was read the article
array:25 [ "pii" => "S2013251420301486" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2019.11.007" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "690" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2020;40:678-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0211699520300059" "issn" => "02116995" "doi" => "10.1016/j.nefro.2019.11.007" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "690" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2020;40:678-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Pembrolizumab en pacientes en hemodiálisis ¿es seguro?" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "678" "paginaFinal" => "679" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pembrolizumab in hemodialysis patients. Is it safe?" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Melisa Guzmán Vasquez, Andrea Patricia Zapata Balcázar, Daniel Germán Gaitán Tocora, Concepción Álamo Caballero, José Ramón Rodríguez Palomares, Marta Sánchez Heras, Gabriel de Arriba de la Fuente" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Melisa" "apellidos" => "Guzmán Vasquez" ] 1 => array:2 [ "nombre" => "Andrea Patricia" "apellidos" => "Zapata Balcázar" ] 2 => array:2 [ "nombre" => "Daniel Germán" "apellidos" => "Gaitán Tocora" ] 3 => array:2 [ "nombre" => "Concepción" "apellidos" => "Álamo Caballero" ] 4 => array:2 [ "nombre" => "José Ramón" "apellidos" => "Rodríguez Palomares" ] 5 => array:2 [ "nombre" => "Marta" "apellidos" => "Sánchez Heras" ] 6 => array:2 [ "nombre" => "Gabriel" "apellidos" => "de Arriba de la Fuente" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2013251420301486" "doi" => "10.1016/j.nefroe.2019.11.007" "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/S2013251420301486?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699520300059?idApp=UINPBA000064" "url" => "/02116995/0000004000000006/v1_202011280641/S0211699520300059/v1_202011280641/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2013251420301371" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2019.11.005" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "691" "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;40:680" "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">Reply to Letter to the Editor</span>" "titulo" => "Two birds with one stone: Anakinra for both gout and Familial Mediterranean fever attacks in a patient with renal transplant" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "680" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dos pájaros de un tiro: anakinra para la gota y ataques de fiebre mediterránea familiar en un paciente con trasplante renal" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Meltem Alkan Melikoglu" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Meltem Alkan" "apellidos" => "Melikoglu" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420301371?idApp=UINPBA000064" "url" => "/20132514/0000004000000006/v1_202012250708/S2013251420301371/v1_202012250708/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2013251420301346" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2020.11.007" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "688" "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;40:676-7" "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" => "Immunoglobulin A vasculitis in a patient with neurofibromatosis type 1" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "676" "paginaFinal" => "677" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Vasculitis por inmunoglobulina A en un paciente con neurofibromatosis tipo 1" ] ] "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" => 802 "Ancho" => 1305 "Tamanyo" => 127167 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Physical examination showed neurofibromas and palpable purpura on the right leg.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Yoshinosuke Shimamura, Yayoi Ogawa, Toshiya Shinohara" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Yoshinosuke" "apellidos" => "Shimamura" ] 1 => array:2 [ "nombre" => "Yayoi" "apellidos" => "Ogawa" ] 2 => array:2 [ "nombre" => "Toshiya" "apellidos" => "Shinohara" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420301346?idApp=UINPBA000064" "url" => "/20132514/0000004000000006/v1_202012250708/S2013251420301346/v1_202012250708/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Pembrolizumab in hemodialysis patients. Is it safe?" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "678" "paginaFinal" => "679" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Melisa Guzmán Vasquez, Andrea Patricia Zapata Balcázar, Daniel Germán Gaitán Tocora, Concepción Álamo Caballero, José Ramón Rodríguez Palomares, Marta Sánchez Heras, Gabriel de Arriba de La Fuente" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Melisa" "apellidos" => "Guzmán Vasquez" "email" => array:1 [ 0 => "mel.g.v315@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" => "Andrea Patricia" "apellidos" => "Zapata Balcázar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Daniel Germán" "apellidos" => "Gaitán Tocora" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Concepción" "apellidos" => "Álamo Caballero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "José Ramón" "apellidos" => "Rodríguez Palomares" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Marta" "apellidos" => "Sánchez Heras" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "Gabriel" "apellidos" => "de Arriba de La Fuente" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Universitario de Guadalajara, Guadalajara, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Medicina y Especialidades Médicas. Universidad de Alcalá (UAH), Alcalá de Henares, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pembrolizumab en pacientes en hemodiálisis ¿es seguro?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Patients with chronic kidney disease on dialysis, and particularly those with kidney transplant, have a higher incidence of cancer than the general population.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Chemotherapy for these patients poses special challenges, primarily in relation to adjusting the dose according to renal function, drug interactions and increased side effects.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In recent years, great advances have been achieved in the treatment of various cancers based on immunotherapy. Specifically, <span class="elsevierStyleItalic">check-point</span> inhibitor drugs have been developed which, by negatively inhibiting co-stimulation signals from T lymphocytes, enable them to remain reactive against cancer cells.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> These drugs inhibit the CTLA-4, PD-1 or PD-L1 protein, and many of their side effects are related to the persistent activation of T lymphocytes, thereby leading to a higher incidence of acute tubulointerstitial nephropathy, acute tubular necrosis and minimal change disease.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Pembrolizumab is a monoclonal antibody which selectively binds to PD-1, blocking the negative impact of this receptor on T lymphocyte function. It is indicated in the treatment of a number of different types of cancer, including melanoma, renal carcinoma and lung cancer.</p><p id="par0010" class="elsevierStylePara elsevierViewall">There is very little experience of such treatment in patients on renal replacement therapy with dialysis or kidney transplantation. We report the case of a patient on haemodialysis with lung cancer who received treatment with pembrolizumab and probably developed immune intolerance of the non-functioning graft.</p><p id="par0015" class="elsevierStylePara elsevierViewall">This was a 58-year-old male, former smoker, having smoked for 24 years (24 pack years), diagnosed with IgA mesangial glomerulonephritis, who began haemodialysis for the first time in 1996. He received a cadaveric kidney transplant a few months later. He developed chronic graft nephropathy and returned to haemodialysis in 2000 with subsequent transplantectomy. He received a second cadaveric kidney transplant in 2006. In 2015, he started on a peritoneal dialysis programme as a result of deteriorating kidney function due to global glomerulosclerosis and interstitial fibrosis with tubular atrophy of probable pyelonephritic origin, subsequently being switched to haemodialysis in March 2019 after peritoneal leakage into the right hemithorax with pleural effusion. At that point the patient was anuric. In May 2019, he developed pain in the right superior costal margins, with chest X-ray showing a lytic lesion in the posterior region of the 2nd right costal cartilage. He was diagnosed with stage IV-A undifferentiated clear cell carcinoma of probable pulmonary origin (cT1a N2 M1b), the molecular study for EGFR/ALK/ROS1 mutations was negative, with PDL-1 expression in 90% of the cells. He was started on treatment with pembrolizumab in July 2019. After 4 weeks of treatment, the patient experienced low-grade fever, graft discomfort and macroscopic haematuria.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Blood tests showed constant elevation of CRP, without leucocytosis, neutrophilia or eosinophilia; from the outset, all cultures, including urine, pleural fluid and blood were negative. Findings of the Doppler ultrasound of the graft were nonspecific, with increased echogenicity of the sinus, thinning of the cortex and pyramid hypertrophy, and persistent intrarenal flow. With suspected immune intolerance of the graft, it was decided to start treatment with low doses of corticosteroids, with some improvement, although the scant haematuria continued. Treatment was continued with 200 mg of pembrolizumab every 3 weeks (after the last weekly session) and low doses of prednisone.</p><p id="par0025" class="elsevierStylePara elsevierViewall">There is very little experience in treating haemodialysis patients with immunotherapy. Reported predisposing factors to developing toxicity include the previous use of corticosteroids, being female, previous history of autoimmune disease, and abnormal kidney function.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Although they are well-tolerated drugs, their side effects are related to the activation of T lymphocytes and are relatively common, most notably skin, gastrointestinal, thyroid, pulmonary and renal disorders.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> From the renal point of view, the main complications are acute tubular necrosis, acute tubulointerstitial nephropathy, and some forms of glomerulonephritis.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Nevertheless, these drugs have been used safely in haemodialysis patients.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">There is also limited experience with these treatments in kidney transplant patients. In fact, there have been reports of some cases in which immunotherapy, by preserving the activation of T lymphocytes, has led to graft rejection and its use is therefore not safe in patients with a functioning transplant.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In our patient, the association of treatment with pembrolizumab and the development of fever, local symptoms and haematuria posed a significant challenge in terms of diagnosis. Furthermore, it was possible that he had developed acute tubulointerstitial nephropathy, and although the blood test showed absence of eosinophilia, we could not exclude this diagnosis. However, we believe it more likely that the patient had developed an immunological intolerance on the non-functioning graft, which until then had been well tolerated. Unfortunately, we were unable to perform a graft biopsy given the patient's situation and the fact that the lesion would presumably have had severe chronic damage.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The differential diagnosis between the two processes was very important, since in the case of patients with a functioning kidney graft, withdrawal of treatment would be indicated, as well as performing the biopsy for an accurate diagnosis and the taking of decisions accordingly.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> In the case of immunological intolerance to the non-functioning graft, which was the most likely case in our patient, treatment with low doses of corticosteroids is recommended, in order not to inhibit the therapeutic effect of pembrolizumab; in fact, the symptoms in our patient improved, and for the moment it has been possible to continue treatment.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Finally, to the best of our knowledge, we have described the first haemodialysis patient treated with pembrolizumab to have likely suffered from treatment-related non-functioning graft immune intolerance.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0050" class="elsevierStylePara elsevierViewall">This work has not required funding from any entity.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">Los autores declaran que no tienen conflictos de interés.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-10-01" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Guzmán Vasquez M, Zapata Balcázar AP, Gaitán Tocora DG, Álamo Caballero C, Rodríguez Palomares JR, Sánchez Heras M, et al. Pembrolizumab en pacientes en hemodiálisis ¿es seguro? Nefrologia. 2020;40:678–679.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Onco-Nefrología: cáncer, quimioterapia y riñón" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.L.M. de Francisco" 1 => "M. Macía" 2 => "F. Alonso" 3 => "P. García" 4 => "E. Gutiérrez" 5 => "L.F. Quintana" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nefro.2018.10.016" "Revista" => array:6 [ "tituloSerie" => "Nefrología" "fecha" => "2019" "volumen" => "39" "paginaInicial" => "473" "paginaFinal" => "481" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30929891" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "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" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathological features of acute kidney injury associated with immune checkpoint inhibitors" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.B. Cortazar" 1 => "K.A. Marrone" 2 => "M.L. Troxell" 3 => "K.M. Ralto" 4 => "M.P. Hoenig" 5 => "J.R. Brahmer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.kint.2016.04.008" "Revista" => array:6 [ "tituloSerie" => "Kidney Int" "fecha" => "2016" "volumen" => "90" "paginaInicial" => "638" "paginaFinal" => "647" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27282937" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of immunotherapy-induced immune-related adverse events" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Kartolo" 1 => "J. Sattar" 2 => "V. Sahai" 3 => "T. Baetz" 4 => "J.M. Lakoff" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3747/co.25.4047" "Revista" => array:6 [ "tituloSerie" => "Curr Oncol" "fecha" => "2018" "volumen" => "25" "paginaInicial" => "e403" "paginaFinal" => "e410" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30464691" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of toxicities of immune checkpoint inhibitors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Spain" 1 => "S. Diem" 2 => "J. Larkin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ctrv.2016.02.001" "Revista" => array:6 [ "tituloSerie" => "Cancer Treat Rev" "fecha" => "2016" "volumen" => "44" "paginaInicial" => "51" "paginaFinal" => "60" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26874776" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renal toxicities associated with pembrolizumab" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Izzedine" 1 => "A. Mathian" 2 => "S. Champiat" 3 => "C. Picard" 4 => "C. Mateus" 5 => "E. Routier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ckj/sfy100" "Revista" => array:6 [ "tituloSerie" => "Clin Kidney J" "fecha" => "2019" "volumen" => "12" "paginaInicial" => "81" "paginaFinal" => "88" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30746132" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful treatment by pembrolizumab in a patient with end-stage renal disease with advanced non-small cell lung cancer and high PD-L1 expression" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Ishizuka" 1 => "S. Sakata" 2 => "C. Yoshida" 3 => "A. Takaki" 4 => "S. Saeki" 5 => "K. Nakamura" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.resinv.2018.03.005" "Revista" => array:6 [ "tituloSerie" => "Respir Investig" "fecha" => "2018" "volumen" => "56" "paginaInicial" => "361" "paginaFinal" => "364" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29764752" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safety and efficacy of pembrolizumab in a patient with advanced melanoma on haemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Chang" 1 => "K. Shirai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bcr-2016-216426" "Revista" => array:2 [ "tituloSerie" => "BMJ Case Rep" "fecha" => "2016" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pembrolizumab for metastatic melanoma in a renal allograft recipient with subsequent graft rejection and treatment response failure: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V. Kwatra" 1 => "N.V. Karanth" 2 => "K. Priyadarshana" 3 => "M. Charakidis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13256-017-1229-z" "Revista" => array:3 [ "tituloSerie" => "J Med Case Rep" "fecha" => "2017" "volumen" => "11" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safe Administration of An Anti-PD-1 Antibody to Kidney-transplant Patients: 2 Clinical Cases and Review of the Literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.K. Winkler" 1 => "R. Gutzmer" 2 => "C. Bender" 3 => "N. Lang" 4 => "M. Zeier" 5 => "A.H. Enk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CJI.0000000000000188" "Revista" => array:6 [ "tituloSerie" => "J Immunother" "fecha" => "2017" "volumen" => "40" "paginaInicial" => "341" "paginaFinal" => "344" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29028789" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000004000000006/v1_202012250708/S2013251420301486/v1_202012250708/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/20132514/0000004000000006/v1_202012250708/S2013251420301486/v1_202012250708/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420301486?idApp=UINPBA000064" ]
Year/Month | Html | Total | |
---|---|---|---|
2024 November | 11 | 7 | 18 |
2024 October | 152 | 53 | 205 |
2024 September | 130 | 43 | 173 |
2024 August | 135 | 67 | 202 |
2024 July | 117 | 32 | 149 |
2024 June | 109 | 57 | 166 |
2024 May | 139 | 40 | 179 |
2024 April | 92 | 47 | 139 |
2024 March | 100 | 23 | 123 |
2024 February | 83 | 42 | 125 |
2024 January | 82 | 38 | 120 |
2023 December | 74 | 34 | 108 |
2023 November | 76 | 40 | 116 |
2023 October | 91 | 37 | 128 |
2023 September | 87 | 39 | 126 |
2023 August | 84 | 23 | 107 |
2023 July | 79 | 32 | 111 |
2023 June | 80 | 36 | 116 |
2023 May | 121 | 49 | 170 |
2023 April | 88 | 24 | 112 |
2023 March | 99 | 39 | 138 |
2023 February | 113 | 26 | 139 |
2023 January | 114 | 34 | 148 |
2022 December | 104 | 56 | 160 |
2022 November | 113 | 38 | 151 |
2022 October | 99 | 48 | 147 |
2022 September | 107 | 47 | 154 |
2022 August | 122 | 46 | 168 |
2022 July | 127 | 53 | 180 |
2022 June | 111 | 52 | 163 |
2022 May | 185 | 37 | 222 |
2022 April | 162 | 64 | 226 |
2022 March | 160 | 53 | 213 |
2022 February | 131 | 71 | 202 |
2022 January | 105 | 41 | 146 |
2021 December | 101 | 44 | 145 |
2021 November | 86 | 27 | 113 |
2021 October | 117 | 60 | 177 |
2021 September | 91 | 44 | 135 |
2021 August | 125 | 43 | 168 |
2021 July | 112 | 25 | 137 |
2021 June | 99 | 44 | 143 |
2021 May | 77 | 54 | 131 |
2021 April | 191 | 83 | 274 |
2021 March | 114 | 55 | 169 |
2021 February | 143 | 53 | 196 |
2021 January | 82 | 27 | 109 |
2020 December | 20 | 12 | 32 |