array:24 [
  "pii" => "S2013251420301024"
  "issn" => "20132514"
  "doi" => "10.1016/j.nefroe.2019.08.009"
  "estado" => "S300"
  "fechaPublicacion" => "2020-07-01"
  "aid" => "668"
  "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). 2020;40:485-6"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2013251420301000"
    "issn" => "20132514"
    "doi" => "10.1016/j.nefroe.2019.08.008"
    "estado" => "S300"
    "fechaPublicacion" => "2020-07-01"
    "aid" => "660"
    "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). 2020;40:486-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Development of C3 glomerulopathy in a patient with acquired partial lipodystrophy"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "486"
          "paginaFinal" => "487"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Desarrollo de glomerulopat&#237;a C3 en paciente con lipodistrofia parcial adquirida"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Elena Hern&#225;ndez Garc&#237;a, Elena Borrego Garc&#237;a, Antonio Navas-Parejo Casado"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Elena Hern&#225;ndez"
              "apellidos" => "Garc&#237;a"
            ]
            1 => array:2 [
              "nombre" => "Elena Borrego"
              "apellidos" => "Garc&#237;a"
            ]
            2 => array:2 [
              "nombre" => "Antonio Navas-Parejo"
              "apellidos" => "Casado"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0211699519301742"
        "doi" => "10.1016/j.nefro.2019.08.002"
        "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/S0211699519301742?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420301000?idApp=UINPBA000064"
    "url" => "/20132514/0000004000000004/v1_202011020618/S2013251420301000/v1_202011020618/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2013251420300973"
    "issn" => "20132514"
    "doi" => "10.1016/j.nefroe.2020.09.005"
    "estado" => "S300"
    "fechaPublicacion" => "2020-07-01"
    "aid" => "644"
    "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "Nefrologia &#40;English Version&#41;. 2020;40:481-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Necrotising glomerulonephritis in a patient with HIV&#44; HCV and visceral leishmaniasis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "481"
          "paginaFinal" => "484"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Glomerulonefritis necrosante en un paciente con VIH&#44; VHC y leishmaniasis visceral"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0010"
          "etiqueta" => "Fig&#46; 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 451
              "Ancho" => 1800
              "Tamanyo" => 267261
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0010"
              "detalle" => "Fig&#46; "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Kidney biopsy&#46; A&#41; Haematoxylin&#8210;eosin staining&#58; segmental necrotising lesion with fibrin and remnants of fragmented nuclei&#46; B&#41; Periodic acid&#8211;Schiff &#40;PAS&#41; staining&#58; epithelial half-moon&#46; C&#41; Silver staining&#58; epithelial half-moon&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Marta Puerta Carretero, Mayra Ortega D&#237;az, Elena Corchete Prats, David Rold&#225;n Cort&#233;s, Guillermo Cuevas Tasc&#243;n, Juan A&#46; Mart&#237;n Navarro, Maria Teresa Jaldo Rodr&#237;guez, Laura Medina Zahonero, Melissa Cintra Cabrera, Pablo Ryan Mur&#250;a, Marta Albalate Ram&#243;n, Patricia de Sequera Ortiz, Roberto Alc&#225;zar Arroyo"
          "autores" => array:13 [
            0 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Puerta Carretero"
            ]
            1 => array:2 [
              "nombre" => "Mayra"
              "apellidos" => "Ortega D&#237;az"
            ]
            2 => array:2 [
              "nombre" => "Elena"
              "apellidos" => "Corchete Prats"
            ]
            3 => array:2 [
              "nombre" => "David"
              "apellidos" => "Rold&#225;n Cort&#233;s"
            ]
            4 => array:2 [
              "nombre" => "Guillermo"
              "apellidos" => "Cuevas Tasc&#243;n"
            ]
            5 => array:2 [
              "nombre" => "Juan A&#46;"
              "apellidos" => "Mart&#237;n Navarro"
            ]
            6 => array:2 [
              "nombre" => "Maria Teresa"
              "apellidos" => "Jaldo Rodr&#237;guez"
            ]
            7 => array:2 [
              "nombre" => "Laura"
              "apellidos" => "Medina Zahonero"
            ]
            8 => array:2 [
              "nombre" => "Melissa"
              "apellidos" => "Cintra Cabrera"
            ]
            9 => array:2 [
              "nombre" => "Pablo"
              "apellidos" => "Ryan Mur&#250;a"
            ]
            10 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Albalate Ram&#243;n"
            ]
            11 => array:2 [
              "nombre" => "Patricia"
              "apellidos" => "de Sequera Ortiz"
            ]
            12 => array:2 [
              "nombre" => "Roberto"
              "apellidos" => "Alc&#225;zar Arroyo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0211699519301432"
        "doi" => "10.1016/j.nefro.2019.05.003"
        "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/S0211699519301432?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420300973?idApp=UINPBA000064"
    "url" => "/20132514/0000004000000004/v1_202011020618/S2013251420300973/v1_202011020618/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Is there an age limit for starting haemodialysis&#63;"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "485"
        "paginaFinal" => "486"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Yanet Parodis L&#243;pez, Tania Monz&#243;n Vazquez, Francisco Valga, Francisco Alonso Alman, Juan Francisco Betancor Jim&#233;nez, Sebastian Hillebrand Ortega, Fernando Henr&#237;quez Palop, Gloria Anton P&#233;rez"
        "autores" => array:8 [
          0 => array:4 [
            "nombre" => "Yanet"
            "apellidos" => "Parodis L&#243;pez"
            "email" => array:1 [
              0 => "yanet.parodis@avericum.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Tania"
            "apellidos" => "Monz&#243;n Vazquez"
          ]
          2 => array:2 [
            "nombre" => "Francisco"
            "apellidos" => "Valga"
          ]
          3 => array:2 [
            "nombre" => "Francisco"
            "apellidos" => "Alonso Alman"
          ]
          4 => array:2 [
            "nombre" => "Juan Francisco"
            "apellidos" => "Betancor Jim&#233;nez"
          ]
          5 => array:2 [
            "nombre" => "Sebastian"
            "apellidos" => "Hillebrand Ortega"
          ]
          6 => array:2 [
            "nombre" => "Fernando"
            "apellidos" => "Henr&#237;quez Palop"
          ]
          7 => array:2 [
            "nombre" => "Gloria"
            "apellidos" => "Anton P&#233;rez"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Unidad de Hemodi&#225;lisis&#44; Centro de Di&#225;lisis Avericum&#44; Las Palmas&#44; Gran Canaria&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "&#191;Existe un l&#237;mite de edad para iniciar hemodi&#225;lisis&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a man with chronic kidney disease &#40;CKD&#41; on haemodialysis &#40;HD&#41; for 11 years&#44; having started dialysis treatment at 86 years of age&#46; His kidney disease started in 2005 with nephrotic syndrome which was not biopsied&#46; He was followed in the low renal function outpatient clinic for approximately three years&#46; He had been a widower for the past six years&#46; Given his desire to receive dialysis treatment and the fact that his only child and carer was living in Las Palmas de Gran Canaria&#44; he moved to the island of Gran Canaria&#46; He received HD through a central venous catheter for three months&#44; then through a native arteriovenous fistula&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">His prior history of note included multifactorial chronic anaemia&#44; chronic obstructive pulmonary disease &#40;COPD&#41; &#40;pulmonary emphysema&#41;&#44; atrial fibrillation with a controlled ventricular response&#44; severe bilateral hearing loss and benign prostatic hyperplasia&#46; He had no known ischaemic cardiomyopathy or cerebrovascular disease&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In November 2012&#44; he was admitted with gallstones in the common bile duct with a need for endoscopic retrograde cholangiopancreatography &#40;ERCP&#41;&#44; sphincterotomy and gallstone removal&#46; He subsequently presented no further similar episodes&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">He visited the emergency department at our reference hospital on only one occasion with acute bronchitis and left ventricular failure&#44; which markedly improved following medical treatment&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">During his follow-up&#44; his excellent adherence to dialysis treatment and complete independence for activities of daily living were always striking&#59; he even went on holiday for up to two months in his city of origin&#44; Le&#243;n&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In March 2019&#44; he came into the emergency department with abdominal pain&#44; vomiting and development of anaemia&#46; He was diagnosed with primary bladder neoplasm in addition to a perivesicular collection suggestive of an abscess&#46; It was decided that the patient would undergo conservative medical treatment and be admitted to the palliative care unit&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Up to a week before his death&#44; at the age of 97&#44; he remained on HD treatment&#59; thus&#44; the decision of the patient and his family was respected as his dialysis treatment was continued&#44; provided&#44; of course&#44; that his haemodynamic situation allowed it&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Presently&#44; with increasing frequency&#44; clinicians taking care of elderly patients&#44; must decide between starting renal replacement therapy &#40;RRT&#41; or a conservative kidney treatment&#46; Hence&#44; it is necessary to weigh up the risks and benefits of both options&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">As reported in the literature&#44; although overall survival is usually higher in patients on dialysis versus patients not on dialysis&#44; this advantage is lost in patients over 80 years of age&#44; who present greater comorbidity&#44; especially if they also have ischaemic cardiomyopathy&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Another factor to be considered is the high burden of symptoms &#40;pain&#44; fatigue&#44; anorexia&#44; dyspnoea&#41; presented by older patients on dialysis&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In addition&#44; health-related quality of life is often deficient<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> and many present gradual secondary functional decline&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Given all the above&#44; there is a growing interest in taking a more conservative approach to treat in elderly patients with advanced CKD&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">However&#44; with this case&#44; we would like to spark reflection on the need to personalise RRT without considering only age as a limitation to starting dialysis&#44; especially in elderly patients with limited associated comorbidity&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Our patient&#44; already an octogenarian from the start&#44; had a very high quality of life for 11 years thanks to an HD treatment that was started taking into consideration his limited personal medical history&#44; given his low risk of mortality on the technique&#44; and &#8212; no less importantly &#8212; respecting his treatment preferences after providing him with suitable information on all available treatment options&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Spain is a democratic country subject to Law 41&#47;2002 of 14 November&#44; regulating basic patient autonomy and rights and responsibilities with regard to clinical information and documentation &#40;Bolet&#237;n Oficial del Estado &#91;Spanish Official State Gazette &#40;BOE&#41;&#93; no&#46; 274&#44; of 15 November 2002&#59; reference&#58; BOE-A-2002-22188&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Under this law&#44; the patient has the right to freely choose among available treatment options after receiving suitable information&#46; This heightens and enshrines patient autonomy regardless of age&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Thus&#44; all healthcare professionals are obliged not only to properly exercise their professions from a technical point of view but also to fulfil their responsibilities in terms of clinical information and documentation and to respect the decisions made freely and voluntarily by their patients even in anticipated manner&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In summary&#44; with this case&#44; we hope to draw the attention of healthcare workers and authorities to the particular needs of elderly people with respect to nephrology medical care and encourage them to consider their patients&#39; preferences and the right to receive all information required&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Even though most people over 80 may not benefit from starting dialysis treatment&#44; the decision to start or not start dialysis treatment should be personalised&#44; as it was the case of our patient&#46; The right of each and every individual&#44; regardless of age&#44; to choose their own present and their own future should be respected and valued&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2019-05-15"
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Parodis L&#243;pez Y&#44; Monz&#243;n Vazquez T&#44; Valga F&#44; Alonso Alman F&#44; Betancor Jim&#233;nez JF&#44; Hillebrand Ortega S&#44; et al&#46; &#191;Existe un l&#237;mite de edad para iniciar hemodi&#225;lisis&#63; Nefrologia&#46; 2020&#59;40&#58;485&#8211;486&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:7 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Geriatric renal palliative care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;A&#46; Swidler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/gerona/gls202"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gerontol A Biol Sci Med Sci&#46;"
                        "fecha" => "2012"
                        "volumen" => "67"
                        "paginaInicial" => "1400"
                        "paginaFinal" => "1409"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23051980"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dialysis or not&#63; A comparative survival study of patients over 75 years with chronic kidney disease stage 5"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; Murtagh"
                            1 => "J&#46; Marsh"
                            2 => "P&#46; Donohoe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ndt/gfm153"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrol Dial Transplant&#46;"
                        "fecha" => "2007"
                        "volumen" => "22"
                        "paginaInicial" => "1955"
                        "paginaFinal" => "1962"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17412702"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Supportive care&#58; comprehensive conservative care in end-stage kidney disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46; Murtagh"
                            1 => "A&#46; Burns"
                            2 => "O&#46; Moranne"
                            3 => "R&#46; Morton"
                            4 => "S&#46; Naicker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2215/CJN.04840516"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin J Am Soc Nephrol&#46;"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "paginaInicial" => "1909"
                        "paginaFinal" => "1914"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27510453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Symptoms in advanced renal disease&#58; a cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managed without dialysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Murtagh"
                            1 => "J&#46;M&#46; Addington-Hall"
                            2 => "P&#46;M&#46; Edmonds"
                            3 => "P&#46; Donohoe"
                            4 => "I&#46; Carey"
                            5 => "K&#46; Jenkins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Palliat Med&#46;"
                        "fecha" => "2007"
                        "volumen" => "10"
                        "paginaInicial" => "1266"
                        "paginaFinal" => "1276"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Revisi&#243;n de estudios sobre calidad de vida relacionada con la salud en la enfermedad renal cr&#243;nica avanzada en Espana"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Rebollo-Rubio"
                            1 => "J&#46;M&#46; Morales-Asensio"
                            2 => "M&#46;E&#46; Pons- Raventos"
                            3 => "J&#46;J&#46; Mansilla-Francisco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3265/Nefrologia.pre2014.Jul.12133"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nefrolog&#237;a&#46;"
                        "fecha" => "2015"
                        "volumen" => "35"
                        "paginaInicial" => "92"
                        "paginaFinal" => "109"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25611838"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Symptom burden&#44; depression&#44; and quality of life in chronic and end-stage kidney disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46; Abdel-Kader"
                            1 => "M&#46; Unruh"
                            2 => "S&#46;D&#46; Weisbord"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2215/CJN.00430109"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin J Am Soc Nephrol&#46;"
                        "fecha" => "2009"
                        "volumen" => "4"
                        "paginaInicial" => "1057"
                        "paginaFinal" => "1064"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19423570"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Ley 41&#47;2002&#44; de 14 de noviembre&#44; b&#225;sica reguladora de la autonom&#237;a del paciente y de derechos y obligaciones en materia de informaci&#243;n y documentaci&#243;n cl&#237;nica &#40; &#171;BOE&#187; n&#250;m&#46; 274&#44; de 15 de noviembre de 2002&#46; Referencia&#58; BOE-A-2002-22188&#41;&#46;"
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000004000000004/v1_202011020618/S2013251420301024/v1_202011020618/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/20132514/0000004000000004/v1_202011020618/S2013251420301024/v1_202011020618/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420301024?idApp=UINPBA000064"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Letter to the Editor
Is there an age limit for starting haemodialysis?
¿Existe un límite de edad para iniciar hemodiálisis?
Yanet Parodis López
Corresponding author
yanet.parodis@avericum.com

Corresponding author.
, Tania Monzón Vazquez, Francisco Valga, Francisco Alonso Alman, Juan Francisco Betancor Jiménez, Sebastian Hillebrand Ortega, Fernando Henríquez Palop, Gloria Anton Pérez
Unidad de Hemodiálisis, Centro de Diálisis Avericum, Las Palmas, Gran Canaria, Spain
Read
16073
Times
was read the article
1943
Total PDF
14130
Total HTML
Share statistics
 array:24 [
  "pii" => "S2013251420301024"
  "issn" => "20132514"
  "doi" => "10.1016/j.nefroe.2019.08.009"
  "estado" => "S300"
  "fechaPublicacion" => "2020-07-01"
  "aid" => "668"
  "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
  "copyrightAnyo" => "2019"
  "documento" => "simple-article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "cor"
  "cita" => "Nefrologia &#40;English Version&#41;. 2020;40:485-6"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2013251420301000"
    "issn" => "20132514"
    "doi" => "10.1016/j.nefroe.2019.08.008"
    "estado" => "S300"
    "fechaPublicacion" => "2020-07-01"
    "aid" => "660"
    "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "Nefrologia &#40;English Version&#41;. 2020;40:486-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Development of C3 glomerulopathy in a patient with acquired partial lipodystrophy"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "486"
          "paginaFinal" => "487"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Desarrollo de glomerulopat&#237;a C3 en paciente con lipodistrofia parcial adquirida"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Elena Hern&#225;ndez Garc&#237;a, Elena Borrego Garc&#237;a, Antonio Navas-Parejo Casado"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Elena Hern&#225;ndez"
              "apellidos" => "Garc&#237;a"
            ]
            1 => array:2 [
              "nombre" => "Elena Borrego"
              "apellidos" => "Garc&#237;a"
            ]
            2 => array:2 [
              "nombre" => "Antonio Navas-Parejo"
              "apellidos" => "Casado"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0211699519301742"
        "doi" => "10.1016/j.nefro.2019.08.002"
        "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/S0211699519301742?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420301000?idApp=UINPBA000064"
    "url" => "/20132514/0000004000000004/v1_202011020618/S2013251420301000/v1_202011020618/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2013251420300973"
    "issn" => "20132514"
    "doi" => "10.1016/j.nefroe.2020.09.005"
    "estado" => "S300"
    "fechaPublicacion" => "2020-07-01"
    "aid" => "644"
    "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "Nefrologia &#40;English Version&#41;. 2020;40:481-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Necrotising glomerulonephritis in a patient with HIV&#44; HCV and visceral leishmaniasis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "481"
          "paginaFinal" => "484"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Glomerulonefritis necrosante en un paciente con VIH&#44; VHC y leishmaniasis visceral"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0010"
          "etiqueta" => "Fig&#46; 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 451
              "Ancho" => 1800
              "Tamanyo" => 267261
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0010"
              "detalle" => "Fig&#46; "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Kidney biopsy&#46; A&#41; Haematoxylin&#8210;eosin staining&#58; segmental necrotising lesion with fibrin and remnants of fragmented nuclei&#46; B&#41; Periodic acid&#8211;Schiff &#40;PAS&#41; staining&#58; epithelial half-moon&#46; C&#41; Silver staining&#58; epithelial half-moon&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Marta Puerta Carretero, Mayra Ortega D&#237;az, Elena Corchete Prats, David Rold&#225;n Cort&#233;s, Guillermo Cuevas Tasc&#243;n, Juan A&#46; Mart&#237;n Navarro, Maria Teresa Jaldo Rodr&#237;guez, Laura Medina Zahonero, Melissa Cintra Cabrera, Pablo Ryan Mur&#250;a, Marta Albalate Ram&#243;n, Patricia de Sequera Ortiz, Roberto Alc&#225;zar Arroyo"
          "autores" => array:13 [
            0 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Puerta Carretero"
            ]
            1 => array:2 [
              "nombre" => "Mayra"
              "apellidos" => "Ortega D&#237;az"
            ]
            2 => array:2 [
              "nombre" => "Elena"
              "apellidos" => "Corchete Prats"
            ]
            3 => array:2 [
              "nombre" => "David"
              "apellidos" => "Rold&#225;n Cort&#233;s"
            ]
            4 => array:2 [
              "nombre" => "Guillermo"
              "apellidos" => "Cuevas Tasc&#243;n"
            ]
            5 => array:2 [
              "nombre" => "Juan A&#46;"
              "apellidos" => "Mart&#237;n Navarro"
            ]
            6 => array:2 [
              "nombre" => "Maria Teresa"
              "apellidos" => "Jaldo Rodr&#237;guez"
            ]
            7 => array:2 [
              "nombre" => "Laura"
              "apellidos" => "Medina Zahonero"
            ]
            8 => array:2 [
              "nombre" => "Melissa"
              "apellidos" => "Cintra Cabrera"
            ]
            9 => array:2 [
              "nombre" => "Pablo"
              "apellidos" => "Ryan Mur&#250;a"
            ]
            10 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Albalate Ram&#243;n"
            ]
            11 => array:2 [
              "nombre" => "Patricia"
              "apellidos" => "de Sequera Ortiz"
            ]
            12 => array:2 [
              "nombre" => "Roberto"
              "apellidos" => "Alc&#225;zar Arroyo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0211699519301432"
        "doi" => "10.1016/j.nefro.2019.05.003"
        "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/S0211699519301432?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420300973?idApp=UINPBA000064"
    "url" => "/20132514/0000004000000004/v1_202011020618/S2013251420300973/v1_202011020618/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Is there an age limit for starting haemodialysis&#63;"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "485"
        "paginaFinal" => "486"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Yanet Parodis L&#243;pez, Tania Monz&#243;n Vazquez, Francisco Valga, Francisco Alonso Alman, Juan Francisco Betancor Jim&#233;nez, Sebastian Hillebrand Ortega, Fernando Henr&#237;quez Palop, Gloria Anton P&#233;rez"
        "autores" => array:8 [
          0 => array:4 [
            "nombre" => "Yanet"
            "apellidos" => "Parodis L&#243;pez"
            "email" => array:1 [
              0 => "yanet.parodis@avericum.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Tania"
            "apellidos" => "Monz&#243;n Vazquez"
          ]
          2 => array:2 [
            "nombre" => "Francisco"
            "apellidos" => "Valga"
          ]
          3 => array:2 [
            "nombre" => "Francisco"
            "apellidos" => "Alonso Alman"
          ]
          4 => array:2 [
            "nombre" => "Juan Francisco"
            "apellidos" => "Betancor Jim&#233;nez"
          ]
          5 => array:2 [
            "nombre" => "Sebastian"
            "apellidos" => "Hillebrand Ortega"
          ]
          6 => array:2 [
            "nombre" => "Fernando"
            "apellidos" => "Henr&#237;quez Palop"
          ]
          7 => array:2 [
            "nombre" => "Gloria"
            "apellidos" => "Anton P&#233;rez"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Unidad de Hemodi&#225;lisis&#44; Centro de Di&#225;lisis Avericum&#44; Las Palmas&#44; Gran Canaria&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "&#191;Existe un l&#237;mite de edad para iniciar hemodi&#225;lisis&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a man with chronic kidney disease &#40;CKD&#41; on haemodialysis &#40;HD&#41; for 11 years&#44; having started dialysis treatment at 86 years of age&#46; His kidney disease started in 2005 with nephrotic syndrome which was not biopsied&#46; He was followed in the low renal function outpatient clinic for approximately three years&#46; He had been a widower for the past six years&#46; Given his desire to receive dialysis treatment and the fact that his only child and carer was living in Las Palmas de Gran Canaria&#44; he moved to the island of Gran Canaria&#46; He received HD through a central venous catheter for three months&#44; then through a native arteriovenous fistula&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">His prior history of note included multifactorial chronic anaemia&#44; chronic obstructive pulmonary disease &#40;COPD&#41; &#40;pulmonary emphysema&#41;&#44; atrial fibrillation with a controlled ventricular response&#44; severe bilateral hearing loss and benign prostatic hyperplasia&#46; He had no known ischaemic cardiomyopathy or cerebrovascular disease&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In November 2012&#44; he was admitted with gallstones in the common bile duct with a need for endoscopic retrograde cholangiopancreatography &#40;ERCP&#41;&#44; sphincterotomy and gallstone removal&#46; He subsequently presented no further similar episodes&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">He visited the emergency department at our reference hospital on only one occasion with acute bronchitis and left ventricular failure&#44; which markedly improved following medical treatment&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">During his follow-up&#44; his excellent adherence to dialysis treatment and complete independence for activities of daily living were always striking&#59; he even went on holiday for up to two months in his city of origin&#44; Le&#243;n&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In March 2019&#44; he came into the emergency department with abdominal pain&#44; vomiting and development of anaemia&#46; He was diagnosed with primary bladder neoplasm in addition to a perivesicular collection suggestive of an abscess&#46; It was decided that the patient would undergo conservative medical treatment and be admitted to the palliative care unit&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Up to a week before his death&#44; at the age of 97&#44; he remained on HD treatment&#59; thus&#44; the decision of the patient and his family was respected as his dialysis treatment was continued&#44; provided&#44; of course&#44; that his haemodynamic situation allowed it&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Presently&#44; with increasing frequency&#44; clinicians taking care of elderly patients&#44; must decide between starting renal replacement therapy &#40;RRT&#41; or a conservative kidney treatment&#46; Hence&#44; it is necessary to weigh up the risks and benefits of both options&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">As reported in the literature&#44; although overall survival is usually higher in patients on dialysis versus patients not on dialysis&#44; this advantage is lost in patients over 80 years of age&#44; who present greater comorbidity&#44; especially if they also have ischaemic cardiomyopathy&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Another factor to be considered is the high burden of symptoms &#40;pain&#44; fatigue&#44; anorexia&#44; dyspnoea&#41; presented by older patients on dialysis&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In addition&#44; health-related quality of life is often deficient<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> and many present gradual secondary functional decline&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Given all the above&#44; there is a growing interest in taking a more conservative approach to treat in elderly patients with advanced CKD&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">However&#44; with this case&#44; we would like to spark reflection on the need to personalise RRT without considering only age as a limitation to starting dialysis&#44; especially in elderly patients with limited associated comorbidity&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Our patient&#44; already an octogenarian from the start&#44; had a very high quality of life for 11 years thanks to an HD treatment that was started taking into consideration his limited personal medical history&#44; given his low risk of mortality on the technique&#44; and &#8212; no less importantly &#8212; respecting his treatment preferences after providing him with suitable information on all available treatment options&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Spain is a democratic country subject to Law 41&#47;2002 of 14 November&#44; regulating basic patient autonomy and rights and responsibilities with regard to clinical information and documentation &#40;Bolet&#237;n Oficial del Estado &#91;Spanish Official State Gazette &#40;BOE&#41;&#93; no&#46; 274&#44; of 15 November 2002&#59; reference&#58; BOE-A-2002-22188&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Under this law&#44; the patient has the right to freely choose among available treatment options after receiving suitable information&#46; This heightens and enshrines patient autonomy regardless of age&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Thus&#44; all healthcare professionals are obliged not only to properly exercise their professions from a technical point of view but also to fulfil their responsibilities in terms of clinical information and documentation and to respect the decisions made freely and voluntarily by their patients even in anticipated manner&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In summary&#44; with this case&#44; we hope to draw the attention of healthcare workers and authorities to the particular needs of elderly people with respect to nephrology medical care and encourage them to consider their patients&#39; preferences and the right to receive all information required&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Even though most people over 80 may not benefit from starting dialysis treatment&#44; the decision to start or not start dialysis treatment should be personalised&#44; as it was the case of our patient&#46; The right of each and every individual&#44; regardless of age&#44; to choose their own present and their own future should be respected and valued&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2019-05-15"
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Parodis L&#243;pez Y&#44; Monz&#243;n Vazquez T&#44; Valga F&#44; Alonso Alman F&#44; Betancor Jim&#233;nez JF&#44; Hillebrand Ortega S&#44; et al&#46; &#191;Existe un l&#237;mite de edad para iniciar hemodi&#225;lisis&#63; Nefrologia&#46; 2020&#59;40&#58;485&#8211;486&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:7 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Geriatric renal palliative care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;A&#46; Swidler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/gerona/gls202"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Gerontol A Biol Sci Med Sci&#46;"
                        "fecha" => "2012"
                        "volumen" => "67"
                        "paginaInicial" => "1400"
                        "paginaFinal" => "1409"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23051980"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dialysis or not&#63; A comparative survival study of patients over 75 years with chronic kidney disease stage 5"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46; Murtagh"
                            1 => "J&#46; Marsh"
                            2 => "P&#46; Donohoe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ndt/gfm153"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrol Dial Transplant&#46;"
                        "fecha" => "2007"
                        "volumen" => "22"
                        "paginaInicial" => "1955"
                        "paginaFinal" => "1962"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17412702"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Supportive care&#58; comprehensive conservative care in end-stage kidney disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46; Murtagh"
                            1 => "A&#46; Burns"
                            2 => "O&#46; Moranne"
                            3 => "R&#46; Morton"
                            4 => "S&#46; Naicker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2215/CJN.04840516"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin J Am Soc Nephrol&#46;"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "paginaInicial" => "1909"
                        "paginaFinal" => "1914"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27510453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Symptoms in advanced renal disease&#58; a cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managed without dialysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Murtagh"
                            1 => "J&#46;M&#46; Addington-Hall"
                            2 => "P&#46;M&#46; Edmonds"
                            3 => "P&#46; Donohoe"
                            4 => "I&#46; Carey"
                            5 => "K&#46; Jenkins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Palliat Med&#46;"
                        "fecha" => "2007"
                        "volumen" => "10"
                        "paginaInicial" => "1266"
                        "paginaFinal" => "1276"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Revisi&#243;n de estudios sobre calidad de vida relacionada con la salud en la enfermedad renal cr&#243;nica avanzada en Espana"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Rebollo-Rubio"
                            1 => "J&#46;M&#46; Morales-Asensio"
                            2 => "M&#46;E&#46; Pons- Raventos"
                            3 => "J&#46;J&#46; Mansilla-Francisco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3265/Nefrologia.pre2014.Jul.12133"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nefrolog&#237;a&#46;"
                        "fecha" => "2015"
                        "volumen" => "35"
                        "paginaInicial" => "92"
                        "paginaFinal" => "109"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25611838"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Symptom burden&#44; depression&#44; and quality of life in chronic and end-stage kidney disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46; Abdel-Kader"
                            1 => "M&#46; Unruh"
                            2 => "S&#46;D&#46; Weisbord"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2215/CJN.00430109"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin J Am Soc Nephrol&#46;"
                        "fecha" => "2009"
                        "volumen" => "4"
                        "paginaInicial" => "1057"
                        "paginaFinal" => "1064"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19423570"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Ley 41&#47;2002&#44; de 14 de noviembre&#44; b&#225;sica reguladora de la autonom&#237;a del paciente y de derechos y obligaciones en materia de informaci&#243;n y documentaci&#243;n cl&#237;nica &#40; &#171;BOE&#187; n&#250;m&#46; 274&#44; de 15 de noviembre de 2002&#46; Referencia&#58; BOE-A-2002-22188&#41;&#46;"
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000004000000004/v1_202011020618/S2013251420301024/v1_202011020618/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/20132514/0000004000000004/v1_202011020618/S2013251420301024/v1_202011020618/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420301024?idApp=UINPBA000064"
]
Article information
ISSN: 20132514
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 72 8 80
2024 October 836 41 877
2024 September 841 48 889
2024 August 822 81 903
2024 July 919 36 955
2024 June 787 56 843
2024 May 598 25 623
2024 April 457 27 484
2024 March 505 19 524
2024 February 572 33 605
2024 January 544 28 572
2023 December 383 25 408
2023 November 373 52 425
2023 October 550 32 582
2023 September 522 38 560
2023 August 491 28 519
2023 July 322 23 345
2023 June 317 22 339
2023 May 308 33 341
2023 April 242 31 273
2023 March 290 28 318
2023 February 156 21 177
2023 January 141 27 168
2022 December 138 34 172
2022 November 199 44 243
2022 October 167 77 244
2022 September 162 48 210
2022 August 125 43 168
2022 July 136 55 191
2022 June 116 47 163
2022 May 112 34 146
2022 April 127 55 182
2022 March 110 60 170
2022 February 108 45 153
2022 January 140 36 176
2021 December 115 47 162
2021 November 111 45 156
2021 October 123 67 190
2021 September 120 47 167
2021 August 100 49 149
2021 July 113 37 150
2021 June 81 34 115
2021 May 80 46 126
2021 April 192 76 268
2021 March 105 33 138
2021 February 101 38 139
2021 January 89 23 112
2020 December 52 19 71
2020 November 40 30 70
2020 October 20 12 32
Show all

Follow this link to access the full text of the article

Idiomas
Nefrología (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?