Editorial
When the sport stops being health: Diets, supplements and substances to increase the performance and its relation with the kidney
Cuando el deporte deja de ser salud: dietas, suplementos y sustancias para aumentar el rendimiento y su relación con el riñón
M. Dolores Arenas Jiménez
Servicio de Nefrología, Hospital Vithas Perpetuo Internacional, Alicante, Spain
Read
10547
Timeswas read the article
2954
Total PDF
7593
Total HTML
Share statistics
array:24 [ "pii" => "S2013251419300768" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2018.10.007" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "561" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Nefrologia (English Version). 2019;39:223-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1214 "formatos" => array:3 [ "EPUB" => 95 "HTML" => 797 "PDF" => 322 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0211699519300025" "issn" => "02116995" "doi" => "10.1016/j.nefro.2018.10.004" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "561" "copyright" => "Sociedad Española de Nefrología" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Nefrologia. 2019;39:223-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 10248 "formatos" => array:3 [ "EPUB" => 155 "HTML" => 7112 "PDF" => 2981 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Cuando el deporte deja de ser salud: dietas, suplementos y sustancias para aumentar el rendimiento y su relación con el riñón" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "223" "paginaFinal" => "226" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "When the sport stops being health: diets, supplements and substances to increase the performance and its relation with the kidney" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Dolores Arenas Jiménez" "autores" => array:1 [ 0 => array:2 [ "nombre" => "M. Dolores" "apellidos" => "Arenas Jiménez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2013251419300768" "doi" => "10.1016/j.nefroe.2018.10.007" "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/S2013251419300768?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699519300025?idApp=UINPBA000064" "url" => "/02116995/0000003900000003/v2_201905101344/S0211699519300025/v2_201905101344/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S201325141930077X" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2018.10.008" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "569" "copyright" => "Sociedad Española de Nefrología" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "ssu" "cita" => "Nefrologia (English Version). 2019;39:227-42" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2289 "formatos" => array:3 [ "EPUB" => 82 "HTML" => 1422 "PDF" => 785 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review</span>" "titulo" => "Osteoporosis, bone mineral density and CKD-MBD (II): Therapeutic implications" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "227" "paginaFinal" => "242" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Osteoporosis, densidad mineral ósea y complejo CKD-MBD (II): implicaciones terapéuticas" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jordi Bover, Pablo Ureña-Torres, Ana María Laiz Alonso, Josep-Vicens Torregrosa, Minerva Rodríguez-García, Cristina Castro-Alonso, José Luis Górriz, Silvia Benito, Víctor López-Báez, María Jesús Lloret Cora, Secundino Cigarrán, Iara DaSilva, Maya Sánchez-Bayá, Silvia Mateu Escudero, Lluis Guirado, Jorge Cannata-Andía" "autores" => array:16 [ 0 => array:2 [ "nombre" => "Jordi" "apellidos" => "Bover" ] 1 => array:2 [ "nombre" => "Pablo" "apellidos" => "Ureña-Torres" ] 2 => array:2 [ "nombre" => "Ana María" "apellidos" => "Laiz Alonso" ] 3 => array:2 [ "nombre" => "Josep-Vicens" "apellidos" => "Torregrosa" ] 4 => array:2 [ "nombre" => "Minerva" "apellidos" => "Rodríguez-García" ] 5 => array:2 [ "nombre" => "Cristina" "apellidos" => "Castro-Alonso" ] 6 => array:2 [ "nombre" => "José Luis" "apellidos" => "Górriz" ] 7 => array:2 [ "nombre" => "Silvia" "apellidos" => "Benito" ] 8 => array:2 [ "nombre" => "Víctor" "apellidos" => "López-Báez" ] 9 => array:2 [ "nombre" => "María Jesús" "apellidos" => "Lloret Cora" ] 10 => array:2 [ "nombre" => "Secundino" "apellidos" => "Cigarrán" ] 11 => array:2 [ "nombre" => "Iara" "apellidos" => "DaSilva" ] 12 => array:2 [ "nombre" => "Maya" "apellidos" => "Sánchez-Bayá" ] 13 => array:2 [ "nombre" => "Silvia" "apellidos" => "Mateu Escudero" ] 14 => array:2 [ "nombre" => "Lluis" "apellidos" => "Guirado" ] 15 => array:2 [ "nombre" => "Jorge" "apellidos" => "Cannata-Andía" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0211699519300128" "doi" => "10.1016/j.nefro.2018.10.009" "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/S0211699519300128?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S201325141930077X?idApp=UINPBA000064" "url" => "/20132514/0000003900000003/v1_201906270707/S201325141930077X/v1_201906270707/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "When the sport stops being health: Diets, supplements and substances to increase the performance and its relation with the kidney" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "223" "paginaFinal" => "226" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "M. Dolores Arenas Jiménez" "autores" => array:1 [ 0 => array:3 [ "nombre" => "M. Dolores" "apellidos" => "Arenas Jiménez" "email" => array:1 [ 0 => "lola@olemiswebs.net" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Nefrología, Hospital Vithas Perpetuo Internacional, Alicante, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cuando el deporte deja de ser salud: dietas, suplementos y sustancias para aumentar el rendimiento y su relación con el riñón" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The adoration for a “perfect body” has been installed in our society. Between 6 and 10% of the clients of a gym use drugs and hormones to increase performance,<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">1</span></a> and in selected populations, such as weightlifters and bodybuilders, the abuse of these substances is much higher, reaching up to 44%.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The danger is not so much from the substances themselves, but from the way they are used: without medical supervision, making different combinations, and at doses much higher than usual in clinical practice. The real consequences of this abuse are not totally known. Due of this polypharmacy, it is often difficult to determine the specific agent responsible for kidney injury in these patients.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The kidney is one of the organs affected by these practices, and nephrology consultations in this population are becoming more frequent, which requires greater knowledge on the part of the nephrologist about this emerging pathology and a high level of suspicion, since the patient does not always recognize this abuse.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Although it is difficult to know the true dimension of the renal pathology associated with these substances, it is relevant for the nephrologist to know that approximately a 30% of anabolic users develop dependency and, therefore, would be at greater risk of developing the medical consequences of the prolonged use of these substances.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The objective of this manuscript is not to make a systematic review of the literature but simply to call the attention and increase the knowledge of the nephrologist regarding the substances that are commonly consumed by some athletes, identifying which of them and how can they affect the kidney. This will be useful to interpret the renal injuries and to learn how to advice about the consumption of these type of substances.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Interpretation of the formulas to estimate glomerular filtration rate</span><p id="par0030" class="elsevierStylePara elsevierViewall">The formulas used to estimate glomerular filtration rate (GFR) include levels of serum creatinine and are influenced by muscle mass and dietary intake, particularly by the supply of creatine.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">4</span></a> Creatine spontaneously and irreversibly becomes creatinine, so those who take creatine or have an important muscle mass can be falsely diagnosed of decreased renal function using the current formulas.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">5</span></a> Cystatin C is also influenced by gender, muscle mass, and steroid intake, so it would not bring advantages in this specific population. Although in research work the GFR has been assessed by the clearance of other exogenous substances as inulin or radioactive isotopes (99TmDTPA or 51Cr-EDTA),<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">5</span></a> the best alternative in our conditions in this type of population is the use of 24<span class="elsevierStyleHsp" style=""></span>h creatinine clearance.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Hyperproteic diets</span><p id="par0035" class="elsevierStylePara elsevierViewall">Increase of high-quality protein intake before and after exercise, improves the adaptive response to exercise,<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">6</span></a> increase the synthesis of glycogen and proteins, and reduce their degradation.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">7</span></a> Therefore, the International Society of Sports Nutrition in 2007 and 2017 considers safe and adequate a protein intake of 1.4–2.0<span class="elsevierStyleHsp" style=""></span>g/kg/day.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">8</span></a> Subsequent studies conducted in rats<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a> and in trained humans showed that a high protein intake (2.51–3.32<span class="elsevierStyleHsp" style=""></span>g/kg/day), during one year, did not produce alterations in lipids, liver function or renal function.<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">10,11</span></a> However, the reality is that athletes, even amateurs, increase the protein intake to levels higher than recommended, reaching up to 5<span class="elsevierStyleHsp" style=""></span>g/kg/day and for prolonged periods of time.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">12</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The normal physiological response of the kidney to high protein intake is to increase GFR,<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">13</span></a> reaching a normal or above normal renal function; these are hyperfiltration states, so called renal functional reserve (RFR). Although these diets may be safe in a trained healthy population, some authors warn about possible dangers, especially in patients with previous kidney disease.<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">14</span></a> It is suggested that this permanent challenge of RFR may cause and/or accelerate the deterioration of renal function.<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">15,16</span></a> It has been demonstrated an association between high protein intake and worsening of renal function.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">16</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Another risk of the hyperproteic diet is dehydration, by increasing the renal excretion of solutes – urea and other nitrogenous wastes–, which requires greater water consumption, especially if there is diabetes, hypertension or cardiovascular disease. And it is an independent risk factor for the development of kidney stones in predisposed individuals.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">17</span></a> They are also associated with an increased risk of type 2 diabetes due to diets with high acid load.<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">18</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Nutritional supplements</span><p id="par0050" class="elsevierStylePara elsevierViewall">Some nutrients used as nutritional supplements such as l-carnitine, choline/phosphatidylcholine, tryptophan and tyrosine, may produce toxic effects in patients with chronic kidney disease (CKD), as they modify the gut microbiota, increasing the number of bacteria that process these compounds into uremic toxins –N-trimethylamine oxide (TMAO), p-cresyl sulfate, indoyl sulfate and indole-3-acetic acid. These toxins are associated with an increased risk of death and cardiovascular disease.<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">19</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Creatine is widely used to increase muscle mass and improve athletic performance. It may increase creatinine levels without causing damage to renal function: in trained athletes, creatinine supplementation for 3 months had no detrimental effects on renal function, measured by 51 Cr-EDTA.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">20</span></a> The problem is that, in this context, an elevation of serum creatinine may reflect creatine supplementation or a real kidney damage, and the nephrologist must differentiate both situations by calculating the 24<span class="elsevierStyleHsp" style=""></span>h creatinine clearance.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Anabolic androgenic steroids (AAS)</span><p id="par0060" class="elsevierStylePara elsevierViewall">The current extent of the use and adverse effects of anabolic androgenic steroids (EAA) is unknown, but there is a significant hidden consumption by professional and amateur athletes worldwide, including adolescents.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">21</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">AAS include testosterone and the numerous synthetic analogs that are modified to increase anabolic effects.<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">22</span></a> They are formulated for oral, parenteral administration: intramuscular, subcutaneous, or transdermal injections. They are used in cycles of 6–12 weeks, and then suspended for a long or short period or continue the consumption at a lower dose. Occasionally, they are administered using a pyramidal pattern, starting with a low daily dose at the beginning until the maximum dose is reached, then gradually decreasing it until its withdrawal (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The amount consumed exceed the therapeutic doses by 10 and 100 times, often combining several preparations, oral and parenteral.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">During the last 4 years, there has been a 3 fold increase in liver complications (cholestatic liver disease and cholestatic liver disease) and renal complications (acute biliary nephropathy or biliary nephrosis,<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">23</span></a> focal and segmental glomerulosclerosis (FSGS) and tubulointerstitial nephropathy (NTI)) associated with AAS requiring hospitalization even dialysis.<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">24</span></a> A recent study conducted in 22 healthy biopsied adults who recognized more than 6 years consumption of high doses of proteins and AAS revealed FSGS in 8 patients, nephroangiosclerosis in 4, chronic interstitial nephritis in 3, acute interstitial nephritis in 2, nephrocalcinosis with interstitial nephritis chronic in 2 and single patients with membranous glomerulopathy, semilunar glomerulopathy and sclerosing glomerulonephritis. Patients with FSGS had a longer duration of exposure, late presentation and worse prognosis, and those with interstitial disease had a shorter exposure and an earlier presentation and the lesions improved or stabilized after the cessation of this practice.<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">25</span></a> The fact that FSGS affects bodybuilders after long-term abuse of AAS suggests that AAS are podocytic toxins.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">26</span></a> The levels of testosterone, creatinine, urea and urate increased with the use of these substances.<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">27</span></a> The decrease in GFR, the fibrosis and proliferation of renal cells may be due to overexpression of nephrin and podocin genes induced oxidative stress.<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">28</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Altered lipid profile, left ventricular hypertrophy and elevated blood pressure in young athletes should suspect the consumption of these substances, since they have a role in the regulation of cardiovascular function: release of nitric oxide (NO), mobilization of calcium, vascular apoptosis, hypertrophy, calcification, senescence and generation of reactive oxygen species.<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">29</span></a> The risk of death in chronic users of AAS is 4.6 times higher than in normal population adjusted for age.<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">30</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clenbuterol</span><p id="par0080" class="elsevierStylePara elsevierViewall">Clenbuterol, a bronchodilator used for the treatment of asthma, is also used for its anabolic properties. Clenbuterol may produce arrhythmias and electrolyte alterations (hypokalemia, hypomagnesemia and hypophosphatemia) that can cause sudden death.<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">31</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Exercise rhabdomyolysis</span><p id="par0085" class="elsevierStylePara elsevierViewall">Training reduces the risk of developing rhabdomyolysis, but in the presence of profuse sweating, the lack of adequate water and electrolyte replacement together with a high temperature may affect to even trained athletes, increasing the risk of renal failure. Any healthy person subjected to extreme and strenuous exercise may have an episode of rhabdomyolysis with acute renal failure and dialysis requirements, which have been described even after the first class of spinning.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">32</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="par0090" class="elsevierStylePara elsevierViewall">A recent systematic search of electronic databases concludes that the literature describing the dietary intake practices of competitive bodybuilders is outdated and often of poor quality<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">33</span></a>; and for all of this, some authors warn of the risk, and recommend to analyze serum creatinine and proteinuria before starting to consume this type of diet and supplements, since CKD is often silent and patients may be unaware of this condition.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">34</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Physicians and patients should be aware that, in patients with CKD, and even in healthy people, certain practices associated with sports can deteriorate the health.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Interpretation of the formulas to estimate glomerular filtration rate" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Hyperproteic diets" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Nutritional supplements" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Anabolic androgenic steroids (AAS)" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Clenbuterol" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Exercise rhabdomyolysis" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Conclusions" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Arenas Jiménez MD. Cuando el deporte deja de ser salud: dietas, suplementos y sustancias para aumentar el rendimiento y su relación con el riñón. Nefrologia. 2019;39:223–226.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dianabol: methandrostenolone (oral tablets of 10<span class="elsevierStyleHsp" style=""></span>mg).</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Testosterone: (1) sustanon: 400<span class="elsevierStyleHsp" style=""></span>mg/ml (contains a mixture of testosterones: 60<span class="elsevierStyleHsp" style=""></span>mg of testosterone propionate, 110<span class="elsevierStyleHsp" style=""></span>mg of testosterone phenylpropionate, 110<span class="elsevierStyleHsp" style=""></span>mg of testosterone isocaproate and 120<span class="elsevierStyleHsp" style=""></span>mg of testosterone decanoate); intramuscular injection; (2) propionate: testosterone propionate (intramuscular injection of 100<span class="elsevierStyleHsp" style=""></span>mmg/ml).</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Deca: nandrolone decanoate (solution for injection of 200<span class="elsevierStyleHsp" style=""></span>mg/ml).</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Primobolan: methenolone enanthate (intramuscular solution for injection 10 ampoules of 1<span class="elsevierStyleHsp" style=""></span>ml).</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Masteron: drostanolone propionate (injectable solution of 100<span class="elsevierStyleHsp" style=""></span>mg/ml).</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Trenbolone: trenbolone acetate (solution 100<span class="elsevierStyleHsp" style=""></span>mg/ml injectable).</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Winstrol: stanozolol (oral tablets of 10<span class="elsevierStyleHsp" style=""></span>mg).</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">T4: levothyroxine sodium (oral tablets of 100<span class="elsevierStyleHsp" style=""></span>μg).</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Clenbuterol: clenbuterol (oral tablets of 0.02<span class="elsevierStyleHsp" style=""></span>μg).</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Nolvadex: tamoxifen (oral tablets of 20<span class="elsevierStyleHsp" style=""></span>mg).</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Provirón: 25<span class="elsevierStyleHsp" style=""></span>mg tablets.</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Clomid: clomiphene; 50<span class="elsevierStyleHsp" style=""></span>mg tablets.</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">HCG: human chorionic gonadotropin; injectable solution in doses of 1500<span class="elsevierStyleHsp" style=""></span>UI.</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Source: information extracted from the clinical history of a bodybuilder patient with focal and segmental glomerulonephritis in a nephrology outpatient clinic.</p>" "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "fx1.jpeg" "imagenAlto" => 1551 "imagenAncho" => 2175 "imagenTamanyo" => 222314 ] ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Example of a steroid cycle used in sport.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib0175" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Masters swimmers use more dietary supplements than a large national comparison population in the United States" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.K. Guthrie" 1 => "S.R. Erickson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1123/ijsnem.2015-0043" "Revista" => array:6 [ "tituloSerie" => "Int J Sport Nutr Exerc Metab" "fecha" => "2016" "volumen" => "26" "paginaInicial" => "123" "paginaFinal" => "127" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26322803" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0180" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors for illicit anabolic-androgenic steroid use in male weightlifters: a cross-sectional cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H.G. Pope Jr." 1 => "G. Kanayama" 2 => "J.I. Hudson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.biopsych.2011.06.024" "Revista" => array:6 [ "tituloSerie" => "Biol Psychiatry" "fecha" => "2012" "volumen" => "71" "paginaInicial" => "254" "paginaFinal" => "261" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21839424" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0185" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anabolic-androgenic steroid dependence: an emerging disorder" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Kanayama" 1 => "K.J. Brower" 2 => "R.I. Wood" 3 => "J.I. Hudson" 4 => "H.G. Pope Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1360-0443.2009.02734.x" "Revista" => array:6 [ "tituloSerie" => "Addiction" "fecha" => "2009" "volumen" => "104" "paginaInicial" => "1966" "paginaFinal" => "1978" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19922565" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0190" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of creatine supplementation on renal function: a randomized, double-blind, placebo-controlled clinical trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Gualano" 1 => "C. Ugrinowitsch" 2 => "R.B. Novaes" 3 => "G.G. Artioli" 4 => "M.H. Shimizu" 5 => "A.C. Seguro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00421-007-0669-3" "Revista" => array:6 [ "tituloSerie" => "Eur J Appl Physiol" "fecha" => "2008" "volumen" => "103" "paginaInicial" => "33" "paginaFinal" => "40" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18188581" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0195" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How we estimate GFR – a pitfall of using a serum creatinine-based formula" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Refaie" 1 => "S.H. Moochhala" 2 => "N.S. Kanagasundaram" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Nephrol" "fecha" => "2007" "volumen" => "68" "paginaInicial" => "235" "paginaFinal" => "237" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0200" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "International Society of Sports Nutrition position stand: protein and exercise" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Jäger" 1 => "C.M. Kerksick" 2 => "B.I. Campbell" 3 => "P.J. Cribb" 4 => "S.D. Wells" 5 => "T.M. Skwiat" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12970-017-0177-8" "Revista" => array:4 [ "tituloSerie" => "J Int Soc Sports Nutr" "fecha" => "2017" "volumen" => "20" "paginaInicial" => "20" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0205" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Macronutrient considerations for the sport of bodybuilding" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.P. Lambert" 1 => "L.L. Frank" 2 => "W.J. Evans" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2165/00007256-200434050-00004" "Revista" => array:6 [ "tituloSerie" => "Sports Med" "fecha" => "2004" "volumen" => "34" "paginaInicial" => "317" "paginaFinal" => "327" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15107010" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0210" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "International Society of Sports Nutrition position stand: protein and exercise" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Campbell" 1 => "R.B. Kreider" 2 => "T. Ziegenfuss" 3 => "P. La Bounty" 4 => "M. Roberts" 5 => "D. Burke" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1550-2783-4-8" "Revista" => array:5 [ "tituloSerie" => "J Int Soc Sports Nutr" "fecha" => "2007" "volumen" => "4" "paginaInicial" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17908291" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0215" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postprandial leucine and insulin responses and toxicological effects of a novel whey protein hydrolysate-based supplement in rats" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.G. Toedebusch" 1 => "T.E. Childs" 2 => "S.R. Hamilton" 3 => "J.R. Crowley" 4 => "F.W. Booth" 5 => "M.D. Roberts" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1550-2783-9-24" "Revista" => array:5 [ "tituloSerie" => "J Int Soc Sports Nutr" "fecha" => "2012" "volumen" => "9" "paginaInicial" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22672725" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0220" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A high protein diet has no harmful effects: a one-year crossover study in resistance-trained males" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Antonio" 1 => "A. Ellerbroek" 2 => "T. Silver" 3 => "L. Vargas" 4 => "A. Tamayo" 5 => "R. Buehn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2016/9104792" "Revista" => array:4 [ "tituloSerie" => "J Nutr Metab" "fecha" => "2016" "volumen" => "2016" "paginaInicial" => "9104792" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0225" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A high protein diet (3.4<span class="elsevierStyleHsp" style=""></span>g/kg/d) combined with a heavy resistance training program improves body composition in healthy trained men and women – a follow-up investigation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Antonio" 1 => "A. Ellerbroek" 2 => "T. Silver" 3 => "S. Orris" 4 => "M. Scheiner" 5 => "A. Gonzalez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12970-015-0100-0" "Revista" => array:5 [ "tituloSerie" => "J Int Soc Sports Nutr" "fecha" => "2015" "volumen" => "12" "paginaInicial" => "39" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26500462" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0230" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy and consequences of very-high-protein diets for athletes and exercisers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K.D. Tipton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Proc Nutr Soc" "fecha" => "2011" "volumen" => "70" "paginaInicial" => "205" "paginaFinal" => "214" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0235" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High-protein diets: potential effects on the kidney in renal health and disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.N. Friedman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2004" "volumen" => "44" "paginaInicial" => "950" "paginaFinal" => "962" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15558517" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0240" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inadequate energy and excess protein intakes may be associated with worsening renal function in chronic kidney disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.C. Huang" 1 => "M.E. Chen" 2 => "H.C. Hung" 3 => "H.C. Chen" 4 => "W.T. Chang" 5 => "C.H. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.jrn.2007.08.003" "Revista" => array:6 [ "tituloSerie" => "J Ren Nutr" "fecha" => "2008" "volumen" => "18" "paginaInicial" => "187" "paginaFinal" => "194" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18267211" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0245" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of renal response to amino acid infusion and oral protein load in normal kidneys and kidney with acute and chronic disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F.B. Gabbai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MNH.0000000000000380" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Nephrol Hypertens" "fecha" => "2018" "volumen" => "27" "paginaInicial" => "23" "paginaFinal" => "29" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29068795" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0250" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High-protein diets and renal health" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Marckmann" 1 => "P. Osther" 2 => "A.N. Pedersen" 3 => "B. Jespersen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Ren Nutr" "fecha" => "2015" "volumen" => "25" "paginaInicial" => "1" "paginaFinal" => "5" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0255" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diet, fluid, or supplements for secondary prevention of nephrolithiasis: a systematic review and meta-analysis of randomized trials" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.A. Fink" 1 => "J.W. Akornor" 2 => "P.S. Garimella" 3 => "R. MacDonald" 4 => "A. Cutting" 5 => "I.R. Rutks" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eururo.2009.03.031" "Revista" => array:6 [ "tituloSerie" => "Eur Urol" "fecha" => "2009" "volumen" => "56" "paginaInicial" => "72" "paginaFinal" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19321253" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0260" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dietary acid load and risk of type 2 diabetes: a systematic review and dose-response meta-analysis of prospective observational studies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Jayedi" 1 => "S. Shab-Bidar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnesp.2017.12.005" "Revista" => array:6 [ "tituloSerie" => "Clin Nutr ESPEN" "fecha" => "2018" "volumen" => "23" "paginaInicial" => "10" "paginaFinal" => "18" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29460782" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0265" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutrients turned into toxins: microbiota modulation of nutrient properties in chronic kidney disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Fernandez-Prado" 1 => "R. Esteras" 2 => "M.V. Perez-Gomez" 3 => "C. Gracia-Iguacel" 4 => "E. Gonzalez-Parra" 5 => "A.B. Sanz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/nu9050489" "Revista" => array:5 [ "tituloSerie" => "Nutrients" "fecha" => "2017" "volumen" => "9" "paginaInicial" => "E489" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28498348" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0270" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Does long-term creatine supplementation impair kidney function in resistance-trained individuals consuming a high-protein diet?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Lugaresi" 1 => "M. Leme" 2 => "V. de Salles Painelli" 3 => "I.H. Murai" 4 => "H. Roschel" 5 => "M.T. Sapienza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1550-2783-10-26" "Revista" => array:5 [ "tituloSerie" => "J Int Soc Sports Nutr" "fecha" => "2013" "volumen" => "10" "paginaInicial" => "26" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23680457" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0275" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anabolic-androgenic steroid use and psychopathology in athletes. A systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Piacentino" 1 => "G.D. Kotzalidis" 2 => "A. del Casale" 3 => "M.R. Aromatario" 4 => "C. Pomara" 5 => "P. Girardi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2174/1570159X13666141210222725" "Revista" => array:6 [ "tituloSerie" => "Curr Neuropharmacol" "fecha" => "2015" "volumen" => "13" "paginaInicial" => "101" "paginaFinal" => "121" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26074746" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0280" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sustancias hormonales utilizadas como agentes ergogénicos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Laudo" 1 => "V. Puigdevall" 2 => "M.J. del Río" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "1999" "volumen" => "112" "paginaInicial" => "67" "paginaFinal" => "73" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0285" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute bile nephropathy secondary to anabolic steroids" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.M. Alkhunaizi" 1 => "M.A. ElTigani" 2 => "R.S. Rabah" 3 => "S.H. Nasr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5414/CN108696" "Revista" => array:6 [ "tituloSerie" => "Clin Nephrol" "fecha" => "2016" "volumen" => "85" "paginaInicial" => "121" "paginaFinal" => "126" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26587777" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0290" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tubulointerstitial injury and drugs of abuse" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Nanavati" 1 => "L.C. Herlitz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.ackd.2016.09.008" "Revista" => array:6 [ "tituloSerie" => "Adv Chronic Kidney Dis" "fecha" => "2017" "volumen" => "24" "paginaInicial" => "80" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28284383" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0295" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complementary bodybuilding: a potential risk for permanent kidney disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W. El-Reshaid" 1 => "K. El-Reshaid" 2 => "S. Al-Bader" 3 => "A. Ramadan" 4 => "J.P. Madda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/1319-2442.229269" "Revista" => array:6 [ "tituloSerie" => "Saudi J Kidney Dis Transpl" "fecha" => "2018" "volumen" => "29" "paginaInicial" => "326" "paginaFinal" => "331" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29657200" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0300" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nephrotoxic effects of common and emerging drugs of abuse" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W.F. Pendergraft 3rd" 1 => "L.C. Herlitz" 2 => "D. Thornley-Brown" 3 => "M. Rosner" 4 => "J.L. Niles" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2215/CJN.04190412" "Revista" => array:6 [ "tituloSerie" => "Clin J Am Soc Nephrol" "fecha" => "2014" "volumen" => "7" "paginaInicial" => "1996" "paginaFinal" => "2005" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22997342" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0305" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Understanding alterations on blood and biochemical parameters in athletes that use dietary supplements, steroids and illicit drugs" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.M. Bordin" 1 => "B.B. Bettim" 2 => "G.C. Perdona" 3 => "E.G. de Campos" 4 => "B.S. de Martinis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.tox.2016.05.019" "Revista" => array:6 [ "tituloSerie" => "Toxicology" "fecha" => "2017" "volumen" => "376" "paginaInicial" => "75" "paginaFinal" => "82" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27234315" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0310" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nandrolone administration with or without strenuous exercise promotes overexpression of nephrin and podocin genes and induces structural and functional alterations in the kidneys of rats" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Tofighi" 1 => "S. Ahmadi" 2 => "S.M. Seyyedi" 3 => "A. Shirpoor" 4 => "F. Kheradmand" 5 => "F.H. Gharalari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.toxlet.2017.10.015" "Revista" => array:6 [ "tituloSerie" => "Toxicol Lett" "fecha" => "2018" "volumen" => "282" "paginaInicial" => "147" "paginaFinal" => "153" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29097219" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0315" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Genomic and non-genomic effects of androgens in the cardiovascular system: clinical implications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.K. Lucas-Herald" 1 => "R. Alves-Lopes" 2 => "A.C. Montezano" 3 => "S.F. Ahmed" 4 => "R.M. Touyz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Sci (Lond)" "fecha" => "2017" "volumen" => "131" "paginaInicial" => "1405" "paginaFinal" => "1418" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0320" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The very high premature mortality rate among active professional wrestlers is primarily due to cardiovascular disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.W. Herman" 1 => "A.S. Conlon" 2 => "M. Rubenfire" 3 => "A.R. Burghardt" 4 => "S.J. McGregor" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0109945" "Revista" => array:4 [ "tituloSerie" => "PLoS One" "fecha" => "2014" "volumen" => "9" "paginaInicial" => "e109945" ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0325" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute clenbuterol overdose resulting in supraventricular tachycardia and atrial fibrillation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.P. Daubert" 1 => "V.H. Mabasa" 2 => "V.W. Leung" 3 => "C. Aaron" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/bf03160909" "Revista" => array:6 [ "tituloSerie" => "J Med Toxicol" "fecha" => "2007" "volumen" => "3" "paginaInicial" => "56" "paginaFinal" => "60" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18072161" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0330" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Freebie rhabdomyolysis: a public health concern. Spin class-induced rhabdomyolysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Brogan" 1 => "R. Ledesma" 2 => "A. Coffino" 3 => "P. Chander" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjmed.2016.11.004" "Revista" => array:6 [ "tituloSerie" => "Am J Med" "fecha" => "2017" "volumen" => "130" "paginaInicial" => "484" "paginaFinal" => "487" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27908792" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0335" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dietary intake of competitive bodybuilders" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Spendlove" 1 => "L. Mitchell" 2 => "J. Gifford" 3 => "D. Hackett" 4 => "G. Slater" 5 => "S. Cobley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Sports Med" "fecha" => "2015" "volumen" => "45" "paginaInicial" => "1041" "paginaFinal" => "1063" ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0340" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efectos metabólicos, renales y óseos de las dietas hiperproteicas. Papel regulador del ejercicio" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V.A. Aparicio" 1 => "E. Nebot" 2 => "J.M. Heredia" 3 => "P. Aranda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Andal Med Deporte [en línea]" "fecha" => "2010" "volumen" => "3" "paginaInicial" => "153" "paginaFinal" => "158" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003900000003/v1_201906270707/S2013251419300768/v1_201906270707/en/main.assets" "Apartado" => array:4 [ "identificador" => "38706" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Editorial" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003900000003/v1_201906270707/S2013251419300768/v1_201906270707/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251419300768?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 17 | 7 | 24 |
| 2024 October | 237 | 54 | 291 |
| 2024 September | 170 | 57 | 227 |
| 2024 August | 242 | 99 | 341 |
| 2024 July | 116 | 49 | 165 |
| 2024 June | 139 | 65 | 204 |
| 2024 May | 150 | 42 | 192 |
| 2024 April | 124 | 60 | 184 |
| 2024 March | 148 | 39 | 187 |
| 2024 February | 119 | 52 | 171 |
| 2024 January | 100 | 40 | 140 |
| 2023 December | 100 | 52 | 152 |
| 2023 November | 125 | 64 | 189 |
| 2023 October | 161 | 48 | 209 |
| 2023 September | 152 | 47 | 199 |
| 2023 August | 126 | 37 | 163 |
| 2023 July | 134 | 30 | 164 |
| 2023 June | 76 | 25 | 101 |
| 2023 May | 137 | 65 | 202 |
| 2023 April | 125 | 30 | 155 |
| 2023 March | 135 | 31 | 166 |
| 2023 February | 113 | 27 | 140 |
| 2023 January | 95 | 32 | 127 |
| 2022 December | 140 | 46 | 186 |
| 2022 November | 118 | 41 | 159 |
| 2022 October | 131 | 57 | 188 |
| 2022 September | 99 | 48 | 147 |
| 2022 August | 120 | 47 | 167 |
| 2022 July | 108 | 52 | 160 |
| 2022 June | 189 | 45 | 234 |
| 2022 May | 110 | 44 | 154 |
| 2022 April | 110 | 61 | 171 |
| 2022 March | 115 | 60 | 175 |
| 2022 February | 104 | 63 | 167 |
| 2022 January | 127 | 68 | 195 |
| 2021 December | 127 | 50 | 177 |
| 2021 November | 83 | 39 | 122 |
| 2021 October | 107 | 55 | 162 |
| 2021 September | 78 | 41 | 119 |
| 2021 August | 78 | 57 | 135 |
| 2021 July | 68 | 44 | 112 |
| 2021 June | 85 | 40 | 125 |
| 2021 May | 106 | 69 | 175 |
| 2021 April | 228 | 128 | 356 |
| 2021 March | 192 | 75 | 267 |
| 2021 February | 130 | 49 | 179 |
| 2021 January | 126 | 30 | 156 |
| 2020 December | 120 | 27 | 147 |
| 2020 November | 76 | 16 | 92 |
| 2020 October | 70 | 23 | 93 |
| 2020 September | 87 | 30 | 117 |
| 2020 August | 73 | 28 | 101 |
| 2020 July | 83 | 20 | 103 |
| 2020 June | 93 | 33 | 126 |
| 2020 May | 84 | 30 | 114 |
| 2020 April | 75 | 23 | 98 |
| 2020 March | 83 | 33 | 116 |
| 2020 February | 85 | 26 | 111 |
| 2020 January | 122 | 44 | 166 |
| 2019 December | 112 | 43 | 155 |
| 2019 November | 170 | 30 | 200 |
| 2019 October | 81 | 34 | 115 |
| 2019 September | 89 | 40 | 129 |
| 2019 August | 54 | 42 | 96 |
| 2019 July | 65 | 35 | 100 |
| 2019 June | 51 | 36 | 87 |
Show all
