ident="fig0015"></elsevierMultimedia>Serum AOPPs was increased in patients with CKD as compared with controls although without statistical significance (7.51ng/ml vs 9.91ng/ml). The pharmacological treatment showed no effect on the serum levels of AOPPs (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>b).DiscussionOur work describes for the first time in CKD patients, an association between circulating levels of EMVs, VEGF, AOPPs and commonly used drugs in our population, specifically, the use of statins and PA. In addition, we have shown an increase in circulating levels of EMVs in patients with CKD corroborating the finding previously described by other authors.<a class="elsevierStyleCrossRef" href="#bib0200">12</a>It is know that patients with CKD are more likely to suffer CVD, as illustrated in previous epidemiological studies<a class="elsevierStyleCrossRef" href="#bib0145">1</a>. There are several changes in the structure and functional characteristics of the artery wall that have been related to CKD, such as arterial stiffness, endothelial dysfunction and a reduction in the production of nitric oxide (NO).<a class="elsevierStyleCrossRefs" href="#bib0205">13,14</a> Although traditional risk factors such as age, hypertension and dyslipidemia are classically associated with these alterations, they do not able to fully explain the changes observed in patients with CKD. Therefore, we need additional information to sustain an integrated and more complete pathological model.Other authors have described high levels of EMVs in patients with CKD, like in other high-risk CV patients with acute coronary syndrome or hypertension.<a class="elsevierStyleCrossRef" href="#bib0160">4</a> We do not know the mechanisms that lead to the increase in EMVs observed in patients with CKD; several hypotheses have been proposed, including oxidative stress, cytokines and endogenous lipopolysaccharides.<a class="elsevierStyleCrossRef" href="#bib0215">15</a>The experiments of Amabile et al.<a class="elsevierStyleCrossRef" href="#bib0180">8</a> showed that EMVs of patients with CKD of any cause generated endothelial dysfunction decreasing generation in vitro of NO and affecting relaxation in the healthy arterial wall dependent on NO and cyclic guanosine monophosphate. For this reason, EMV could be more an effector agent than a biomarker of endothelial damage in CVD associated with CKD, in which case it becomes therapeutic target.The role of statins in the formation of EMVs has been previously tested with non uniform results. Probably, this is due to the complexity of the pathophysiological mechanisms that involve CVD and the effects of confounding factors such as age, gender and associated comorbidity. Previous studies have described that atorvastatin decreases levels of circulating EMVs in patients with ischemic cardiomyopathy, independently of TC levels and their fractions<a class="elsevierStyleCrossRef" href="#bib0220">16</a>; this results have been confirmed in our study.The clinical trial of cardiac and renal protection (SHARP) demonstrated that statin therapy modifies atherosclerotic events in CKD patients, regardless of the serum levels of TC<a class="elsevierStyleCrossRef" href="#bib0225">17</a> suggesting pleiotropic effect of these drugs.Our previous in vitro studies have shown that the addition of atorvastatin decreases the production of reactive oxygen species (ROS) induced by indoxyl sulfate in Human umbilical vein endothelial cells (HUVEC) (unpublished data) that support the previous hypothesis of the existence of pleiotropic effects of statins on endothelial cells.<a class="elsevierStyleCrossRefs" href="#bib0230">18,19</a>The results presented here, raise the possible existence of other mechanisms pleiotropics of the statin on the vascular wall, in this case mediated by EMVs.Antiplatelet drugs have also been shown to modify the amount of EMVs circulating in various clinical and experimental scenarios.<a class="elsevierStyleCrossRef" href="#bib0240">20</a> In this sense, Bulut et al.<a class="elsevierStyleCrossRef" href="#bib0245">21</a> demonstrated that treatment with acetylsalicylic acid reduces the number of circulating EMVs in patients with acute coronary disease by an unknown mechanism. It is known that aspirin improves vascular endothelial function by mechanisms independent of Cyclooxygenase<a class="elsevierStyleCrossRef" href="#bib0250">22</a> and it is debatable whether this could have additional cardioprotective effects beyond those attributed to the antithrombotic activity.Since EMVs can directly induce endothelial dysfunction, the effect of aspirin in r reducing circulating EMVs could explain the mechanism of endothelial protection of this drug.Inflammatory mediators such as tumor necrosis factor α, interleukin-1β and thrombin drive the generation of EMVs and it is believed that these MVs act in a paracrine fashion, inducing further vascular inflammation.<a class="elsevierStyleCrossRef" href="#bib0255">23</a> It is known that VEGF, one of the main mediators of angiogenesis, has potent effects for mobilization in progenitor endothelial cells. However, its effect on the circulating levels of EMVs is controversial. EMVs have been shown to alter angiogenesis in different clinical situations<a class="elsevierStyleCrossRef" href="#bib0180">8</a> and are also promoters of the generation of VEGF in some cellular subtypes such as the renal tubular cell; data described by Fernández-Martínez et al.<a class="elsevierStyleCrossRef" href="#bib0260">24</a>In our series we have reported that treatment with antiplatelet agents and Statins decrease serum levels of VEGF, without correlation with EMVs levels. Therefore, with the results of our study we cannot clarify whether both phenomena are related or are independent pathophysiological mechanisms.Finally, we observe an increase in the state of oxidative stress estimated by circulating concentrations of AOPP in patients with CKD. Oxidative stress is defined as an alteration of the balance between the oxidants generation and the antioxidant systems activity. Hence, this plays an important role in the development of the inflammatory syndrome associated with chronic renal failure.<a class="elsevierStyleCrossRef" href="#bib0190">10</a> Serum levels of AOPPs have been shown to be a very good marker of oxidative stress derived from phagocytes, but they are also active mediators of the inflammatory state associated with uremia. In this sense, Arsat et al. demonstrated that the levels of AOPP are already increased in the early stages of CKD and increase with the progression of uremia.<a class="elsevierStyleCrossRef" href="#bib0190">10</a> Experimental studies suggest that AOPP could increase oxidative stress in the kidney and be involved in the genesis of the glomerulosclerosis.<a class="elsevierStyleCrossRef" href="#bib0265">25</a> In fact, intravenous administration of AOPPs in diabetic mice increase AOPP in the kidney, promote renal inflammation, glomerular hypertrophy and overexpression of fibronectin, and led to albuminuria.<a class="elsevierStyleCrossRef" href="#bib0260">24</a>In our study, age is associated with decreased levels of EMVs, similar results to those previously described by Anne Forest et al. and the Erez Eitan group. The latter supports the hypothesis that MVs decrease with age because of an increase in their internalization in leukocytes<a class="elsevierStyleCrossRef" href="#bib0270">26</a> or simply that low levels of EMVs could reflect a deceleration of the replacement due to a senescent endothelium with lower metabolism and cellular activity.<a class="elsevierStyleCrossRef" href="#bib0275">27</a> After analyzing the effect of stratifying treatment by age, it was observed that the use of statins and PA correlates with the decrease in EMVs levels being statistically significant in the second tertile.Another fact that should be emphasized, is the low percentage of diabetics without treatment (statin and AP). The decrease in circulating EMVs that we observe in our diabetic population is not in agreement with previously reported analysis of an association between Diabetes Mellitus and micro/macrovascular complications with an increase in EMVs.<a class="elsevierStyleCrossRef" href="#bib0280">28</a> This discrepancy could be related with the effect of the treatment with statin and PA, but since it was hard to find diabetic patients without treatment (Statin and PA) in our sample, we could not pursue this issue any further.Our pilot study has some limitations. The control group consists of healthy subjects of unpaired age with those of the study population and without associated comorbidity, but it is essential to include these results given the absence of normal reference values for these factors. Finally, it is important to emphasize the data variability, given that they are unconventional measures. To try to minimize this possible error, we use inter-assay pattern lines that allow to homogenize results. In addition, we determined each sample in triplicate, using the average of the determinations.ConclusionsThe present study has shown that CKD patients present modifications in the count of circulating EMVs, and in the VEGF and AOPP levels. The use of statins and AP is associated with a correction of this effect, indicating the existence of pleiotropic mechanisms on endothelial function in this group of patients. In the population with CKD, age also seems to be a determinant in the number of EMVs. Further studies are needed to clarify whether EMVs act as subrogated biomarkers or are themselves effectors of endothelial damage.Conflicts of interestThe authors have no conflicts of interest to declare.FinancingProyecto FIS, Instituto Carlos III. 2014 Expediente: Q2818018JPI14/00806." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres1212213" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Backgrounds and purposes" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Experimental approach" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1128241" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1212212" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Enfoque experimental" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1128240" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Blood collection, isolation and analysis by flow cytometry of EMVs" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "AOPPs and VEGF" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Levels of EMVs in the ERC" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "VEGF and AOPPs in patients with CKD." ] ] ] 7 => array:2 [ "identificador" => "sec0045" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0050" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0055" "titulo" => "Conflicts of interest" ] 10 => array:2 [ "identificador" => "sec9055" "titulo" => "Financing" ] 11 => array:2 [ "identificador" => "xack414342" "titulo" => "Acknowledgment" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-02-01" "fechaAceptado" => "2018-11-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1128241" "palabras" => array:5 [ 0 => "Endothelial microvesicles" 1 => "Chronic kidney disease" 2 => "Endothelial dysfunction" 3 => "Statins" 4 => "Antiplatelet agents" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1128240" "palabras" => array:5 [ 0 => "Microvesículas endoteliales" 1 => "Insuficiencia renal crónica" 2 => "Disfunción endotelial" 3 => "Estatinas" 4 => "Antiagregantes plaquetarios" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "Backgrounds and purposesPatients with chronic kidney disease (CKD) have higher risk of developing cardiovascular disease. In CKD patients the mechanisms involved in, endothelial damage and the role of different drugs used on these patients are not completely understood. The aim of this work is to analyze the effect of statins and platelet antiaggregant (PA) on endothelial microvesicles (EMVs) and other markers of endothelial dysfunction. Experimental approachCross-sectional study of 41 patients with CKD 3b-4 and 8 healthy volunteers. Circulating levels of EMVs, vascular endothelial growth factor (VEGF), and advance oxidized protein products (AOPPS) were quantified and the correlation with different comorbidity variables and therapeutic strategies were evaluated. ResultsEMVs are increased in CKD patients as compared with controls (171.1 vs. 68.3/μl, p<0.001). It was observed a negative correlation between age and EMVs. Statins and PA were associated with a reduction in EMVs and VEGF levels, independently of the serum total cholesterol levels (TC). The levels of AOPPS and VEGF were not different in CKD vs. controls. ConclusionCKD is associated with a change in EMVs, VEGF and AOPP levels. The treatment with statins and PA normalizes these values to almost the observed in controls and this effect is independently of the prevailing TC level. These findings explain the existence of the pleiotropic effects of statins and PA which deserve further studies." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Backgrounds and purposes" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Experimental approach" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "Antecedentes y objetivosLos pacientes con insuficiencia renal crónica (IRC) corren mayor riesgo de desarrollar enfermedad cardiovascular. En los pacientes con IRC, los mecanismos implicados en la disfunción endotelial y el papel de los diferentes fármacos utilizados en estos pacientes no se conocen por completo. El objetivo de este artículo es analizar el efecto de las estatinas y los antiagregantes plaquetarios (AP) sobre las microvesículas endoteliales (MVE) y otros marcadores de la disfunción endotelial. Enfoque experimentalEstudio transversal con 41 pacientes con IRC 3b-4 y 8 voluntarios sanos. Se cuantificaron los niveles de MVE, factor de crecimiento vascular endotelial (FCVE) y productos avanzados de oxidación de proteínas (AOPP, por sus siglas en inglés) en la circulación y se evaluó la correlación con diferentes variables de comorbilidad y estrategias terapéuticas. ResultadosLas MVE aumentaron en pacientes con IRC al comparar los niveles con los controles (171,1 frente a 68,3/μl; p<0,001). Se observó una correlación negativa entre la edad y las MVE. Las estatinas y los AP se asociaron con una reducción de los niveles de MVE y FCVE, independientemente de los niveles séricos de colesterol total (CT). Los niveles de AOPP y FCVE no fueron diferentes entre los pacientes con IRC y los controles. ConclusiónLa IRC se asocia con un cambio de los niveles de MVE, FCVE y AOPP. El tratamiento con estatinas y AP normaliza estos valores a casi los observados en los controles y este efecto es independiente del nivel de CT predominante. Estos hallazgos explican la existencia de los efectos pleiotrópicos de las estatinas y los AP que merecen estudios adicionales." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Enfoque experimental" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: García Menéndez E, Marques Vidas M, Alique M, Carracedo J, de Sequerac P, Corchete E, et al. El uso de estatinas y antiagregantes se asocia con cambios en los marcadores de disfunción endotelial en la enfermedad renal crónica. Nefrologia. 2019;39:287–293." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 945 "Ancho" => 1402 "Tamanyo" => 53275 ] ] "descripcion" => array:1 [ "en" => "EMVs values according to the treatment with statin or PA. Values of p<0.05 are indicated by an asterisk (*) and outlayer values with this symbol (o). EMVs: endothelial microvesicles; PA: platelet antiaggregants. Box plots indicate median and interquartile range." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 933 "Ancho" => 1367 "Tamanyo" => 74985 ] ] "descripcion" => array:1 [ "en" => "EMVs values stratifying the population by age tertiles. The statistical significance of the Ktau Trend test is indicated with two asterisks (**) and the outlayer values with this symbol (o). EMVs: endothelial microvesicles. Box plots indicate median and interquartile range." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 829 "Ancho" => 2345 "Tamanyo" => 85413 ] ] "descripcion" => array:1 [ "en" => "AOPP (a) and VEGF (b) values according to the treatment with statin or PA. Values of p<0.05 are indicated by an asterisk (*) and outlayer values with this symbol (o). AOPP: advanced protein oxidation products; VEGF: vascular endothelial growth factor; PA: platelet antiaggregants. Box plots indicate median and interquartile range." ] ] 3 => 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" => "PA: platelet antiaggregants; TC: total cholesterol; DM: diabetes mellitus; eGFR: estimated glomerular filtration rate by CKD-EPI ml/min/1.73m2; IQR: interquartile range. Are considered significant values: p<0.05." "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="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No treatment \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Statin \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PA \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Statin and PA \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Men (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">73.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (median [IQR]) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.0 [37.5–52.5] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">54.5 [45.5–71.5] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">76.5 [62.5–81.5] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">76.5 [66.5–81.5] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51.5 [42.4–72.5] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age>50 years (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.08 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hypertension (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">91.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">78.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DM (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hyperuricemia (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dyslipemia (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.02 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">eGFR CKD-EPI (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31–44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45–59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">>60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TC mg/dl (median [IQR]) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">191.0 [161.0–226.0] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">161.5 [140.0–189.5] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">162.0 [150.0–184.5] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">127.0 [116.0–168.0] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">173.0 [149.0–196.0] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.005 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TC>200mg/dl (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.048 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2069435.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Baseline characteristics according to received treatment." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0145" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.J. Sarnak" 1 => "A.S. Levey" 2 => "A.C. Schoolwerth" 3 => "J. Coresh" 4 => "B. Culleton" 5 => "L.L. Hamm" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/01.CIR.0000095676.90936.80" "Revista" => array:7 [ "tituloSerie" => "Circulation" "fecha" => "2003" "volumen" => "108" "numero" => "17" "paginaInicial" => "2154" "paginaFinal" => "2169" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14581387" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0150" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Arterial stiffness and kidney function" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.E. Safar" 1 => "G.M. London" 2 => "G.E. Plante" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/01.HYP. 0000114571.75762.b0" "Revista" => array:6 [ "tituloSerie" => "Hypertension" "fecha" => "2004" "volumen" => "43" "paginaInicial" => "163" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14732732" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0155" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of microparticles in endothelial dysfunction and arterial hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T. Helbing" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4330/wjc.v6.i11.1135" "Revista" => array:5 [ "tituloSerie" => "World J Cardiol" "fecha" => "2014" "volumen" => "6" "paginaInicial" => "1135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25429325" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0160" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of circulating endothelial microparticles with cardiometabolic risk factors in the Framingham Heart Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Amabile" 1 => "S. Cheng" 2 => "J.M. Renard" 3 => "M.G. Larson" 4 => "A. Ghorbani" 5 => "E. McCabe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Heart J." "fecha" => "2014" "paginaInicial" => "1" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1362151" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0165" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The many faces of endothelial microparticles" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Dignat-George" 1 => "C.M. Boulanger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/ATVBAHA.110.218123" "Revista" => array:6 [ "tituloSerie" => "Arterioscler Thromb Vasc Biol" "fecha" => "2011" "volumen" => "31" "paginaInicial" => "27" "paginaFinal" => "33" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21160065" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0170" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Biological properties of extracellular vesicles and their physiological functions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Yáñez-Mó" 1 => "P.R. Siljander" 2 => "Z. Andreu" 3 => "A.B. Zavec" 4 => "F.E. Borràs" 5 => "E.I. Buzas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3402/jev.v4.27066" "Revista" => array:6 [ "tituloSerie" => "J Extracell Vesicles" "fecha" => "2015" "volumen" => "4" "numero" => "2015" "paginaInicial" => "1" "paginaFinal" => "60" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0175" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic renal failure is accompanied by endothelial activation and a large increase in microparticle numbers with reduced procoagulant capacity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.C. Trappenburg" 1 => "M. van Schilfgaarde" 2 => "F.C.P. Frerichs" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndt/gfr474" "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transplant" "fecha" => "2012" "volumen" => "27" "paginaInicial" => "1446" "paginaFinal" => "1453" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0180" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Circulating Endothelial Microparticles Are Associated with Vascular Dysfunction in Patients with End-Stage Renal Failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Amabile" 1 => "A.P. Guérin" 2 => "A. Leroyer" 3 => "Z. Mallat" 4 => "C. Nguyen" 5 => "J. Boddaert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1681/ASN.2005050535" "Revista" => array:7 [ "tituloSerie" => "J Am Soc Nephrol." "fecha" => "2005" "volumen" => "16" "numero" => "11" "paginaInicial" => "3381" "paginaFinal" => "3388" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16192427" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0185" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Optimisation of an advanced oxidation protein products assay: its application to studies of oxidative stress in diabetes mellitus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.L. Taylor" 1 => "K.R. Armstrong" 2 => "D. Perrett" 3 => "A.T. Hattersley" 4 => "P.G. Winyard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2015/496271" "Revista" => array:4 [ "tituloSerie" => "Oxid Med Cell Longev" "fecha" => "2015" "volumen" => "2015" "paginaInicial" => "496271" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0190" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Are advanced oxidation protein products potential uremic toxins?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. Vitko-Sarsat" 1 => "V. Gausson" 2 => "B. Descamps-Latscha" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Kidney Int" "fecha" => "2003" "volumen" => "63" "paginaInicial" => "11" "paginaFinal" => "14" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0195" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Standardization of platelet-derived microparticle counting using calibrated beads and a cytomics FC500 routine flow cytometer: a first step towards multicenter studies?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Robert" 1 => "P. Poncelet" 2 => "R. Lacroix" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1538-7836.2008.03200.x" "Revista" => array:6 [ "tituloSerie" => "J Thromb Haemost" "fecha" => "2009" "volumen" => "7" "paginaInicial" => "190" "paginaFinal" => "197" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18983485" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0200" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endothelial damage and vascular calcification in patients with chronic kidney disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Soriano" 1 => "A. Carmona" 2 => "F. Triviño" 3 => "M. Rodriguez" 4 => "M. Alvarez-Benito" 5 => "A. Martín-Malo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1152/ajprenal.00114.2014" "Revista" => array:6 [ "tituloSerie" => "Am J Physiol - Ren Physiol" "fecha" => "2014" "volumen" => "307" "numero" => "11" "paginaInicial" => "1302" "paginaFinal" => "1311" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0205" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impairment of Vascular Responses to Reactive Hyperemia and Nitric Oxide in Chronic Renal Failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Nakanishi" 1 => "Y. Ishigami" 2 => "Y. Otaki" 3 => "M. Izumi" 4 => "K. Hiraoka" 5 => "T. Inoue" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000064078" "Revista" => array:7 [ "tituloSerie" => "Nephron." "fecha" => "2002" "volumen" => "92" "numero" => "3" "paginaInicial" => "529" "paginaFinal" => "535" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12372934" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0210" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nitric oxide production is reduced in patients with chronic renal failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Wever" 1 => "P. Boer" 2 => "M. Hijmering" 3 => "E. Stroes" 4 => "M. Verhaar" 5 => "J. Kastelein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/01.ATV.19.5.1168" "Revista" => array:7 [ "tituloSerie" => "Arterioscler Thromb Vasc Biol." "fecha" => "1999" "volumen" => "19" "numero" => "5" "paginaInicial" => "1168" "paginaFinal" => "1172" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10323766" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0215" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endothelium-derived microparticles impair endothelial function in vitro" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.V. Brodsky" 1 => "F. Zhang" 2 => "A. Nasjletti" 3 => "M.S. Goligorsky" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "AJP Hear Circ Physiol." "fecha" => "2004" "volumen" => "286" "numero" => "5" "paginaInicial" => "1910" "paginaFinal" => "1915" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0220" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of 40 mg Versus 10 mg of Atorvastatin on Oxidized Low-Density Lipoprotein, High-Sensitivity C-Reactive Protein" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Huang" 1 => "Y. Cheng" 2 => "Q. Xie" 3 => "G. Lin" 4 => "Y. Wu" 5 => "Y. Feng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/clc.21017 ET-2012/01/25" "Revista" => array:7 [ "tituloSerie" => "Circulating Endothelial-Derived Microparticles, and Endothelial Progenitor Cells in Patients With Ischemic Cardiomyopathy. Clin Cardiol." "fecha" => "2012" "volumen" => "35" "numero" => "2" "paginaInicial" => "125" "paginaFinal" => "130" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22271072" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0225" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): A randomised placebo-controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Baigent" 1 => "M.J. Landray" 2 => "C. Reith" 3 => "J. Emberson" 4 => "D.C. Wheeler" 5 => "C. Tomson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(11)60739-3" "Revista" => array:6 [ "tituloSerie" => "Lancet." "fecha" => "2011" "volumen" => "377" "numero" => "9784" "paginaInicial" => "2181" "paginaFinal" => "2192" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0230" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Simvastatin pretreatment enhances ischemia-induced neovascularization and blood flow recovery in streptozotocin-treated mice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.H. Huang" 1 => "J.Y. Chen" 2 => "C.Y. Chen" 3 => "J.W. Chen" 4 => "S.J. Lin" 5 => "C.C. Shih" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jvs.2014.11.088" "Revista" => array:6 [ "tituloSerie" => "J Vasc Surg" "fecha" => "2016" "volumen" => "64" "paginaInicial" => "1112" "paginaFinal" => "1120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26830691" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0235" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Simvastatin ameliorates matrix stiffness-mediated endothelial monolayer disruption" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.C. Lampi" 1 => "C.J. Faber" 2 => "J. Huynh" 3 => "F. Bordeleau" 4 => "M.R. Zanotelli" 5 => "C.A. Reinhart-King" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0147033" "Revista" => array:4 [ "tituloSerie" => "PLoS One" "fecha" => "2016" "volumen" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28002457" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0240" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of low-dose aspirin on endothelial function in hypertensive patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Monobe" 1 => "H. Yamanari" 2 => "K. Nakamura" 3 => "T. Ohe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/clc.4960241104" "Revista" => array:6 [ "tituloSerie" => "Clin Cardiol" "fecha" => "2001" "volumen" => "24" "paginaInicial" => "705" "paginaFinal" => "709" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11714127" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0245" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acetylsalicylate reduces endothelial and platelet-derived microparticles in patients with coronary artery disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Bulut" 1 => "V. Becker" 2 => "A. 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Guo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/en.2007-1544" "Revista" => array:7 [ "tituloSerie" => "Endocrinology." "fecha" => "2008" "volumen" => "149" "numero" => "4" "paginaInicial" => "1829" "paginaFinal" => "1839" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18174276" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0270" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Age-Related Changes in Plasma Extracellular Vesicle Characteristics and Internalization by Leukocytes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Eitan" 1 => "J. Green" 2 => "M. Bodogai" 3 => "N.A. Mode" 4 => "R. Bæk" 5 => "M.M. Jørgensen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/s41598-017-01386-z" "Revista" => array:7 [ "tituloSerie" => "Sci Rep." 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El uso de estatinas y antiagregantes se asocia con cambios en los marcadores de disfunción endotelial en la enfermedad renal crónica

Estefanya García Menéndeza,

Corresponding author

estefanyagarciam@gmail.com

Corresponding author.

, María Marques Vidasa,e, Matilde Aliqueb, Julia Carracedoc, Patricia de Sequerad, Elena Corcheted, Rafael Pérez Garcíad, Rafael Ramírez Chamondb, José M. Portolésa,e

a Servicio de Nefrología, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain

b Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Departmento Biología de Sistemas, Alcalá de Henares, Madrid, Spain

c Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain

d Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, Spain

e REDInREN ISCiii 016/0091009 RETYC, Madrid, Spain

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Patients with chronic kidney disease &#40;CKD&#41; are more likely to develop cardiovascular disease &#40;CVD&#41;&#44; this is observed regardless of the rate of progression to advanced stages&#46; It is a fact that the main cause of death in patients with CKD is cardiovascular&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> The development of CVD in uremic patients involves complex processes of inflammation and endothelial dysfunction&#44; whose final result is the atherosclerosis&#46; In addition&#44; the loss of arterial wall elasticity is a finding common in CKD and has been described as an independent predictor of cardiovascular events&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The microvesicles &#40;MVs&#41; are corpuscles that can be released from almost any eukaryotic cell during both activation and cellular apoptosis&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">3</span></a> During the recent decades it has been shown that MVs derived from the endothelium &#40;EMVs&#41; are useful blood markers for different pathological situations such as vascular inflammation &#40;acute or chronic&#41; and endothelial dysfunction&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a> In addition&#44; many studies have shown that circulating EMVs can interact a subsequent fusion with cell membrane of different cells&#44; such as endothelial cells and leukocytes&#44; this results in an effective delivery of components of its original cells to the target cells&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">3</span></a> The measurement of EMVs plasma levels may provide relevant information in both healthy and patients&#46; Normally&#44; the EMVs count increases after the induction of acute or chronic endothelial dysfunction&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a> The mechanisms mediating the released these particles are not totally clear&#44; and have been postulated as intermediate regulators of several growth factors and cytokines such as vascular endothelial growth factor &#40;VEGF&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Several studies have reported the association between CKD and circulating MVs&#44; showing changes in serum MV levels&#44; according to the stage of CKD or the modalities of renal replacement therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> However&#44; studies focused on circulating EMVs and CKD have led to nonuniform data&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">8&#44;9</span></a> It has not been analyzed whether drugs commonly used in CKD that act on endothelial function &#40;statins and antiplatelet agents&#41; have some effect on the production of EMVs and other biomarkers&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The advanced oxidation protein products &#40;AOPP&#41; are a family of oxidized proteins that contain dithyrosine&#44; which are generated during stress oxidative and are measurable in plasma and that are useful as an early marker of oxidative tissue damage&#46; They have also been described as active mediators of the inflammation associated with the uremic state&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The aim of this study was to analyze the effect of the use of statins and platelet antiaggregants &#40;PA&#41; on circulating EMVs and the expression of serum markers of endothelial dysfunction&#44; oxidative stress and inflammation as AOPP and VEGF in a cohort of patients with CKD&#46; Likewise&#44; their relationship with other cardiovascular risk factors will be analyzed&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">A cross-sectional study was conducted on 41 patients with CKD&#46; The patients with a history of autoimmune diseases such as Lupus&#44; Vasculitis or Glomerulonephritis with active urinary sediment were excluded&#46; The control group included 8 healthy volunteers&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The study was approved by the Hospital Puerta de Hierro Ethics and Clinical research committee and before inclusion all participants provided written consent&#46; Baseline demographics&#44; clinical and laboratory data &#40;total cholesterol level and fractions&#44; uric acid&#44; creatinine&#44; etc&#46;&#41; and pharmacological treatment were recorded from structured electronic medical record-EMR &#40;Nefrolink<span class="elsevierStyleSup">&#174;</span> and Selene<span class="elsevierStyleSup">&#174;</span>&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Blood collection&#44; isolation and analysis by flow cytometry of EMVs</span><p id="par0040" class="elsevierStylePara elsevierViewall">Blood samples were taken with a 21G gauge needle after applying a light tourniquet&#46; The first 4<span class="elsevierStyleHsp" style=""></span>ml were discarded&#44; the blood was collected in tubes with 3&#46;2&#37; trisodium citrate &#40;Becton Dickinson&#44; Plymouth&#44; UK&#41;&#93;&#46; Twenty minutes after collection&#44; the plasma was centrifuged at 1500<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">g</span>&#44; without brake&#44; for 20<span class="elsevierStyleHsp" style=""></span>min at room temperature&#46; The plasma was centrifuged again for 2 more minutes at 13&#44;000<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">g</span> to obtain platelet-poor plasma&#44; according to the method developed previously with minor modifications&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> Aliquots of plasma were instantly frozen and stored at &#8722;80<span class="elsevierStyleHsp" style=""></span>&#176; C until use&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The characterization of EMVs was obtained as previously described in other studies<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> using flow cytometry &#40;Beckman Coulter Cytomic FC 500&#44; CoulterInc&#44; Fullerton&#44; CA&#44; USA&#41; with CXP software &#40;Beckman Coulter&#41;&#46; According to the side scatter vs forward scatter dot-plot&#44; MVs were considered those events gated in a size between 0&#46;5 and 1&#46;5<span class="elsevierStyleHsp" style=""></span>&#956;m&#46; This system was previously established in a standardization experiment using size-calibrated fluorescent beads with sizes ranging from 0&#46;1 to 1&#46;9<span class="elsevierStyleHsp" style=""></span>&#956;m &#40;SPHERO&#8482; Flow Cytometry Nano Fluorescent Size Standard Kit&#44; Spherotech&#44; Lake Forest&#44; IL USA&#41;&#46; A triple-fluorescent labeling was performed for EMVs characterization&#46; One hundred ml of platelet-poor plasma was incubated with fluorescein isothiocyanate-conjugated labeled monoclonal anti-CD31 &#40;BD Pharmingen&#44; San Diego&#44; California&#44; USA&#41;&#44; Peridinin Chlorophyll Protein Complex monoclonal anti-CD42b &#40;Abcam&#44; Cambridge&#44; MA&#41;&#44; and phycoerythrin-annexin V kits &#40;BD Pharmingen&#44; San Diego&#44; California&#44; USA&#41; in annexin V-binding buffer &#40;10<span class="elsevierStyleHsp" style=""></span>mM HEPES&#44; 7&#46;4 pH&#44; 140<span class="elsevierStyleHsp" style=""></span>mM NaCl&#44; 2&#46;5<span class="elsevierStyleHsp" style=""></span>mM CaCl2&#41; following the manufacturer&#39;s instructions of annexin V kit&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">To identify the cell-specific monoclonal antibodies of MVs&#44; these were incubated with identical concentrations of isotype-matched control antibodies to set the threshold&#46; As both platelets and endothelial cells express CD31&#44; but CD42b occurs only on platelets&#44; EMVs were CD31&#43;&#47;CD42&#8722; events&#46; The absolute number of EMVs per microliter was quantified according to the manufacturer specification using Flow Count Calibrator beads &#40;Beckman Coulter Inc&#44; Fullerton&#44; CA&#44; US&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">AOPPs and VEGF</span><p id="par0055" class="elsevierStylePara elsevierViewall">The plasma concentration of AOPP was measured in fasting plasma samples collected in tubes with ethylenediaminetetraacetic and kept frozen at &#8722;80<span class="elsevierStyleHsp" style=""></span>&#176;C&#46; AOPP concentration was measured by Western Blot using the Oxy Blot&#8482; Protein Oxidation Detection Kit&#44; catalog no&#46; S7150&#44; Millipore&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">THeVEGF levels were analyzed in serum by ELISA using Quantikine VEGF ELISA kit &#40;R&#38;D Systems&#44; Minneapolis&#44; MN&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0065" class="elsevierStylePara elsevierViewall">Results are expressed as percentage&#44; median&#44; range or interquartile range &#40;IQR&#41;&#44; unless indicated otherwise&#46; Differences between groups were assessed by chi-square test&#44; Fisher&#39;s exact test&#44; Kruskal&#8211;Wallis test&#44; Bonferroni correction or ANOVA according to the variables studied &#40;post hoc analysis performed with Turkey&#39;s test&#41;&#46; A linear regression analysis was performed to determine the level of EMVs according to treatment &#40;statins or PA&#41; adjusted for total cholesterol &#40;TC&#41; levels&#44; indicating the <span class="elsevierStyleItalic">&#946;</span> value and its 95&#37; confidence interval &#40;CI&#41;&#46; The differences were considered significant if the <span class="elsevierStyleItalic">p</span> values &#60;0&#46;05&#46; All tests were performed with software SSPS v 15&#46;0 &#40;Spss Inc&#46;&#44; Chicago&#44; IL&#44; US&#41; and Stata &#40;StataCorp 2015&#46; Stata Statistical Software&#58; Release 14&#46; College Station&#44; TX&#58; StataCorp LP&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0070" class="elsevierStylePara elsevierViewall">The study included 41 patients with a median age of 51&#46;5 years IQR &#91;42&#46;5&#8211;72&#46;5&#93;&#46; A 39&#37; of the patients were diabetic&#44; 85&#46;4&#37; hypertensive and 9&#46;8&#37; had a history of ischemic heart disease&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The most frequent cause of CKD was diabetic nephropathy in 39&#37;&#44; followed by a 19&#37; of undiagnosed&#47;other causes&#44; 14&#46;6&#37; polycystic disease&#44; 14&#46;6&#37; glomerular disease and 12&#46;2&#37;&#46;vascular disease</p><p id="par0080" class="elsevierStylePara elsevierViewall">The median estimated glomerular filtration rate &#40;eGFR&#41; using the CKD-EPI equation &#40;Chronic Kidney Disease Epidemiology Collaboration&#41; was 31&#46;9<span class="elsevierStyleHsp" style=""></span>ml&#47;min &#40;a 48&#46;8&#37; had eGFR<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Respect to pharmacological treatment&#44; most patients received angiotensin converting enzyme inhibitors &#40;ACEIs&#41; and&#47;or Angiotensin Receptor Blocker &#40;ARB&#41; &#40;78&#37;&#41;&#44; statins &#40;48&#46;8&#37;&#41; and PA &#40;14&#46;3&#37;&#41;&#46;</p><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Levels of EMVs in the ERC</span><p id="par0090" class="elsevierStylePara elsevierViewall">We detected an increase in circulating EMVs in patients with CKD as compared with the control group &#40;171&#46;1 EMVs&#47;&#956;l vs 68&#46;3 EMVs&#47;&#956;l&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; no significant correlation was observed between the eGFR and the amount of circulating EMVs&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">In our CKD patients&#44; we did not find differences in the amount of EMVs according to the treatment received&#44; for ACEIs&#47;ARB&#44; diuretics&#44; beta-blockers&#44; or erythropoietin&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">However the association of statin and PA significantly decreases the amount of EMVs&#46; The results were&#58; in patients without treatment&#44; 225&#46;55 EMVs&#47;&#956;l &#40;119&#46;11&#8211;304&#46;88&#41;&#59; Statin 169&#46;33 EMVs&#47;&#956;l &#40;86&#46;9&#8211;271&#46;56&#41;&#59; AP 138&#46;33 EMVs&#47;&#956;l &#40;102&#46;44&#8211;181&#46;11&#41;&#59; Statin plus PA 93&#46;11 EMVs&#47;&#956;l &#40;63&#46;11&#8211;160&#46;22&#41; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 by Kruskall&#8211;Wallis test&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The post hoc analysis with the Bonferroni correction indicates statistically significant differences only between statin plus PA vs no treatment <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> describes the baseline characteristics according to the treatment&#46; Patients on statins or PA were older&#44; with higher proportion of diabetes mellitus &#40;DM&#41; and lower total serum cholesterol &#40;TC&#41; levels&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">A subanalysis in the diabetic population could not be performed because most of them were receiving statin or PA&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">We found a positive association between EMVs count and TC levels&#46; In patients with a TC<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>200<span class="elsevierStyleHsp" style=""></span>mg&#47;dl treated with statins the EMVs levels were reduced &#40;191&#46;0 EMVs&#47;&#956;l vs 119&#46;8 EMVs&#47;&#956;l&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;032&#41;&#46; By linear regression&#44; it was identified that patients on treatment with statins or PA had reduced circulating levels of EMVs&#44; independently of the TC levels &#40;<span class="elsevierStyleItalic">&#946;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;46&#46;02&#44; IC &#91;&#8722;88&#46;59 to &#8722;3&#46;46&#93;&#41;&#46; Age correlated negatively with EMV levels &#40;Spearman test <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">To eliminate the bias produced by age&#44; patients were stratified by tertiles of age and it was observed the use of statins and PA together significantly decreased EMVs levels only in the 2nd tertile &#40;50&#8211;70 years&#41; as shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> &#40;K-tau trend test &#60;0&#46;05&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">VEGF and AOPPs in patients with CKD&#46;</span><p id="par0130" class="elsevierStylePara elsevierViewall">No differences were observed in the serum levels of VEGF of CKD vs control groups&#46; The treatment with statins and PA had an effect on the serum levels of VEGF that was similar to the observed in circulating EMVs &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>a&#41; although without achieving statistical significance&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Serum AOPPs was increased in patients with CKD as compared with controls although without statistical significance &#40;7&#46;51<span class="elsevierStyleHsp" style=""></span>ng&#47;ml vs 9&#46;91<span class="elsevierStyleHsp" style=""></span>ng&#47;ml&#41;&#46; The pharmacological treatment showed no effect on the serum levels of AOPPs &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>b&#41;&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">Our work describes for the first time in CKD patients&#44; an association between circulating levels of EMVs&#44; VEGF&#44; AOPPs and commonly used drugs in our population&#44; specifically&#44; the use of statins and PA&#46; In addition&#44; we have shown an increase in circulating levels of EMVs in patients with CKD corroborating the finding previously described by other authors&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">It is know that patients with CKD are more likely to suffer CVD&#44; as illustrated in previous epidemiological studies<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a>&#46; There are several changes in the structure and functional characteristics of the artery wall that have been related to CKD&#44; such as arterial stiffness&#44; endothelial dysfunction and a reduction in the production of nitric oxide &#40;NO&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">13&#44;14</span></a> Although traditional risk factors such as age&#44; hypertension and dyslipidemia are classically associated with these alterations&#44; they do not able to fully explain the changes observed in patients with CKD&#46; Therefore&#44; we need additional information to sustain an integrated and more complete pathological model&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Other authors have described high levels of EMVs in patients with CKD&#44; like in other high-risk CV patients with acute coronary syndrome or hypertension&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a> We do not know the mechanisms that lead to the increase in EMVs observed in patients with CKD&#59; several hypotheses have been proposed&#44; including oxidative stress&#44; cytokines and endogenous lipopolysaccharides&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">15</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">The experiments of Amabile et al&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> showed that EMVs of patients with CKD of any cause generated endothelial dysfunction decreasing generation in vitro of NO and affecting relaxation in the healthy arterial wall dependent on NO and cyclic guanosine monophosphate&#46; For this reason&#44; EMV could be more an effector agent than a biomarker of endothelial damage in CVD associated with CKD&#44; in which case it becomes therapeutic target&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The role of statins in the formation of EMVs has been previously tested with non uniform results&#46; Probably&#44; this is due to the complexity of the pathophysiological mechanisms that involve CVD and the effects of confounding factors such as age&#44; gender and associated comorbidity&#46; Previous studies have described that atorvastatin decreases levels of circulating EMVs in patients with ischemic cardiomyopathy&#44; independently of TC levels and their fractions<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a>&#59; this results have been confirmed in our study&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">The clinical trial of cardiac and renal protection &#40;SHARP&#41; demonstrated that statin therapy modifies atherosclerotic events in CKD patients&#44; regardless of the serum levels of TC<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> suggesting pleiotropic effect of these drugs&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Our previous in vitro studies have shown that the addition of atorvastatin decreases the production of reactive oxygen species &#40;ROS&#41; induced by indoxyl sulfate in Human umbilical vein endothelial cells &#40;HUVEC&#41; &#40;unpublished data&#41; that support the previous hypothesis of the existence of pleiotropic effects of statins on endothelial cells&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">18&#44;19</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">The results presented here&#44; raise the possible existence of other mechanisms pleiotropics of the statin on the vascular wall&#44; in this case mediated by EMVs&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Antiplatelet drugs have also been shown to modify the amount of EMVs circulating in various clinical and experimental scenarios&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">20</span></a> In this sense&#44; Bulut et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">21</span></a> demonstrated that treatment with acetylsalicylic acid reduces the number of circulating EMVs in patients with acute coronary disease by an unknown mechanism&#46; It is known that aspirin improves vascular endothelial function by mechanisms independent of Cyclooxygenase<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a> and it is debatable whether this could have additional cardioprotective effects beyond those attributed to the antithrombotic activity&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Since EMVs can directly induce endothelial dysfunction&#44; the effect of aspirin in r reducing circulating EMVs could explain the mechanism of endothelial protection of this drug&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Inflammatory mediators such as tumor necrosis factor &#945;&#44; interleukin-1&#946; and thrombin drive the generation of EMVs and it is believed that these MVs act in a paracrine fashion&#44; inducing further vascular inflammation&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">23</span></a> It is known that VEGF&#44; one of the main mediators of angiogenesis&#44; has potent effects for mobilization in progenitor endothelial cells&#46; However&#44; its effect on the circulating levels of EMVs is controversial&#46; EMVs have been shown to alter angiogenesis in different clinical situations<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> and are also promoters of the generation of VEGF in some cellular subtypes such as the renal tubular cell&#59; data described by Fern&#225;ndez-Mart&#237;nez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">24</span></a></p><p id="par0195" class="elsevierStylePara elsevierViewall">In our series we have reported that treatment with antiplatelet agents and Statins decrease serum levels of VEGF&#44; without correlation with EMVs levels&#46; Therefore&#44; with the results of our study we cannot clarify whether both phenomena are related or are independent pathophysiological mechanisms&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Finally&#44; we observe an increase in the state of oxidative stress estimated by circulating concentrations of AOPP in patients with CKD&#46; Oxidative stress is defined as an alteration of the balance between the oxidants generation and the antioxidant systems activity&#46; Hence&#44; this plays an important role in the development of the inflammatory syndrome associated with chronic renal failure&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">10</span></a> Serum levels of AOPPs have been shown to be a very good marker of oxidative stress derived from phagocytes&#44; but they are also active mediators of the inflammatory state associated with uremia&#46; In this sense&#44; Arsat et al&#46; demonstrated that the levels of AOPP are already increased in the early stages of CKD and increase with the progression of uremia&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">10</span></a> Experimental studies suggest that AOPP could increase oxidative stress in the kidney and be involved in the genesis of the glomerulosclerosis&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a> In fact&#44; intravenous administration of AOPPs in diabetic mice increase AOPP in the kidney&#44; promote renal inflammation&#44; glomerular hypertrophy and overexpression of fibronectin&#44; and led to albuminuria&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">24</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">In our study&#44; age is associated with decreased levels of EMVs&#44; similar results to those previously described by Anne Forest et al&#46; and the Erez Eitan group&#46; The latter supports the hypothesis that MVs decrease with age because of an increase in their internalization in leukocytes<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">26</span></a> or simply that low levels of EMVs could reflect a deceleration of the replacement due to a senescent endothelium with lower metabolism and cellular activity&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">27</span></a> After analyzing the effect of stratifying treatment by age&#44; it was observed that the use of statins and PA correlates with the decrease in EMVs levels being statistically significant in the second tertile&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Another fact that should be emphasized&#44; is the low percentage of diabetics without treatment &#40;statin and AP&#41;&#46; The decrease in circulating EMVs that we observe in our diabetic population is not in agreement with previously reported analysis of an association between Diabetes Mellitus and micro&#47;macrovascular complications with an increase in EMVs&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a> This discrepancy could be related with the effect of the treatment with statin and PA&#44; but since it was hard to find diabetic patients without treatment &#40;Statin and PA&#41; in our sample&#44; we could not pursue this issue any further&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Our pilot study has some limitations&#46; The control group consists of healthy subjects of unpaired age with those of the study population and without associated comorbidity&#44; but it is essential to include these results given the absence of normal reference values for these factors&#46; Finally&#44; it is important to emphasize the data variability&#44; given that they are unconventional measures&#46; To try to minimize this possible error&#44; we use inter-assay pattern lines that allow to homogenize results&#46; In addition&#44; we determined each sample in triplicate&#44; using the average of the determinations&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusions</span><p id="par0220" class="elsevierStylePara elsevierViewall">The present study has shown that CKD patients present modifications in the count of circulating EMVs&#44; and in the VEGF and AOPP levels&#46; The use of statins and AP is associated with a correction of this effect&#44; indicating the existence of pleiotropic mechanisms on endothelial function in this group of patients&#46; In the population with CKD&#44; age also seems to be a determinant in the number of EMVs&#46; Further studies are needed to clarify whether EMVs act as subrogated biomarkers or are themselves effectors of endothelial damage&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicts of interest</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span><span id="sec9055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect9115">Financing</span><p id="par9225" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleGrantSponsor" id="gs1">Proyecto FIS&#44; Instituto Carlos III&#46; 2014 Expediente</span>&#58; <span class="elsevierStyleGrantNumber" refid="gs1">Q2818018J</span><span class="elsevierStyleGrantNumber" refid="gs1">PI14&#47;00806</span>&#46;</p></span></span>"
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              "identificador" => "sec0015"
              "titulo" => "Blood collection&#44; isolation and analysis by flow cytometry of EMVs"
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              "titulo" => "AOPPs and VEGF"
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              "titulo" => "Levels of EMVs in the ERC"
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              "titulo" => "VEGF and AOPPs in patients with CKD&#46;"
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          "clase" => "keyword"
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          "palabras" => array:5 [
            0 => "Endothelial microvesicles"
            1 => "Chronic kidney disease"
            2 => "Endothelial dysfunction"
            3 => "Statins"
            4 => "Antiplatelet agents"
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        ]
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        0 => array:4 [
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          "titulo" => "Palabras clave"
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          "palabras" => array:5 [
            0 => "Microves&#237;culas endoteliales"
            1 => "Insuficiencia renal cr&#243;nica"
            2 => "Disfunci&#243;n endotelial"
            3 => "Estatinas"
            4 => "Antiagregantes plaquetarios"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Backgrounds and purposes</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patients with chronic kidney disease &#40;CKD&#41; have higher risk of developing cardiovascular disease&#46; In CKD patients the mechanisms involved in&#44; endothelial damage and the role of different drugs used on these patients are not completely understood&#46; The aim of this work is to analyze the effect of statins and platelet antiaggregant &#40;PA&#41; on endothelial microvesicles &#40;EMVs&#41; and other markers of endothelial dysfunction&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Experimental approach</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional study of 41 patients with CKD 3b-4 and 8 healthy volunteers&#46; Circulating levels of EMVs&#44; vascular endothelial growth factor &#40;VEGF&#41;&#44; and advance oxidized protein products &#40;AOPPS&#41; were quantified and the correlation with different comorbidity variables and therapeutic strategies were evaluated&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">EMVs are increased in CKD patients as compared with controls &#40;171&#46;1 vs&#46; 68&#46;3&#47;&#956;l&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; It was observed a negative correlation between age and EMVs&#46; Statins and PA were associated with a reduction in EMVs and VEGF levels&#44; independently of the serum total cholesterol levels &#40;TC&#41;&#46; The levels of AOPPS and VEGF were not different in CKD vs&#46; controls&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">CKD is associated with a change in EMVs&#44; VEGF and AOPP levels&#46; The treatment with statins and PA normalizes these values to almost the observed in controls and this effect is independently of the prevailing TC level&#46; These findings explain the existence of the pleiotropic effects of statins and PA which deserve further studies&#46;</p></span>"
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            "titulo" => "Backgrounds and purposes"
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            "titulo" => "Experimental approach"
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          2 => array:2 [
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con insuficiencia renal cr&#243;nica &#40;IRC&#41; corren mayor riesgo de desarrollar enfermedad cardiovascular&#46; En los pacientes con IRC&#44; los mecanismos implicados en la disfunci&#243;n endotelial y el papel de los diferentes f&#225;rmacos utilizados en estos pacientes no se conocen por completo&#46; El objetivo de este art&#237;culo es analizar el efecto de las estatinas y los antiagregantes plaquetarios &#40;AP&#41; sobre las microves&#237;culas endoteliales &#40;MVE&#41; y otros marcadores de la disfunci&#243;n endotelial&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Enfoque experimental</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal con 41 pacientes con IRC 3b-4 y 8 voluntarios sanos&#46; Se cuantificaron los niveles de MVE&#44; factor de crecimiento vascular endotelial &#40;FCVE&#41; y productos avanzados de oxidaci&#243;n de prote&#237;nas &#40;AOPP&#44; por sus siglas en ingl&#233;s&#41; en la circulaci&#243;n y se evalu&#243; la correlaci&#243;n con diferentes variables de comorbilidad y estrategias terap&#233;uticas&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Las MVE aumentaron en pacientes con IRC al comparar los niveles con los controles &#40;171&#44;1 frente a 68&#44;3&#47;&#956;l&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Se observ&#243; una correlaci&#243;n negativa entre la edad y las MVE&#46; Las estatinas y los AP se asociaron con una reducci&#243;n de los niveles de MVE y FCVE&#44; independientemente de los niveles s&#233;ricos de colesterol total &#40;CT&#41;&#46; Los niveles de AOPP y FCVE no fueron diferentes entre los pacientes con IRC y los controles&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La IRC se asocia con un cambio de los niveles de MVE&#44; FCVE y AOPP&#46; El tratamiento con estatinas y AP normaliza estos valores a casi los observados en los controles y este efecto es independiente del nivel de CT predominante&#46; Estos hallazgos explican la existencia de los efectos pleiotr&#243;picos de las estatinas y los AP que merecen estudios adicionales&#46;</p></span>"
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            "titulo" => "Enfoque experimental"
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            "titulo" => "Resultados"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Garc&#237;a Men&#233;ndez E&#44; Marques Vidas M&#44; Alique M&#44; Carracedo J&#44; de Sequerac P&#44; Corchete E&#44; et al&#46; El uso de estatinas y antiagregantes se asocia con cambios en los marcadores de disfunci&#243;n endotelial en la enfermedad renal cr&#243;nica&#46; Nefrologia&#46; 2019&#59;39&#58;287&#8211;293&#46;</p>"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">AOPP &#40;a&#41; and VEGF &#40;b&#41; values according to the treatment with statin or PA&#46; Values of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 are indicated by an asterisk &#40;&#42;&#41; and outlayer values with this symbol &#40;<span class="elsevierStyleSup">o</span>&#41;&#46; AOPP&#58; advanced protein oxidation products&#59; VEGF&#58; vascular endothelial growth factor&#59; PA&#58; platelet antiaggregants&#46; Box plots indicate median and interquartile range&#46;</p>"
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                    ]
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                        "paginaInicial" => "163"
                        "paginaFinal" => "168"
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                          0 => array:2 [
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                            0 => "T&#46; Helbing"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25429325"
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                            2 => "F&#46;C&#46;P&#46; Frerichs"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ndt/gfr474"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nephrol Dial Transplant"
                        "fecha" => "2012"
                        "volumen" => "27"
                        "paginaInicial" => "1446"
                        "paginaFinal" => "1453"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Circulating Endothelial Microparticles Are Associated with Vascular Dysfunction in Patients with End-Stage Renal Failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Amabile"
                            1 => "A&#46;P&#46; Gu&#233;rin"
                            2 => "A&#46; Leroyer"
                            3 => "Z&#46; Mallat"
                            4 => "C&#46; Nguyen"
                            5 => "J&#46; Boddaert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1681/ASN.2005050535"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Soc Nephrol&#46;"
                        "fecha" => "2005"
                        "volumen" => "16"
                        "numero" => "11"
                        "paginaInicial" => "3381"
                        "paginaFinal" => "3388"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16192427"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Optimisation of an advanced oxidation protein products assay&#58; its application to studies of oxidative stress in diabetes mellitus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;L&#46; Taylor"
                            1 => "K&#46;R&#46; Armstrong"
                            2 => "D&#46; Perrett"
                            3 => "A&#46;T&#46; Hattersley"
                            4 => "P&#46;G&#46; Winyard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1155/2015/496271"
                      "Revista" => array:4 [
                        "tituloSerie" => "Oxid Med Cell Longev"
                        "fecha" => "2015"
                        "volumen" => "2015"
                        "paginaInicial" => "496271"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Are advanced oxidation protein products potential uremic toxins&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46; Vitko-Sarsat"
                            1 => "V&#46; Gausson"
                            2 => "B&#46; Descamps-Latscha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Kidney Int"
                        "fecha" => "2003"
                        "volumen" => "63"
                        "paginaInicial" => "11"
                        "paginaFinal" => "14"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Standardization of platelet-derived microparticle counting using calibrated beads and a cytomics FC500 routine flow cytometer&#58; a first step towards multicenter studies&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Robert"
                            1 => "P&#46; Poncelet"
                            2 => "R&#46; Lacroix"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1538-7836.2008.03200.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thromb Haemost"
                        "fecha" => "2009"
                        "volumen" => "7"
                        "paginaInicial" => "190"
                        "paginaFinal" => "197"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18983485"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endothelial damage and vascular calcification in patients with chronic kidney disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Soriano"
                            1 => "A&#46; Carmona"
                            2 => "F&#46; Trivi&#241;o"
                            3 => "M&#46; Rodriguez"
                            4 => "M&#46; Alvarez-Benito"
                            5 => "A&#46; Mart&#237;n-Malo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/ajprenal.00114.2014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Physiol - Ren Physiol"
                        "fecha" => "2014"
                        "volumen" => "307"
                        "numero" => "11"
                        "paginaInicial" => "1302"
                        "paginaFinal" => "1311"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impairment of Vascular Responses to Reactive Hyperemia and Nitric Oxide in Chronic Renal Failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Nakanishi"
                            1 => "Y&#46; Ishigami"
                            2 => "Y&#46; Otaki"
                            3 => "M&#46; Izumi"
                            4 => "K&#46; Hiraoka"
                            5 => "T&#46; Inoue"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000064078"
                      "Revista" => array:7 [
                        "tituloSerie" => "Nephron&#46;"
                        "fecha" => "2002"
                        "volumen" => "92"
                        "numero" => "3"
                        "paginaInicial" => "529"
                        "paginaFinal" => "535"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12372934"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nitric oxide production is reduced in patients with chronic renal failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Wever"
                            1 => "P&#46; Boer"
                            2 => "M&#46; Hijmering"
                            3 => "E&#46; Stroes"
                            4 => "M&#46; Verhaar"
                            5 => "J&#46; Kastelein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.ATV.19.5.1168"
                      "Revista" => array:7 [
                        "tituloSerie" => "Arterioscler Thromb Vasc Biol&#46;"
                        "fecha" => "1999"
                        "volumen" => "19"
                        "numero" => "5"
                        "paginaInicial" => "1168"
                        "paginaFinal" => "1172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10323766"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endothelium-derived microparticles impair endothelial function in vitro"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46;V&#46; Brodsky"
                            1 => "F&#46; Zhang"
                            2 => "A&#46; Nasjletti"
                            3 => "M&#46;S&#46; Goligorsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "AJP Hear Circ Physiol&#46;"
                        "fecha" => "2004"
                        "volumen" => "286"
                        "numero" => "5"
                        "paginaInicial" => "1910"
                        "paginaFinal" => "1915"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of 40 mg Versus 10 mg of Atorvastatin on Oxidized Low-Density Lipoprotein&#44; High-Sensitivity C-Reactive Protein"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Huang"
                            1 => "Y&#46; Cheng"
                            2 => "Q&#46; Xie"
                            3 => "G&#46; Lin"
                            4 => "Y&#46; Wu"
                            5 => "Y&#46; Feng"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/clc.21017 ET-2012/01/25"
                      "Revista" => array:7 [
                        "tituloSerie" => "Circulating Endothelial-Derived Microparticles&#44; and Endothelial Progenitor Cells in Patients With Ischemic Cardiomyopathy&#46; Clin Cardiol&#46;"
                        "fecha" => "2012"
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                        "numero" => "2"
                        "paginaInicial" => "125"
                        "paginaFinal" => "130"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22271072"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0225"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease &#40;Study of Heart and Renal Protection&#41;&#58; A randomised placebo-controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Baigent"
                            1 => "M&#46;J&#46; Landray"
                            2 => "C&#46; Reith"
                            3 => "J&#46; Emberson"
                            4 => "D&#46;C&#46; Wheeler"
                            5 => "C&#46; Tomson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(11)60739-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet&#46;"
                        "fecha" => "2011"
                        "volumen" => "377"
                        "numero" => "9784"
                        "paginaInicial" => "2181"
                        "paginaFinal" => "2192"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Simvastatin pretreatment enhances ischemia-induced neovascularization and blood flow recovery in streptozotocin-treated mice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46;H&#46; Huang"
                            1 => "J&#46;Y&#46; Chen"
                            2 => "C&#46;Y&#46; Chen"
                            3 => "J&#46;W&#46; Chen"
                            4 => "S&#46;J&#46; Lin"
                            5 => "C&#46;C&#46; Shih"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jvs.2014.11.088"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Vasc Surg"
                        "fecha" => "2016"
                        "volumen" => "64"
                        "paginaInicial" => "1112"
                        "paginaFinal" => "1120"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26830691"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Simvastatin ameliorates matrix stiffness-mediated endothelial monolayer disruption"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;C&#46; Lampi"
                            1 => "C&#46;J&#46; Faber"
                            2 => "J&#46; Huynh"
                            3 => "F&#46; Bordeleau"
                            4 => "M&#46;R&#46; Zanotelli"
                            5 => "C&#46;A&#46; Reinhart-King"
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                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0147033"
                      "Revista" => array:4 [
                        "tituloSerie" => "PLoS One"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28002457"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of low-dose aspirin on endothelial function in hypertensive patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Monobe"
                            1 => "H&#46; Yamanari"
                            2 => "K&#46; Nakamura"
                            3 => "T&#46; Ohe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/clc.4960241104"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Cardiol"
                        "fecha" => "2001"
                        "volumen" => "24"
                        "paginaInicial" => "705"
                        "paginaFinal" => "709"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11714127"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acetylsalicylate reduces endothelial and platelet-derived microparticles in patients with coronary artery disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Bulut"
                            1 => "V&#46; Becker"
                            2 => "A&#46; M&#252;gge"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1139/y11-013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Physiol Pharmacol"
                        "fecha" => "2011"
                        "volumen" => "89"
                        "paginaInicial" => "239"
                        "paginaFinal" => "244"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21539467"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aspirin induces nitric oxide release from vascular endothelium&#58; a novel mechanism of action"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46; Taubert"
                            1 => "R&#46; Berkels"
                            2 => "N&#46; Grosser"
                            3 => "H&#46; Schr&#246;der"
                            4 => "D&#46; Gr&#252;ndemann"
                            5 => "E&#46; Sch&#246;mig"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.bjp.0705907"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Pharmacol"
                        "fecha" => "2004"
                        "volumen" => "143"
                        "paginaInicial" => "159"
                        "paginaFinal" => "165"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15289285"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Circulating microparticles&#58; a potential prognostic marker for atherosclerotic vascular disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;M&#46; Boulanger"
                            1 => "N&#46; Amabile"
                            2 => "A&#46; Tedgui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.HYP. 0000231507.00962.b5"
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                        "tituloSerie" => "Hypertension"
                        "fecha" => "2006"
                        "volumen" => "48"
                        "paginaInicial" => "180"
                        "paginaFinal" => "186"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16801490"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Microparticles released by vascular endothelial cells increase hypoxia inducible factor expression in human proximal tubular HK-2 cells"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:5 [
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                            3 => "R&#46; Ramirez"
                            4 => "F&#46;J&#46; de Lucio-Caza&#241;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.biocel.2014.05.025"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Biochem Cell Biol"
                        "fecha" => "2014"
                        "volumen" => "53"
                        "paginaInicial" => "334"
                        "paginaFinal" => "342"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24878611"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Advanced oxidation protein products promote inflammation in diabetic kidney through activation of renal nicotinamide adenine dinucleotide phosphate oxidase"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
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                            1 => "F&#46;F&#46; Hou"
                            2 => "H&#46;X&#46; Niu"
                            3 => "G&#46;B&#46; Wang"
                            4 => "D&#46; Xie"
                            5 => "Z&#46;J&#46; Guo"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                        "paginaFinal" => "1839"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18174276"
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                    0 => array:2 [
                      "titulo" => "Age-Related Changes in Plasma Extracellular Vesicle Characteristics and Internalization by Leukocytes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Eitan"
                            1 => "J&#46; Green"
                            2 => "M&#46; Bodogai"
                            3 => "N&#46;A&#46; Mode"
                            4 => "R&#46; B&#230;k"
                            5 => "M&#46;M&#46; J&#248;rgensen"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1038/s41598-017-01386-z"
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                        "tituloSerie" => "Sci Rep&#46;"
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                        "volumen" => "7"
                        "numero" => "1"
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                        "paginaFinal" => "14"
                        "link" => array:1 [
                          0 => array:2 [
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                    ]
                  ]
                ]
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              "etiqueta" => "27"
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                      "titulo" => "Circulating microparticles and procoagulant activity in elderly patients"
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                          "autores" => array:6 [
                            0 => "A&#46; Forest"
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                            2 => "P&#46; Ray"
                            3 => "D&#46; Bonnet"
                            4 => "M&#46; Verny"
                            5 => "N&#46; Amabile"
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                        "tituloSerie" => "Journals Gerontol - Ser A Biol Sci Med Sci&#46;"
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                        "numero" => "4"
                        "paginaInicial" => "414"
                        "paginaFinal" => "420"
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                    ]
                  ]
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                          "autores" => array:3 [
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                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1038/aps.2013.188"
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                        "tituloSerie" => "Nat Publ Gr"
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                        "volumen" => "35"
                        "paginaInicial" => "433"
                        "paginaFinal" => "443"
                      ]
                    ]
                  ]
                ]
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Article information

ISSN: 20132514
Original language: English

DOI:10.1016/j.nefroe.2019.01.002

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Year/Month	Html	Pdf	Total

2024 November	6	2	8
2024 October	45	31	76
2024 September	39	26	65
2024 August	63	59	122
2024 July	42	21	63
2024 June	46	44	90
2024 May	46	44	90
2024 April	50	43	93
2024 March	46	29	75
2024 February	108	37	145
2024 January	29	32	61
2023 December	33	24	57
2023 November	67	38	105
2023 October	93	32	125
2023 September	272	38	310
2023 August	224	23	247
2023 July	56	28	84
2023 June	77	25	102
2023 May	64	31	95
2023 April	43	13	56
2023 March	46	26	72
2023 February	33	16	49
2023 January	40	34	74
2022 December	68	32	100
2022 November	64	38	102
2022 October	78	46	124
2022 September	46	51	97
2022 August	47	46	93
2022 July	50	57	107
2022 June	34	36	70
2022 May	41	30	71
2022 April	33	50	83
2022 March	33	54	87
2022 February	42	52	94
2022 January	54	42	96
2021 December	58	42	100
2021 November	47	42	89
2021 October	44	44	88
2021 September	34	38	72
2021 August	34	54	88
2021 July	36	40	76
2021 June	28	26	54
2021 May	49	62	111
2021 April	81	109	190
2021 March	57	45	102
2021 February	66	41	107
2021 January	72	24	96
2020 December	59	19	78
2020 November	50	12	62
2020 October	27	26	53
2020 September	40	21	61
2020 August	48	17	65
2020 July	49	12	61
2020 June	27	18	45
2020 May	44	11	55
2020 April	38	17	55
2020 March	38	13	51
2020 February	38	20	58
2020 January	75	35	110
2019 December	66	22	88
2019 November	44	22	66
2019 October	40	20	60
2019 September	39	27	66
2019 August	44	22	66
2019 July	43	38	81
2019 June	43	30	73
2019 May	59	53	112
2019 April	89	35	124
2019 March	39	35	74
2019 February	30	24	54
2019 January	19	8	27

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