Letter to the Editor
Chemotherapy and dialysis: A challenge
Quimioterapia y diálisis: un reto
Read
21969
Timeswas read the article
2989
Total PDF
18980
Total HTML
Share statistics
array:25 [ "pii" => "S2013251419300860" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2018.10.010" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "560" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2019" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2019;39:314-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1711 "formatos" => array:3 [ "EPUB" => 98 "HTML" => 1306 "PDF" => 307 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0211699519300013" "issn" => "02116995" "doi" => "10.1016/j.nefro.2018.10.003" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "560" "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;39:314-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7527 "formatos" => array:3 [ "EPUB" => 149 "HTML" => 5635 "PDF" => 1743 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Quimioterapia y diálisis: un reto" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "314" "paginaFinal" => "315" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Chemotherapy and dialysis: A challenge" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carolt Arana Aliaga, Jorge Luna-Abanto" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Carolt" "apellidos" => "Arana Aliaga" ] 1 => array:2 [ "nombre" => "Jorge" "apellidos" => "Luna-Abanto" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2013251419300860" "doi" => "10.1016/j.nefroe.2018.10.010" "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/S2013251419300860?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699519300013?idApp=UINPBA000064" "url" => "/02116995/0000003900000003/v2_201905101344/S0211699519300013/v2_201905101344/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S201325141930080X" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2019.05.002" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "567" "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;39:315-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 692 "formatos" => array:3 [ "EPUB" => 80 "HTML" => 437 "PDF" => 175 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Facial crusted scabies on renal transplant patient" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "315" "paginaFinal" => "317" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sarna costrosa facial en paciente con trasplante renal" ] ] "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" => 607 "Ancho" => 1255 "Tamanyo" => 123685 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lesions in the face: erythematous-scaly plaques (a and b).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Fernanda Poy Dondonis, Daniel Martins Costa Jappur, Gabriel Challub Pires, André da Silva Cartell, Renan Rangel Bonamigo" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Fernanda Poy" "apellidos" => "Dondonis" ] 1 => array:2 [ "nombre" => "Daniel Martins Costa" "apellidos" => "Jappur" ] 2 => array:2 [ "nombre" => "Gabriel Challub" "apellidos" => "Pires" ] 3 => array:2 [ "nombre" => "André da Silva" "apellidos" => "Cartell" ] 4 => array:2 [ "nombre" => "Renan Rangel" "apellidos" => "Bonamigo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S201325141930080X?idApp=UINPBA000064" "url" => "/20132514/0000003900000003/v1_201906270707/S201325141930080X/v1_201906270707/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2013251419300902" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2018.11.015" "estado" => "S300" "fechaPublicacion" => "2019-05-01" "aid" => "574" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2019;39:313-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 361 "formatos" => array:3 [ "EPUB" => 76 "HTML" => 153 "PDF" => 132 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "The efficacy of antiviral therapy after renal transplant in a HCV-positive recipient from a HCV-positive donor" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "313" "paginaFinal" => "314" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La eficacia de la terapia antiviral después del trasplante renal en un receptor con HCV positivo de un donante con HCV positivo" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Gioacchino Li Cavoli, Camillo Carollo, Barbara Oliva, Antonio Amato, Rosa Anna Turdo, Vitalba Azzolina, Rosalia Mongiovì, Flavia Caputo" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Gioacchino" "apellidos" => "Li Cavoli" ] 1 => array:2 [ "nombre" => "Camillo" "apellidos" => "Carollo" ] 2 => array:2 [ "nombre" => "Barbara" "apellidos" => "Oliva" ] 3 => array:2 [ "nombre" => "Antonio" "apellidos" => "Amato" ] 4 => array:2 [ "nombre" => "Rosa Anna" "apellidos" => "Turdo" ] 5 => array:2 [ "nombre" => "Vitalba" "apellidos" => "Azzolina" ] 6 => array:2 [ "nombre" => "Rosalia" "apellidos" => "Mongiovì" ] 7 => array:2 [ "nombre" => "Flavia" "apellidos" => "Caputo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251419300902?idApp=UINPBA000064" "url" => "/20132514/0000003900000003/v1_201906270707/S2013251419300902/v1_201906270707/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Chemotherapy and dialysis: A challenge" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "314" "paginaFinal" => "315" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carolt Arana Aliaga, Jorge Luna-Abanto" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Carolt" "apellidos" => "Arana Aliaga" "email" => array:1 [ 0 => "aranacaro100891@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Jorge" "apellidos" => "Luna-Abanto" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Fundació Puigvert, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Escuela de Posgrado, Universidad Peruana Cayetano Heredia, Lima, Peru" "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" => "Quimioterapia y diálisis: un reto" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">With a population of more than 4 million patients, Spain is one of the European countries with the highest prevalence of chronic kidney disease. Of that population, 31,735 are on renal replacement therapy, either on kidney transplant programmes, peritoneal dialysis or haemodialysis (HD); 23,709 are in the HD group, and more males are affected than females.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The causes of end-stage renal disease (ESRD) are multiple (diabetes, glomerulopathies, vascular diseases, etc.); in these patients, replacement therapy has shown benefits and increased life expectancy.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Cancer is one of the main causes of morbidity and mortality in Spain. It is predicted that 315,413 new cases will be diagnosed by 2035.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Chemotherapy is a standard systemic treatment for cancer, the efficacy of which has been reported in randomised studies, where an improvement in patients’ disease-free time and survival has been demonstrated. However, the majority of clinical trials demonstrating the efficacy of chemotherapy include populations with normal renal function.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In this context, it is now more common to find patients with kidney disease who develop cancer and vice versa.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> This has led to the importance of involving Nephrology and Oncology being assessed in recent years.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">There is a higher incidence of cancer in HD patients compared to controls<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> and urogenital cancers have been found to be the most prevalent in this population.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,5</span></a> A recent epidemiological study examined the causes of death in patients on renal replacement therapy and found cancer to be the third leading cause, at 20%, after cardiovascular events and infections.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,5</span></a> Carcinogenesis in patients with HD could be explained by the increase in chronic oxidative stress, which damages cell structures, the alteration of the cellular immune system, exposure to viral infections and the medications administered in these patients.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6,7</span></a> Alternatively, the increased incidence of cancer may be related to screening in kidney transplant programmes.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Chemotherapy is not contraindicated in patients with ESRD on replacement therapy. However, as described by Funakoshi et al. in a retrospective study of 675 patients,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> these patients are reported to have a high mortality rate due to causes other than cancer compared to non-dialysed patients. The CANDY (CANcer and DialYsis) multicentre study studied anti-cancer treatment in patients on long-term HD. This study reported that 88% of the patients required specific management of the cytotoxic drug, 44% developed iatrogenic toxicity in relation to inappropriate dose adjustment due to the lack of management recommendations in this specific group of patients, and overdose of chemotherapy drugs was more often associated with haematological, gastric and neurological side effects.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> As renal excretion plays an important role in the elimination of anti-cancer agents, renal failure can lead to accumulation of the drug, which increases toxicity.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> In contrast, some reports point to a reduction in neurotoxicity in patients with non-Hodgkin's lymphoma on chemotherapy and renal failure requiring HD.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The current challenge is to establish the role of the nephrologist when our patients on HD or with acute kidney injury are indicated chemotherapy. First of all, it must be borne in mind that each patient has a unique context: type of cancer; clinical stage; performance status; and a type of drug indicated with established doses and specific pre- or post-HD administration time.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In day-to-day practice, the clinical course of these patients is complex in view of the lack of evidence in the literature on the management of cytotoxic drugs in patients with ESRD on HD; the optimal time for administration, dose adjustments depending on the size of the molecule and pharmacokinetic behaviour are poorly understood. There are a few case series and scarce expert opinions that fail to reach a consensus on this subject and this is reflected in the small number of retrospective systemic reviews of certain chemotherapy drugs which have aimed to assess their pharmacokinetics and pharmacodynamics.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In conclusion, we are going to find an increasing number of patients with ESRD and cancer who require systemic treatment with cytotoxic drugs. In this scenario, we need to understand the pharmacology of chemotherapeutic agents in representative populations of patients with ESRD on HD, evaluate the characteristics of each molecule and prevent non-renal toxicity due to pharmacokinetic modifications of anti-cancer drugs. We also need to prevent early drug elimination in the dialysis process without altering their therapeutic efficacy. We believe that this is an important subject and there is still much to discuss: therapeutic algorithms, the type of dialysis to indicate and the efficacy and toxicity of anti-cancer drugs, all of which will have an impact on the survival of our patients.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => 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: Arana Aliaga C, Luna-Abanto J. Quimioterapia y diálisis: un reto. Nefrologia. 2019;39:314–315.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Informe Actualización" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Registro español de enfermos renales" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2015" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of anticancer treatment in patients under chronic dialysis: results of the multicentric CANDY (CANcer and DialYsis) study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Janus" 1 => "V. Launay-Vacher" 2 => "A. Thyss" 3 => "H. Boulanger" 4 => "O. Moranne" 5 => "M.S. Islam" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/annonc/mds344" "Revista" => array:6 [ "tituloSerie" => "Ann Oncol" "fecha" => "2013" "volumen" => "24" "paginaInicial" => "501" "paginaFinal" => "507" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23038759" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Las cifras del cáncer en España" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Sociedad Española de Oncología Médica (SEOM)" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2018" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chemotherapy in cancer patients undergoing haemodialysis: a nationwide study in Japan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Funakoshi" 1 => "T. Horimatsu" 2 => "M. Nakamura" 3 => "K. Shiroshita" 4 => "K. Suyama" 5 => "M. Mukoyama" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/esmoopen-2017-000301" "Revista" => array:6 [ "tituloSerie" => "ESMO Open" "fecha" => "2018" "volumen" => "3" "paginaInicial" => "e000301" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29531838" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1474442209703400" "estado" => "S300" "issn" => "14744422" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cancer in patients on dialysis for end-stage renal disease: an international collaborative study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Maisonneuve" 1 => "L. Agodoa" 2 => "R. Gellert" 3 => "J.H. Stewart" 4 => "G. Buccianti" 5 => "A.B. Lowenfels" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0140-6736(99)06154-1" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1999" "volumen" => "354" "paginaInicial" => "93" "paginaFinal" => "99" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10408483" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison and survival of patients receiving hemodialysis and peritoneal dialysis in a single center" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Uchida" 1 => "J. Shoda" 2 => "S. Sugahara" 3 => "N. Ikeda" 4 => "K. Kobayashi" 5 => "Y. Kanno" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Adv Perit Dial" "fecha" => "2007" "volumen" => "23" "paginaInicial" => "144" "paginaFinal" => "149" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17886622" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Are chronic dialysis patients at increased risk for cáncer?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Mandayam" 1 => "V.B. Shahinian" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Nephrol" "fecha" => "2008" "volumen" => "21" "paginaInicial" => "166" "paginaFinal" => "174" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18446710" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Onco-nephrology: current concepts and future perspectives" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y. Kitai" 1 => "T. Matsubara" 2 => "M. Yanagita" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jjco/hyv035" "Revista" => array:6 [ "tituloSerie" => "Jpn J Clin Oncol" "fecha" => "2015" "volumen" => "45" "paginaInicial" => "617" "paginaFinal" => "628" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25784734" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful use of cytarabine and bendamustine in a patient with mantle cell lymphoma and acute renal failure using intermittent hemodialysis: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Ettleson" 1 => "K. Bongers" 2 => "K. Vitale" 3 => "A.J. Perissinotti" 4 => "T. Phillips" 5 => "B.L. Marini" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "J Oncol Pharm Pract" "fecha" => "2018" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chemotherapeutic agents eligible for prior dosing in pancreatic cancer patients requiring hemodialysis: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Hann" 1 => "E. Nosalski" 2 => "P.C. Hermann" 3 => "J. Egger" 4 => "T. Seufferlein" 5 => "F. Keller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Clin Nephrol" "fecha" => "2018" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003900000003/v1_201906270707/S2013251419300860/v1_201906270707/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/20132514/0000003900000003/v1_201906270707/S2013251419300860/v1_201906270707/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251419300860?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 43 | 2 | 45 |
| 2024 October | 491 | 42 | 533 |
| 2024 September | 515 | 50 | 565 |
| 2024 August | 457 | 89 | 546 |
| 2024 July | 556 | 59 | 615 |
| 2024 June | 468 | 46 | 514 |
| 2024 May | 411 | 52 | 463 |
| 2024 April | 372 | 35 | 407 |
| 2024 March | 335 | 41 | 376 |
| 2024 February | 357 | 41 | 398 |
| 2024 January | 472 | 30 | 502 |
| 2023 December | 393 | 27 | 420 |
| 2023 November | 426 | 62 | 488 |
| 2023 October | 462 | 62 | 524 |
| 2023 September | 454 | 52 | 506 |
| 2023 August | 515 | 39 | 554 |
| 2023 July | 415 | 52 | 467 |
| 2023 June | 463 | 38 | 501 |
| 2023 May | 416 | 62 | 478 |
| 2023 April | 264 | 41 | 305 |
| 2023 March | 296 | 42 | 338 |
| 2023 February | 279 | 42 | 321 |
| 2023 January | 216 | 35 | 251 |
| 2022 December | 205 | 48 | 253 |
| 2022 November | 287 | 49 | 336 |
| 2022 October | 322 | 58 | 380 |
| 2022 September | 278 | 44 | 322 |
| 2022 August | 251 | 50 | 301 |
| 2022 July | 246 | 59 | 305 |
| 2022 June | 182 | 62 | 244 |
| 2022 May | 243 | 39 | 282 |
| 2022 April | 236 | 69 | 305 |
| 2022 March | 265 | 79 | 344 |
| 2022 February | 254 | 58 | 312 |
| 2022 January | 242 | 54 | 296 |
| 2021 December | 218 | 60 | 278 |
| 2021 November | 203 | 56 | 259 |
| 2021 October | 234 | 70 | 304 |
| 2021 September | 215 | 43 | 258 |
| 2021 August | 239 | 47 | 286 |
| 2021 July | 281 | 54 | 335 |
| 2021 June | 293 | 47 | 340 |
| 2021 May | 244 | 57 | 301 |
| 2021 April | 645 | 90 | 735 |
| 2021 March | 344 | 58 | 402 |
| 2021 February | 212 | 56 | 268 |
| 2021 January | 274 | 36 | 310 |
| 2020 December | 236 | 28 | 264 |
| 2020 November | 217 | 23 | 240 |
| 2020 October | 193 | 34 | 227 |
| 2020 September | 261 | 39 | 300 |
| 2020 August | 235 | 24 | 259 |
| 2020 July | 213 | 27 | 240 |
| 2020 June | 229 | 40 | 269 |
| 2020 May | 177 | 34 | 211 |
| 2020 April | 158 | 18 | 176 |
| 2020 March | 182 | 25 | 207 |
| 2020 February | 190 | 32 | 222 |
| 2020 January | 230 | 35 | 265 |
| 2019 December | 200 | 35 | 235 |
| 2019 November | 236 | 44 | 280 |
| 2019 October | 198 | 39 | 237 |
| 2019 September | 142 | 26 | 168 |
| 2019 August | 80 | 32 | 112 |
| 2019 July | 64 | 36 | 100 |
| 2019 June | 50 | 34 | 84 |
Show all
