Letter to the Editor
Immunotherapy in cancer: Great expectations in the world of oncology, but a reason for renal concern
Inmunoterapia en el cáncer: grandes expectativas en el mundo de la oncología, pero un motivo de preocupación renal
Read
5494
Timeswas read the article
2432
Total PDF
3062
Total HTML
Share statistics
array:25 [ "pii" => "S2013251419300069" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2018.05.005" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "499" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2018" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2019;39:94-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 941 "formatos" => array:3 [ "EPUB" => 120 "HTML" => 505 "PDF" => 316 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0211699518300778" "issn" => "02116995" "doi" => "10.1016/j.nefro.2018.05.002" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "499" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2019;39:94-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3966 "formatos" => array:3 [ "EPUB" => 245 "HTML" => 2697 "PDF" => 1024 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Inmunoterapia en el cáncer: grandes expectativas en el mundo de la oncología, pero un motivo de preocupación renal" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "94" "paginaFinal" => "96" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cancer immunotherapy: Great expectations in the world of oncology but a cause for kidney concern" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 159519 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Microfotografía de uno de los 8 glomérulos que aportó la muestra en el que no se observan lesiones relevantes (H&E, ×40).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Beatriz Redondo, Candela Moliz, Marina Alonso, Luis Paz-Ares, Manuel Praga, Enrique Morales" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Redondo" ] 1 => array:2 [ "nombre" => "Candela" "apellidos" => "Moliz" ] 2 => array:2 [ "nombre" => "Marina" "apellidos" => "Alonso" ] 3 => array:2 [ "nombre" => "Luis" "apellidos" => "Paz-Ares" ] 4 => array:2 [ "nombre" => "Manuel" "apellidos" => "Praga" ] 5 => array:2 [ "nombre" => "Enrique" "apellidos" => "Morales" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2013251419300069" "doi" => "10.1016/j.nefroe.2018.05.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251419300069?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699518300778?idApp=UINPBA000064" "url" => "/02116995/0000003900000001/v1_201901090606/S0211699518300778/v1_201901090606/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S201325141930001X" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2019.01.001" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "498" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2019;39:96-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1227 "formatos" => array:3 [ "EPUB" => 151 "HTML" => 701 "PDF" => 375 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "A case report of cyanotic nephropathy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "96" "paginaFinal" => "98" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nefropatía por cianosis. A propósito de un caso" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1567 "Ancho" => 2157 "Tamanyo" => 349216 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pathophysiology of cyanotic nephropathy.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">FF: filtration fraction; RBF: renal blood flow; FSGE: focal and segmental glomerulosclerosis; GLM: glomerulus; MCGN: minimal change glomerulonephritis; GHF: glomerular hyperfiltration; HT: hypertrophy; PDGF: platelet derived growth factor; PCT: proximal convoluted tubule; TGFβ: tumor growth factor β; AA VSD: arteriolar afferent vasodilation.</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Continuous line: pathway of vascular damage; broken line: path of proliferative damage; double grid: path of final damage.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mayra Ortega-Díaz, Marta Puerta Carretero, Elena Corchete, Juan A. Martín Navarro, M. Teresa Jaldo, Marta Albalate, Patricia de Sequera, Roberto Alcázar Arroyo" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Mayra" "apellidos" => "Ortega-Díaz" ] 1 => array:2 [ "nombre" => "Marta" "apellidos" => "Puerta Carretero" ] 2 => array:2 [ "nombre" => "Elena" "apellidos" => "Corchete" ] 3 => array:2 [ "nombre" => "Juan A." "apellidos" => "Martín Navarro" ] 4 => array:2 [ "nombre" => "M. Teresa" "apellidos" => "Jaldo" ] 5 => array:2 [ "nombre" => "Marta" "apellidos" => "Albalate" ] 6 => array:2 [ "nombre" => "Patricia" "apellidos" => "de Sequera" ] 7 => array:2 [ "nombre" => "Roberto" "apellidos" => "Alcázar Arroyo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0211699518300766" "doi" => "10.1016/j.nefro.2018.05.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699518300766?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S201325141930001X?idApp=UINPBA000064" "url" => "/20132514/0000003900000001/v1_201903030617/S201325141930001X/v1_201903030617/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2013251418301433" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2018.11.008" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "481" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2019;39:92-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1476 "formatos" => array:3 [ "EPUB" => 158 "HTML" => 681 "PDF" => 637 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Potentially inappropriate prescribing in patients on dialysis using STOPP-START criteria" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "92" "paginaFinal" => "94" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prescripción potencialmente inapropiada en pacientes en diálisis utilizando los criterios STOPP-START" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Anunciación Gonzalez-Lopez, Alvaro Nava-Rebollo, Angel Chocarro-Martinez, Beatriz Andres-Martin, Henar Santana-Zapatero, Francisco Herrera-Gomez, Julia Diego-Martin, Cipriano Escaja-Muga, Jesús Grande-Villoria" "autores" => array:9 [ 0 => array:2 [ "nombre" => "Anunciación" "apellidos" => "Gonzalez-Lopez" ] 1 => array:2 [ "nombre" => "Alvaro" "apellidos" => "Nava-Rebollo" ] 2 => array:2 [ "nombre" => "Angel" "apellidos" => "Chocarro-Martinez" ] 3 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Andres-Martin" ] 4 => array:2 [ "nombre" => "Henar" "apellidos" => "Santana-Zapatero" ] 5 => array:2 [ "nombre" => "Francisco" "apellidos" => "Herrera-Gomez" ] 6 => array:2 [ "nombre" => "Julia" "apellidos" => "Diego-Martin" ] 7 => array:2 [ "nombre" => "Cipriano" "apellidos" => "Escaja-Muga" ] 8 => array:2 [ "nombre" => "Jesús" "apellidos" => "Grande-Villoria" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0211699518300584" "doi" => "10.1016/j.nefro.2018.03.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699518300584?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251418301433?idApp=UINPBA000064" "url" => "/20132514/0000003900000001/v1_201903030617/S2013251418301433/v1_201903030617/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Immunotherapy in cancer: Great expectations in the world of oncology, but a reason for renal concern" "tieneTextoCompleto" => true "saludo" => "Director," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "94" "paginaFinal" => "96" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Beatriz Redondo, Candela Moliz, Marina Alonso, Luis Paz-Ares, Manuel Praga, Enrique Morales" "autores" => array:6 [ 0 => array:3 [ "nombre" => "Beatriz" "apellidos" => "Redondo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Candela" "apellidos" => "Moliz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Marina" "apellidos" => "Alonso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Luis" "apellidos" => "Paz-Ares" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Manuel" "apellidos" => "Praga" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:4 [ "nombre" => "Enrique" "apellidos" => "Morales" "email" => array:1 [ 0 => "emoralesr@senefro.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Oncología, Hospital Universitario 12 de Octubre, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Inmunoterapia en el cáncer: grandes expectativas en el mundo de la oncología, pero un motivo de preocupación renal" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 950 "Ancho" => 950 "Tamanyo" => 246678 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ultrastructural image of a glomerular capillary wall in which irregular pedicle fusion is observed.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In recent years, the field of therapy in oncological has expanded significantly with the introduction of new immunomodulatory therapies that have resulted in an important change in patient survival; in addition there is an increase in the spectrum of adverse effects which are the consequence of its own mechanism of action.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a 55-year-old woman with a history of active smoking who came to the emergency room for right frontoparietal headache, a non quantified weight loss and progressive focal neurological deterioration in the form of behavioral changes, paraphasia-dysphasias, gait instability and urinary incontinence. A cranial scan was performed, which revealed lesions suggestive of malignancy at the right temporal and left frontal levels with displacement of the midline and subfalcine herniation. These lesions, together with the presence of a pulmonary nodule in the left upper lobe seen in chest radiography, established a diagnosis of suspected intracranial metastasis due to a possible primary lung tumor. Several days later resection surgery of the right temporal lesion was performed. The histological study of the surgical specimen showed the presence of a pulmonary adenocarcinoma with non-mutated EGFR, and negative ALK and ROS1. The extension study was completed with a complete scan that confirmed the presence of a mass of 7<span class="elsevierStyleHsp" style=""></span>cm in the posterior segment of the left upper pulmonary lobe that encompassed the left pulmonary artery and an ipsilateral mediastinal adenopathy of 12<span class="elsevierStyleHsp" style=""></span>mm. Due to the fact that it was a stage IV pulmonary adenocarcinoma, a combined treatment with radiotherapy was decided on the left unresected left lesion and the administration of chemotherapy within an experimental protocol with nivolumab and ipilimumab achieving a maintained partial response according to morphological criteria by control image tests.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Six months after initiation of the immunomodulatory therapy, the patient developed nephrotic syndrome by biochemical data and no edema. The renal function remained normal. The oncology service decided to discontinue the drugs temporarily because of the possible causal relationship with the nephrotic syndrome. However, in view of the persistence of proteinuria, it was decided together with the nephrology service, to perform a renal biopsy to establish a histological diagnosis and the possibility of subsequent treatment.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The renal biopsy showed the presence of a renal parenchyma with 8 glomeruli, one of which was sclerotic, with no relevant lesions in the remaining glomeruli(<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The renal interstitium presented moderate fibrosis and areas of tubular atrophy with a discrete nonspecific inflammatory infiltrate. The arteries showed a 25% reduction of their inner diameter due to an atherosclerotic process, together with occasional hyalinosis in arterioles and without damage in the tubular capillaries. The immunohistochemical study did not demonstrate the presence of deposits, but the ultrastructural study (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) identified a 60% fusion of foot processes of the capillary surface with rearrangement of the actin filaments. Combining the clinical and anatomopathological data, it was assumed the diagnosis of a disease due to minimal changes secondary to immunomodulatory treatment, so treatment with prednisone was started at a dose of 1<span class="elsevierStyleHsp" style=""></span>mg/kg/day in a 10-mg regimen every 15 days, reaching a complete remission in the first 4 weeks of treatment.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The drugs inhibiting the “checkpoint”, such as nivolumab and ipilimumab, are monoclonal antibodies that act by inhibiting the receptors expressed on the surface of T lymphocytes (CTLA-4 and PD-1/PD-L1), responsible for inhibiting the stimulation that prevents the attack and the lysis of own cells. Overexpression of these receptors is frequent to evade immune control over tumor proliferation. By blocking these two receptors, there is an increase in the response of the immune system with loss of tolerance to tumor cells with a demonstrated beneficial effect against solid and hematological tumors.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> Previous studies have described the presence of acute renal failure (together with involvement of other organs, mainly glandular in the form of hypophysitis, adrenalitis and sialadenitis) with non-nephrotic proteinuria and predominantly interstitial damage in the renal histological study.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> However, glomerular involvement in this context is scarcely described in the literature. Some cases similar to our patient have been described, highlighting as common elements: the latency time from the beginning of the treatment, the excellent renal response to the administration of steroids and the suspension of the drug, the recurrence of the clinical picture after the reintroduction of the drug. treatment and extensive fusion of foot processes as a histological finding in the ultrastructural study.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">3–5</span></a> As already described in cases of idiopathic nephrotic syndrome,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> the proposed etiopathogenic mechanism of this entity is a direct damage of podocyte induced by self-reactive T lymphocytes through the expression and function of the podocyte CD80 (B7-1) receptor. The increase in the use of these therapies in oncology, should increase the incidence of cases similar the one presented here. Finally, we believe that it is necessary to monitor renal function and proteinuria in this group of patients in order to make an early diagnosis and establish an effective treatment.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Redondo B, Moliz C, Alonso M, Paz-Ares L, Praga M, Morales E. Inmunoterapia en el cáncer: grandes expectativas en el mundo de la oncología, pero un motivo de preocupación renal. Nefrologia. 2019;39:94–96.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 159519 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Microphotograph of one of the 8 glomeruli in which no relevant lesions were observed (H & E,<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>40).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 950 "Ancho" => 950 "Tamanyo" => 246678 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ultrastructural image of a glomerular capillary wall in which irregular pedicle fusion is observed.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nivolumab plus ipilimumab versus sunitinib in advanced renal-cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.J. Motzer" 1 => "N.M. Tannir" 2 => "D.F. McDermott" 3 => "O. Arén Frontera" 4 => "B. Melichar" 5 => "T.K. Choueiri" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1712126" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2018" "volumen" => "378" "paginaInicial" => "1277" "paginaFinal" => "1290" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29562145" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathological features of acute kidney injury associated with immune checkpoint inhibitors" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.B. Cortazar" 1 => "K.A. Marrone" 2 => "M.L. Troxell" 3 => "K.M. Ralto" 4 => "M.P. Hoenig" 5 => "J.R. Brahmer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.kint.2016.04.008" "Revista" => array:6 [ "tituloSerie" => "Kidney Int" "fecha" => "2016" "volumen" => "90" "paginaInicial" => "638" "paginaFinal" => "647" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27282937" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nephrotic syndrome with cancer immunotherapies: a report of 2 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Kitchlu" 1 => "W. Fingrut" 2 => "C. Avila-Casado" 3 => "C.T. Chan" 4 => "M. Crump" 5 => "D. Hogg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.ajkd.2017.04.026" "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2017" "volumen" => "70" "paginaInicial" => "581" "paginaFinal" => "585" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28648302" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nivolumab-associated nephrotic syndrome in a patient with renal cell carcinoma: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.A. Daanen" 1 => "R.J.H. Mass" 2 => "E.J. Steenbergen" 3 => "C.M.L. van Herpen" 4 => "A.E.C.A.B. Willemsen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Inmmunother" "fecha" => "2017" "volumen" => "40" "paginaInicial" => "345" "paginaFinal" => "348" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.M. Kidd" 1 => "A.B. Gizaw" 2 => "Ipilimumab-associated minimal-change disease" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.kint.2015.11.028" "Revista" => array:5 [ "tituloSerie" => "Kidney Int" "fecha" => "2016" "volumen" => "89" "paginaInicial" => "720" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26880464" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Induction of B7-1 in podocytes is associated with nephrotic syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Reiser" 1 => "G. von Gersdorff" 2 => "M. Loss" 3 => "J. Oh" 4 => "K. Asanuma" 5 => "L. Giardino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1172/JCI20402" "Revista" => array:6 [ "tituloSerie" => "J Clin Invest" "fecha" => "2004" "volumen" => "113" "paginaInicial" => "1390" "paginaFinal" => "1397" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15146236" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003900000001/v1_201903030617/S2013251419300069/v1_201903030617/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003900000001/v1_201903030617/S2013251419300069/v1_201903030617/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251419300069?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 47 | 37 | 84 |
| 2024 September | 45 | 41 | 86 |
| 2024 August | 51 | 57 | 108 |
| 2024 July | 26 | 32 | 58 |
| 2024 June | 46 | 38 | 84 |
| 2024 May | 36 | 37 | 73 |
| 2024 April | 39 | 43 | 82 |
| 2024 March | 38 | 25 | 63 |
| 2024 February | 25 | 38 | 63 |
| 2024 January | 23 | 24 | 47 |
| 2023 December | 31 | 30 | 61 |
| 2023 November | 58 | 49 | 107 |
| 2023 October | 51 | 63 | 114 |
| 2023 September | 51 | 53 | 104 |
| 2023 August | 35 | 19 | 54 |
| 2023 July | 49 | 34 | 83 |
| 2023 June | 38 | 31 | 69 |
| 2023 May | 39 | 42 | 81 |
| 2023 April | 31 | 23 | 54 |
| 2023 March | 61 | 33 | 94 |
| 2023 February | 40 | 24 | 64 |
| 2023 January | 31 | 33 | 64 |
| 2022 December | 60 | 37 | 97 |
| 2022 November | 48 | 51 | 99 |
| 2022 October | 57 | 69 | 126 |
| 2022 September | 48 | 41 | 89 |
| 2022 August | 31 | 38 | 69 |
| 2022 July | 27 | 54 | 81 |
| 2022 June | 30 | 42 | 72 |
| 2022 May | 76 | 27 | 103 |
| 2022 April | 72 | 47 | 119 |
| 2022 March | 61 | 50 | 111 |
| 2022 February | 67 | 57 | 124 |
| 2022 January | 34 | 35 | 69 |
| 2021 December | 61 | 47 | 108 |
| 2021 November | 39 | 23 | 62 |
| 2021 October | 51 | 69 | 120 |
| 2021 September | 68 | 41 | 109 |
| 2021 August | 43 | 42 | 85 |
| 2021 July | 52 | 40 | 92 |
| 2021 June | 60 | 32 | 92 |
| 2021 May | 53 | 58 | 111 |
| 2021 April | 97 | 107 | 204 |
| 2021 March | 77 | 38 | 115 |
| 2021 February | 59 | 40 | 99 |
| 2021 January | 55 | 32 | 87 |
| 2020 December | 38 | 19 | 57 |
| 2020 November | 43 | 12 | 55 |
| 2020 October | 36 | 31 | 67 |
| 2020 September | 40 | 17 | 57 |
| 2020 August | 17 | 19 | 36 |
| 2020 July | 35 | 17 | 52 |
| 2020 June | 26 | 19 | 45 |
| 2020 May | 41 | 14 | 55 |
| 2020 April | 24 | 19 | 43 |
| 2020 March | 23 | 17 | 40 |
| 2020 February | 34 | 23 | 57 |
| 2020 January | 38 | 20 | 58 |
| 2019 December | 35 | 21 | 56 |
| 2019 November | 26 | 23 | 49 |
| 2019 October | 37 | 23 | 60 |
| 2019 September | 37 | 21 | 58 |
| 2019 August | 22 | 17 | 39 |
| 2019 July | 33 | 26 | 59 |
| 2019 June | 55 | 26 | 81 |
| 2019 May | 43 | 42 | 85 |
| 2019 April | 83 | 46 | 129 |
| 2019 March | 33 | 17 | 50 |
| 2019 February | 46 | 20 | 66 |
Show all
