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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival analysis of clinical outcomes peritonitis according the timing of PD start&#46; &#40;A&#41; First peritonitis episode &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; &#40;B&#41; Dropout &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Among the renal replacement therapies &#40;RRT&#41;&#44; in the vast majority of industrialized countries&#44; Peritoneal Dialysis &#40;PD&#41; is still underused&#46; Compared to countries as Mexico or Taiwan&#44; PD use in the United States of America is restricted to only 7&#37; of patients with End-Stage Renal Disease &#40;ESRD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> According to the registry of the Portuguese Society of Nephrology&#44; during the year 2018&#44; only 8&#46;7&#37; of patients started PD&#59; when considering patients treated by dialysis or with a functioning renal transplant in the same period&#44; the numbers are even lower&#44; about 3&#46;8&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> The reasons of PD underuse are well identified and are either patient or caregiver centered&#46; Reimbursement policies favoring HD in most healthcare systems and the restraint to perform PD in private facilities are also important obstacles to the widespread of this modality&#46; Despite the efforts made by countries as Portugal to promote the expansion of PD programs&#44; like pre-dialysis education care&#44; about 35&#37; of patient who reach ESRD do not have any definite plan for this stage of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> This subset of patients poses a specific problem&#58; the concern with the urgent access placement and initial PD prescription seem to justify the choice of HD through a central venous catheter as the first option&#44; even though most of them would be considered suitable for PD&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1&#44;3&#8211;6</span></a> The purpose of our study was to demonstrate that the urgent PD start&#44; defined as the use of catheter in the next 14 days of its placement to perform the technique&#44; could be a safe option in patients without a dialysis plan or without the possibility to use a central venous catheter&#44; due to central vein thrombosis or stenosis&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">In our study&#44; we enrolled patients who started PD between October 2012 and March 2018 in a medium sized Nephrology Department in Portugal&#46; Patients were divided in two Groups concerning the mode of starting PD&#58; Urgent-Start PD &#40;Group 1&#41; and Non-urgent Start &#40;Group 2&#41;&#46; As stated before&#44; urgent start PD refers to those patients without a dialysis plan care at the time of the beginning of technique&#44; who choose PD as RRT modality and who start dialysis in the first 14 days after catheter implantation&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">For each patient&#44; we evaluated baseline demographic data&#44; Charlson comorbidity index &#40;CCI&#41;&#44; etiology of ESRD&#44; previous nephrology follow-up and mode of catheter placement &#40;surgical or percutaneous&#41;&#46; Early clinical outcomes &#40;weekly Kt&#47;V&#44; daily ultrafiltration&#44; hemoglobin&#44; iron saturation&#44; intact parathyroid hormone&#44; phosphorus&#44; calcium&#44; and albumin&#41; were evaluated 90 days after the beginning of PD program&#44; as well as the prevalence of infectious &#91;peritonitis&#44; exit-site infections &#40;ESI&#41;&#93; and mechanical complications &#40;leaks&#44; catheter malfunction&#41;&#46; Patient and technique survival and causes for PD dropout were also evaluated&#46; Baseline demographic data&#44; short-term &#40;90-day&#41; clinical outcomes&#44; infectious and mechanical complications&#44; dropout causes were compared between Groups&#46; <span class="elsevierStyleItalic">p</span> values were determined by using Chi-square test for comparing proportions and <span class="elsevierStyleItalic">t</span>-Student test for comparing means&#46; A <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 was considered statistically significant&#46; Time to adverse events was examined with standard survival analysis methods&#44; including Kaplan&#8211;Meier models and Cox regressions for multivariate analyses&#46; Relative risk &#40;with a 95&#37; confidence interval&#41; and hazard ratio &#40;HR&#41; were calculated&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0020" class="elsevierStylePara elsevierViewall">A total of 52 patients were included in the study&#44; 34&#46;6&#37; &#40;N&#250;mero de doentes&#41; in Group 1 and 65&#46;4&#37; &#40;N&#250;mero de doentes&#41; in Group 2&#46; We observed male predominance in Group 1&#44; but no statistical differences in age or body mass index&#46; Group 1 also presented a higher prevalence of chronic pulmonary obstructive and cardiovascular diseases &#40;but not diabetes&#41; and higher CCI&#44; with an estimated 10-year mortality of 59&#46;4&#37;&#46; As expected&#44; patients on Group 2 had more frequently a previous Nephrology follow-up&#46; ESRD etiology was also correlated with urgent start of PD&#44; with 44&#46;4&#37; of the patients in Group 1 beginning dialysis because of cardiorenal syndrome&#46; Patients&#8217; characteristics are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Percutaneous technique was the main form of catheter implantation in both Groups&#46; The average time until catheter use was&#44; in Group 1&#44; 4&#46;94<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;21days&#44; with 38&#46;9&#37; inducing dialysis in the first 24<span class="elsevierStyleHsp" style=""></span>h due to severe uremic symptoms and&#47;or volume overload&#46; No significant difference was reported in the first PD prescription between Groups&#44; except for the lower dwell volumes in the urgent start patients&#46; Biochemical and hematological parameters related to CKD complications &#40;anemia&#44; mineral bone disease and nutrition&#41;&#44; either at baseline or 90 days after technique beginning were similar among Groups&#44; with the exception of the parathyroid hormone and albumin levels &#40;lower in Group 1 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; in both moments&#46; Adequacy parameters &#40;weekly KtV&#44; creatinine clearance and ultrafiltration volume&#41; were also evaluated 90 days after beginning and the results were similar &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;05</span>&#41;&#46; Despite of the higher rates of leak &#40;18&#46;8 vs 8&#46;8&#37;&#41; and catheter dysfunction &#40;33&#46;3 vs 24&#46;2&#37;&#41; in Group 1&#44; the risk was not statistically higher &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;05</span>&#41;&#46; Regarding infectious complications&#44; 29 episodes of exit-site infection &#40;ESI&#41; and 33 of peritonitis were recorded&#44; mainly due to Staphylococcus aureus &#40;31&#46;0&#37;&#41; and Staphylococcus epidermis &#40;13&#46;8&#37;&#41;&#59; however its occurrence was also similar between the Groups &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;05</span>&#41;&#46; Despite of the earlier occurrence of first peritonitis in Group 1 &#40;478 vs 831 days&#41;&#44; this time difference was not statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;05</span>&#41; and&#44; according to the Kaplan&#8211;Meier analysis&#44; these patients did not have worse free-time to first peritonitis episode&#40;long rank test&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#44; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; In multivariate Cox regression model&#44; Group 2 was associated with 32&#37; reduction in risk of first peritonitis episode compared with Group 1 &#40;HR 0&#46;68&#59; 95&#37; CI 0&#46;24&#8211;1&#46;99&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;487&#41;&#46; Regarding to technique survival&#44; Group 2 presented a lower rate &#40;61&#46;8&#37; versus 77&#46;1&#37;&#41;&#44; and a reduction in dropout risk of 43&#37;&#59; however this difference was not statistically significant &#40;HR 0&#46;57&#59; 95&#37; CI 0&#46;29&#8211;1&#46;13&#59; <span class="elsevierStyleItalic">p</span> 0&#46;105&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">For a long time&#44; the concerns related with mechanical and infectious complications have justified the non-use of PD as the first option to patients that need urgent RRT but the question that remain is&#58; are those risks truly higher when compared to conventional dialysis outcomes&#63; The advantages of a period around 2&#8211;4 weeks between the catheter placement and the initiation of PD are well known and are mainly related to allow proper peritoneal healing&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">7&#8211;11</span></a> Unfortunately&#44; in some cases&#44; patient survival depends on urgent initiation of dialysis and a subset of patients seldom presents with unstable clinical features that also affects dialysis &#40;HD and DP&#41; and patient&#39;s outcomes&#46; In our study&#44; urgent start patients were more likely to be referred late&#44; which implied PD initiation often without hemodynamic stabilization and&#47;or under uremic syndrome&#46; Despite the clinical condition&#44; no statistical difference was observed in PD modality or catheter placement&#44; being the modified Seldinger technique the main option due the shorter time admission and smaller complexity of the procedure&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a> Biochemical laboratorial values were similar in both groups&#44; with the exception of serum albumin and intact parathyroid hormone levels&#44; probably related to the lack of adequate follow-up and worse overall clinical condition&#46; Regardless higher initial exchange volumes in the conventional group&#44; this difference had no impact on the adequacy parameters&#44; including daily UF&#46; As expected&#44; mechanical complications occurred earlier in Group 1&#44; but the prevalence and risk were comparable&#46; These adverse effects could easily be minimized with measures as laparoscopic catheter insertion&#44; purse-string suture&#44; PD in supine position as well as the use of smaller exchange volumes&#44; which explain the lower volumes prescribed in Group 1&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">7&#44;9&#44;13&#44;14</span></a> It is also well known that infections are also an important cause of lower efficacy and technique survival&#46; In our cohort&#44; despite the occurrence of earlier events in the urgent-start Group&#44; there was no significant difference in the incidence between both groups&#46; It is important to properly monitor and educate these patients&#44; who do not have a timely placed peritoneal access&#44; to minimize the difference in the risk of infectious complications compard to patients with a standard pre-dialysis educational care&#46; We must not forget that several factors that are not directly related to the early start of the technique &#40;age&#44; CCI or cardiovascular comorbidities&#44; acute illness with the need of hospital admission&#41; may have an important impact on morbidity&#47;mortality and influence the outcomes in all the modalities of urgent dialysis&#44; PD and HD&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">14&#8211;20</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Our study has its limitations&#58; it is a single-center non-randomized study with a relatively small sample size&#44; with no control Group&#44; which makes it difficult to interpreted and generalize our results to other centers&#46; However&#44; we described a very diverse population that represents the reality of ESRD patients&#59; that is why we find that these results may be able to confirm the safety and the positive outcomes of urgent PD in patients with severe conditions&#44; that require immediate dialysis&#44; mainly the ones who traditionally would start urgent HD with a temporary central venous catheter&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Urgent-start PD could be a safe alternative to HD with a temporary central venous catheter&#44; with similar technique survival to conventional-start PD patients&#46; Despite of the apparently higher risk of complications&#44; the equivalent rates of early and late infectious&#44; as well as the marginally higher rates of mechanical complications&#44; should not discourage the use in patients who do not have major contraindications to PD&#46; In fact&#44; the rates of infectious and mechanical complications associated to HD transcutaneous vascular access &#40;like bacteremia&#44; central venous stenosis or vascular thrombosis&#41; are responsible for the lower longevity and success of the technique&#44; as well as&#44; for the higher morbidity and mortality&#46; For all those reasons&#44; urgent-start PD seems to be valid alternative in patients requiring urgent RRT&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflict of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">No conflict of interest&#46;</p></span></span>"
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    "fechaRecibido" => "2020-05-16"
    "fechaAceptado" => "2020-11-30"
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            2 => "Infectious complications"
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          "palabras" => array:5 [
            0 => "Eficacia de la di&#225;lisis"
            1 => "Inicio temprano"
            2 => "Complicaciones infecciosas"
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    "resumen" => array:2 [
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Despite the increasing prevalence of end-stage renal disease&#44; peritoneal dialysis &#40;PD&#41; is still offered to a minor subset of patients&#46; One way to increment the utilization rates of this technique is the early start of PD after catheter placement&#44; but there are several concerns related to this approach&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective analysis in a single-center&#59; 52 patients&#44; 34&#46;6&#37; of the patients started in the first 14 days after catheter placement &#40;Urgent start Group &#8211; Group 1&#41; and percentage started PD in a conventional mode &#40;Non-urgent start Group &#8211; Group 2&#41;&#46; Baseline data&#44; short-term &#40;90-day&#41; clinical outcomes&#44; mechanical complications and infectious episodes were compared among Groups&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">At baseline&#44; Group 1 had an higher Charlson Comobidity Index &#40;CCI&#41;&#46; Exchange volumes were significantly lower in Group 1&#44; as expected&#46; Short-term outcomes were equal except for iPTH and albumin&#44; both lower in urgent-start Group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Episodes of leak&#44; catheter dysfunction and rate of infections were similar among Groups &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;05</span>&#41;&#46; In Urgent-start Group we didn&#8217;t observed a higher risk for the first peritonitis episode &#40;HR 0&#46;68&#59; 95&#37; CI 0&#46;24&#8211;1&#46;99&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; higher dropout rate or risk to quit the technique &#40;long rank test&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#59; HR 0&#46;57&#59; 95&#37; CI 0&#46;29&#8211;1&#46;13&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">According to our observations&#44; urgent-start PD seems to be a valid and safe alternative to urgent hemodialysis with central venous catheter and should be offered to patients without major contraindications&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A pesar de la creciente prevalencia de la enfermedad renal terminal&#44; la di&#225;lisis peritoneal &#40;DP&#41; sigue ofreci&#233;ndose a un reducido subconjunto de pacientes&#46; Una forma de incrementar las tasas de utilizaci&#243;n de esta t&#233;cnica es el inicio temprano de la DP despu&#233;s de la colocaci&#243;n del cat&#233;ter&#44; pero existen varias dudas respecto a esta estrategia&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis retrospectivo en un &#250;nico centro&#59; 52 pacientes&#59; en el 34&#44;6&#37; de los pacientes se inici&#243; en los 14 primeros d&#237;as tras la colocaci&#243;n del cat&#233;ter &#40;grupo de inicio urgente &#91;grupo 1&#93;&#41; y el resto comenz&#243; la DP de forma convencional &#40;grupo de inicio no urgente &#91;grupo 2&#93;&#41;&#46; Se compararon los datos iniciales&#44; los resultados cl&#237;nicos a corto plazo &#40;90 d&#237;as&#41;&#44; las complicaciones mec&#225;nicas y los episodios infecciosos entre los grupos&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Al inicio del estudio&#44; el grupo 1 ten&#237;a un &#237;ndice de comorbilidad de Charlson &#40;ICC&#41; m&#225;s alto&#46; Los vol&#250;menes de intercambio fueron significativamente menores en el grupo 1&#44; como se esperaba&#46; Los resultados a corto plazo fueron iguales&#44; excepto para la hormona paratiroidea intacta &#40;HPTi&#41; y la alb&#250;mina&#44; ambas inferiores en el grupo de inicio urgente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Los episodios de fuga y de disfunci&#243;n del cat&#233;ter&#44; as&#237; como la tasa de infecciones&#44; fueron similares entre los grupos &#40;p<span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>&#62;</span><span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; En el grupo de inicio urgente no se observ&#243; un mayor riesgo de sufrir el primer episodio de peritonitis &#40;CRI&#58; 0&#44;68&#59; IC del 95&#37;&#58; 0&#44;24-1&#44;99&#59; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; ni una mayor tasa de abandono o riesgo de abandonar la t&#233;cnica &#40;prueba del orden logar&#237;tmico&#44; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#59; CRI&#58;0&#44;57&#59; IC del 95&#37;&#58; 0&#44;29-1&#44;13&#59; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Seg&#250;n nuestras observaciones&#44; la DP de inicio urgente parece ser una alternativa v&#225;lida y segura a la hemodi&#225;lisis urgente con cat&#233;ter venoso central&#44; y deber&#237;a ofrecerse a los pacientes sin contraindicaciones importantes&#46;</p></span>"
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                  \t\t\t\t">0&#46;108<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;025</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">BMI &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Previous follow up</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;66&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;97&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;005</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbidities</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;33&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;17&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;202<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arterial hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;88&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;91&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;790<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Heart failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;38&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;003</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Previous cerebrovascular accident&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;165<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peripheral vascular disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;44&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;002</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pulmonary chronic disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;38&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;022</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HCV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;157<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HBV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;207<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HIV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;641<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Smoking&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;38&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;14&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;049<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CCI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;001</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estimated 10-year survival&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>28&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>37&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Etiology of CKD</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;001</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Chronic glomerulonephritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;11&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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Original article
Urgent start peritoneal dialysis: Is there room for more?
Diálisis peritoneal de inicio urgente: ¿es posible hacer más?
Ana Rita Marcelino Abrantes
Corresponding author
anaritamabrantes@gmail.com

Corresponding author.
, Hernâni Gonçalves, Francisco Alexandre Dina Ferrer, Ana Maria Vila Lobos
Nephrology and Dialysis Department – Centro Hospitalar do Médio Tejo, EPE, Portugal
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival analysis of clinical outcomes peritonitis according the timing of PD start&#46; &#40;A&#41; First peritonitis episode &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; &#40;B&#41; Dropout &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Among the renal replacement therapies &#40;RRT&#41;&#44; in the vast majority of industrialized countries&#44; Peritoneal Dialysis &#40;PD&#41; is still underused&#46; Compared to countries as Mexico or Taiwan&#44; PD use in the United States of America is restricted to only 7&#37; of patients with End-Stage Renal Disease &#40;ESRD&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> According to the registry of the Portuguese Society of Nephrology&#44; during the year 2018&#44; only 8&#46;7&#37; of patients started PD&#59; when considering patients treated by dialysis or with a functioning renal transplant in the same period&#44; the numbers are even lower&#44; about 3&#46;8&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> The reasons of PD underuse are well identified and are either patient or caregiver centered&#46; Reimbursement policies favoring HD in most healthcare systems and the restraint to perform PD in private facilities are also important obstacles to the widespread of this modality&#46; Despite the efforts made by countries as Portugal to promote the expansion of PD programs&#44; like pre-dialysis education care&#44; about 35&#37; of patient who reach ESRD do not have any definite plan for this stage of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> This subset of patients poses a specific problem&#58; the concern with the urgent access placement and initial PD prescription seem to justify the choice of HD through a central venous catheter as the first option&#44; even though most of them would be considered suitable for PD&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1&#44;3&#8211;6</span></a> The purpose of our study was to demonstrate that the urgent PD start&#44; defined as the use of catheter in the next 14 days of its placement to perform the technique&#44; could be a safe option in patients without a dialysis plan or without the possibility to use a central venous catheter&#44; due to central vein thrombosis or stenosis&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">In our study&#44; we enrolled patients who started PD between October 2012 and March 2018 in a medium sized Nephrology Department in Portugal&#46; Patients were divided in two Groups concerning the mode of starting PD&#58; Urgent-Start PD &#40;Group 1&#41; and Non-urgent Start &#40;Group 2&#41;&#46; As stated before&#44; urgent start PD refers to those patients without a dialysis plan care at the time of the beginning of technique&#44; who choose PD as RRT modality and who start dialysis in the first 14 days after catheter implantation&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">For each patient&#44; we evaluated baseline demographic data&#44; Charlson comorbidity index &#40;CCI&#41;&#44; etiology of ESRD&#44; previous nephrology follow-up and mode of catheter placement &#40;surgical or percutaneous&#41;&#46; Early clinical outcomes &#40;weekly Kt&#47;V&#44; daily ultrafiltration&#44; hemoglobin&#44; iron saturation&#44; intact parathyroid hormone&#44; phosphorus&#44; calcium&#44; and albumin&#41; were evaluated 90 days after the beginning of PD program&#44; as well as the prevalence of infectious &#91;peritonitis&#44; exit-site infections &#40;ESI&#41;&#93; and mechanical complications &#40;leaks&#44; catheter malfunction&#41;&#46; Patient and technique survival and causes for PD dropout were also evaluated&#46; Baseline demographic data&#44; short-term &#40;90-day&#41; clinical outcomes&#44; infectious and mechanical complications&#44; dropout causes were compared between Groups&#46; <span class="elsevierStyleItalic">p</span> values were determined by using Chi-square test for comparing proportions and <span class="elsevierStyleItalic">t</span>-Student test for comparing means&#46; A <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 was considered statistically significant&#46; Time to adverse events was examined with standard survival analysis methods&#44; including Kaplan&#8211;Meier models and Cox regressions for multivariate analyses&#46; Relative risk &#40;with a 95&#37; confidence interval&#41; and hazard ratio &#40;HR&#41; were calculated&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0020" class="elsevierStylePara elsevierViewall">A total of 52 patients were included in the study&#44; 34&#46;6&#37; &#40;N&#250;mero de doentes&#41; in Group 1 and 65&#46;4&#37; &#40;N&#250;mero de doentes&#41; in Group 2&#46; We observed male predominance in Group 1&#44; but no statistical differences in age or body mass index&#46; Group 1 also presented a higher prevalence of chronic pulmonary obstructive and cardiovascular diseases &#40;but not diabetes&#41; and higher CCI&#44; with an estimated 10-year mortality of 59&#46;4&#37;&#46; As expected&#44; patients on Group 2 had more frequently a previous Nephrology follow-up&#46; ESRD etiology was also correlated with urgent start of PD&#44; with 44&#46;4&#37; of the patients in Group 1 beginning dialysis because of cardiorenal syndrome&#46; Patients&#8217; characteristics are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Percutaneous technique was the main form of catheter implantation in both Groups&#46; The average time until catheter use was&#44; in Group 1&#44; 4&#46;94<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;21days&#44; with 38&#46;9&#37; inducing dialysis in the first 24<span class="elsevierStyleHsp" style=""></span>h due to severe uremic symptoms and&#47;or volume overload&#46; No significant difference was reported in the first PD prescription between Groups&#44; except for the lower dwell volumes in the urgent start patients&#46; Biochemical and hematological parameters related to CKD complications &#40;anemia&#44; mineral bone disease and nutrition&#41;&#44; either at baseline or 90 days after technique beginning were similar among Groups&#44; with the exception of the parathyroid hormone and albumin levels &#40;lower in Group 1 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; in both moments&#46; Adequacy parameters &#40;weekly KtV&#44; creatinine clearance and ultrafiltration volume&#41; were also evaluated 90 days after beginning and the results were similar &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;05</span>&#41;&#46; Despite of the higher rates of leak &#40;18&#46;8 vs 8&#46;8&#37;&#41; and catheter dysfunction &#40;33&#46;3 vs 24&#46;2&#37;&#41; in Group 1&#44; the risk was not statistically higher &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;05</span>&#41;&#46; Regarding infectious complications&#44; 29 episodes of exit-site infection &#40;ESI&#41; and 33 of peritonitis were recorded&#44; mainly due to Staphylococcus aureus &#40;31&#46;0&#37;&#41; and Staphylococcus epidermis &#40;13&#46;8&#37;&#41;&#59; however its occurrence was also similar between the Groups &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;05</span>&#41;&#46; Despite of the earlier occurrence of first peritonitis in Group 1 &#40;478 vs 831 days&#41;&#44; this time difference was not statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;05</span>&#41; and&#44; according to the Kaplan&#8211;Meier analysis&#44; these patients did not have worse free-time to first peritonitis episode&#40;long rank test&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#44; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; In multivariate Cox regression model&#44; Group 2 was associated with 32&#37; reduction in risk of first peritonitis episode compared with Group 1 &#40;HR 0&#46;68&#59; 95&#37; CI 0&#46;24&#8211;1&#46;99&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;487&#41;&#46; Regarding to technique survival&#44; Group 2 presented a lower rate &#40;61&#46;8&#37; versus 77&#46;1&#37;&#41;&#44; and a reduction in dropout risk of 43&#37;&#59; however this difference was not statistically significant &#40;HR 0&#46;57&#59; 95&#37; CI 0&#46;29&#8211;1&#46;13&#59; <span class="elsevierStyleItalic">p</span> 0&#46;105&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">For a long time&#44; the concerns related with mechanical and infectious complications have justified the non-use of PD as the first option to patients that need urgent RRT but the question that remain is&#58; are those risks truly higher when compared to conventional dialysis outcomes&#63; The advantages of a period around 2&#8211;4 weeks between the catheter placement and the initiation of PD are well known and are mainly related to allow proper peritoneal healing&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">7&#8211;11</span></a> Unfortunately&#44; in some cases&#44; patient survival depends on urgent initiation of dialysis and a subset of patients seldom presents with unstable clinical features that also affects dialysis &#40;HD and DP&#41; and patient&#39;s outcomes&#46; In our study&#44; urgent start patients were more likely to be referred late&#44; which implied PD initiation often without hemodynamic stabilization and&#47;or under uremic syndrome&#46; Despite the clinical condition&#44; no statistical difference was observed in PD modality or catheter placement&#44; being the modified Seldinger technique the main option due the shorter time admission and smaller complexity of the procedure&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a> Biochemical laboratorial values were similar in both groups&#44; with the exception of serum albumin and intact parathyroid hormone levels&#44; probably related to the lack of adequate follow-up and worse overall clinical condition&#46; Regardless higher initial exchange volumes in the conventional group&#44; this difference had no impact on the adequacy parameters&#44; including daily UF&#46; As expected&#44; mechanical complications occurred earlier in Group 1&#44; but the prevalence and risk were comparable&#46; These adverse effects could easily be minimized with measures as laparoscopic catheter insertion&#44; purse-string suture&#44; PD in supine position as well as the use of smaller exchange volumes&#44; which explain the lower volumes prescribed in Group 1&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">7&#44;9&#44;13&#44;14</span></a> It is also well known that infections are also an important cause of lower efficacy and technique survival&#46; In our cohort&#44; despite the occurrence of earlier events in the urgent-start Group&#44; there was no significant difference in the incidence between both groups&#46; It is important to properly monitor and educate these patients&#44; who do not have a timely placed peritoneal access&#44; to minimize the difference in the risk of infectious complications compard to patients with a standard pre-dialysis educational care&#46; We must not forget that several factors that are not directly related to the early start of the technique &#40;age&#44; CCI or cardiovascular comorbidities&#44; acute illness with the need of hospital admission&#41; may have an important impact on morbidity&#47;mortality and influence the outcomes in all the modalities of urgent dialysis&#44; PD and HD&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">14&#8211;20</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Our study has its limitations&#58; it is a single-center non-randomized study with a relatively small sample size&#44; with no control Group&#44; which makes it difficult to interpreted and generalize our results to other centers&#46; However&#44; we described a very diverse population that represents the reality of ESRD patients&#59; that is why we find that these results may be able to confirm the safety and the positive outcomes of urgent PD in patients with severe conditions&#44; that require immediate dialysis&#44; mainly the ones who traditionally would start urgent HD with a temporary central venous catheter&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Urgent-start PD could be a safe alternative to HD with a temporary central venous catheter&#44; with similar technique survival to conventional-start PD patients&#46; Despite of the apparently higher risk of complications&#44; the equivalent rates of early and late infectious&#44; as well as the marginally higher rates of mechanical complications&#44; should not discourage the use in patients who do not have major contraindications to PD&#46; In fact&#44; the rates of infectious and mechanical complications associated to HD transcutaneous vascular access &#40;like bacteremia&#44; central venous stenosis or vascular thrombosis&#41; are responsible for the lower longevity and success of the technique&#44; as well as&#44; for the higher morbidity and mortality&#46; For all those reasons&#44; urgent-start PD seems to be valid alternative in patients requiring urgent RRT&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflict of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">No conflict of interest&#46;</p></span></span>"
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            0 => "Eficacia de la di&#225;lisis"
            1 => "Inicio temprano"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Despite the increasing prevalence of end-stage renal disease&#44; peritoneal dialysis &#40;PD&#41; is still offered to a minor subset of patients&#46; One way to increment the utilization rates of this technique is the early start of PD after catheter placement&#44; but there are several concerns related to this approach&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective analysis in a single-center&#59; 52 patients&#44; 34&#46;6&#37; of the patients started in the first 14 days after catheter placement &#40;Urgent start Group &#8211; Group 1&#41; and percentage started PD in a conventional mode &#40;Non-urgent start Group &#8211; Group 2&#41;&#46; Baseline data&#44; short-term &#40;90-day&#41; clinical outcomes&#44; mechanical complications and infectious episodes were compared among Groups&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">At baseline&#44; Group 1 had an higher Charlson Comobidity Index &#40;CCI&#41;&#46; Exchange volumes were significantly lower in Group 1&#44; as expected&#46; Short-term outcomes were equal except for iPTH and albumin&#44; both lower in urgent-start Group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Episodes of leak&#44; catheter dysfunction and rate of infections were similar among Groups &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">0&#46;05</span>&#41;&#46; In Urgent-start Group we didn&#8217;t observed a higher risk for the first peritonitis episode &#40;HR 0&#46;68&#59; 95&#37; CI 0&#46;24&#8211;1&#46;99&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; higher dropout rate or risk to quit the technique &#40;long rank test&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#59; HR 0&#46;57&#59; 95&#37; CI 0&#46;29&#8211;1&#46;13&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">According to our observations&#44; urgent-start PD seems to be a valid and safe alternative to urgent hemodialysis with central venous catheter and should be offered to patients without major contraindications&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A pesar de la creciente prevalencia de la enfermedad renal terminal&#44; la di&#225;lisis peritoneal &#40;DP&#41; sigue ofreci&#233;ndose a un reducido subconjunto de pacientes&#46; Una forma de incrementar las tasas de utilizaci&#243;n de esta t&#233;cnica es el inicio temprano de la DP despu&#233;s de la colocaci&#243;n del cat&#233;ter&#44; pero existen varias dudas respecto a esta estrategia&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis retrospectivo en un &#250;nico centro&#59; 52 pacientes&#59; en el 34&#44;6&#37; de los pacientes se inici&#243; en los 14 primeros d&#237;as tras la colocaci&#243;n del cat&#233;ter &#40;grupo de inicio urgente &#91;grupo 1&#93;&#41; y el resto comenz&#243; la DP de forma convencional &#40;grupo de inicio no urgente &#91;grupo 2&#93;&#41;&#46; Se compararon los datos iniciales&#44; los resultados cl&#237;nicos a corto plazo &#40;90 d&#237;as&#41;&#44; las complicaciones mec&#225;nicas y los episodios infecciosos entre los grupos&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Al inicio del estudio&#44; el grupo 1 ten&#237;a un &#237;ndice de comorbilidad de Charlson &#40;ICC&#41; m&#225;s alto&#46; Los vol&#250;menes de intercambio fueron significativamente menores en el grupo 1&#44; como se esperaba&#46; Los resultados a corto plazo fueron iguales&#44; excepto para la hormona paratiroidea intacta &#40;HPTi&#41; y la alb&#250;mina&#44; ambas inferiores en el grupo de inicio urgente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Los episodios de fuga y de disfunci&#243;n del cat&#233;ter&#44; as&#237; como la tasa de infecciones&#44; fueron similares entre los grupos &#40;p<span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>&#62;</span><span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; En el grupo de inicio urgente no se observ&#243; un mayor riesgo de sufrir el primer episodio de peritonitis &#40;CRI&#58; 0&#44;68&#59; IC del 95&#37;&#58; 0&#44;24-1&#44;99&#59; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; ni una mayor tasa de abandono o riesgo de abandonar la t&#233;cnica &#40;prueba del orden logar&#237;tmico&#44; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#59; CRI&#58;0&#44;57&#59; IC del 95&#37;&#58; 0&#44;29-1&#44;13&#59; p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Seg&#250;n nuestras observaciones&#44; la DP de inicio urgente parece ser una alternativa v&#225;lida y segura a la hemodi&#225;lisis urgente con cat&#233;ter venoso central&#44; y deber&#237;a ofrecerse a los pacientes sin contraindicaciones importantes&#46;</p></span>"
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;025</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;005</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;202<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;790<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;003</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">1 &#40;5&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;165<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;44&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;002</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">7 &#40;38&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3 &#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;022</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;157<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2 &#40;11&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;2&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;207<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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ISSN: 20132514
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