Placing the elderly undergoing hemodialysis in the spotlight
Situar a los ancianos tratados con hemodiálisis en el foco de mira
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"apellidos" => "Fernández Lucas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699508033459" "doi" => " " "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699508033459?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408033456?idApp=UINPBA000064" "url" => "/20132514/0000002800000001/v0_201502091616/X2013251408033456/v0_201502091616/en/main.assets" ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Placing the elderly undergoing hemodialysis in the spotlight" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "30" "paginaFinal" => "31" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Fernando García López, R. Saracho Rotaeche" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Fernando" "apellidos" => "García López" "email" => array:1 [ 0 => "fjgarcia@medynet.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "Iniciales" => "R." "apellidos" => "Saracho Rotaeche" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Coordinador de Registros de la Sociedad Española de Nefrología, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Futuro Coordinador de Registros de la Sociedad Española de Nefrología., " "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Situar a los ancianos tratados con hemodiálisis en el foco de mira" ] ] "textoCompleto" => "<p class="elsevierStylePara">Currently, the proportion of elderly patients in renal replacement therapy programs is considerable. In Europe, more than half of the new patients starting therapy are older than 65 years, whereas more than half of prevalent patients are older than 55 years.<span class="elsevierStyleSup">1</span> This situation is the result of the upsurge of acceptance for renal replacement therapy that has occurred in developed countries for the last two decades, mainly due to the incorporation to the programs of elderly patients and patients with diabetes mellitus,<span class="elsevierStyleSup">2</span> which were initially excluded, mainly due to financial issues. This upsurge that led to a sustained increase in incidence rates<span class="elsevierStyleSup">3</span> seems to be reaching a new stabilization phase, and even a slight decrease in the last years; this phenomenon is also happening in Spain, according to the last annual report.<span class="elsevierStyleSup">4</span> This stabilization occurs across all age groups, including those older than 65 years.<span class="elsevierStyleSup">5</span> The reasons for this stabilization are unknown and it is premature to attribute them to the effects of preventive measures taken against hypertension, diabetes, or during early phases of chronic renal disease, without taking into account other population-related issues less known or difficult to interpret. However, although the incidence is not increasing, or even slightly decreasing, the prevalence of chronic renal failure requiring renal replacement therapy still is increasing with the subsequent increase in consumption of needed resources.<span class="elsevierStyleSup">5</span></p><p class="elsevierStylePara">In spite of the numerical importance of elderly patients in renal replacement therapy, and in particular in dialysis, the reports focusing on chronic renal failure management in this age group are scant. The elderly constitute a particular group with peculiar demographical and clinical characteristics, and their management gives rise to financial and ethical concerns.<span class="elsevierStyleSup">6</span> Observational studies carried out in Spain have contributed to undo topics on health-related quality of life in elderly patients on dialysis.<span class="elsevierStyleSup">7-9</span> Fortunately, in recent times there has been an increasing interest in the epidemiology of chronic renal disease in the elderly, which manifests in recent publications both in patients receiving dialysis<span class="elsevierStyleSup">10-12</span> and patients on conservative therapy.<span class="elsevierStyleSup">13, 14</span></p><p class="elsevierStylePara">This issue of Nephrology includes the report on a multicenter study carried out in Spain<span class="elsevierStyleSup">15</span> describing multiple issues in hemodialysis therapy of patients older than 65 and 75 years at different hospital and extra-hospital centers. This is the first comprehensive report of the like analyzing relevant issues for the nephrologists such as compliance with the most important indicators included in clinical practice guidelines on hemodialysis, together with especially relevant issues in the elderly such as place of residence, functional status, level of dependence for daily living activities, as well as other of general importance such as the transportation type to commute to the dialysis center, the time spent for that task, the time elapsed from diagnosis of chronic renal failure to dialysis onset, or the kind of physician referring the patient to the nephrologist. This information is highly valuable and may constitute a comparison pattern for future studies measuring the progress in multiple issues related with hemodialysis therapy in the elderly.</p><p class="elsevierStylePara">Despite of being a multicenter study with a large patient coverage, the study by De Francisco et al.<span class="elsevierStyleSup">15</span> does not include the whole set of patients managed with hemodialysis in Spain, as would have happened had the data source be the dialysis and transplantation registries, and it is not a random sample. This raises the concern about the possibility that the sample size will not be completely representative of the current population of elderly patients on dialysis therapy, so that the results of the study may not be completely inferable to the Spanish population receiving this therapy. However, the sample size is considerable and there are no reasons for expecting big differences with the Spanish population.</p><p class="elsevierStylePara">On the other hand, as the authors point out, the cross-sectional design does not allow following the patients to analyze their mortality or future morbidity. The patients included in the sample are not incident patients but prevalent ones, they are not analyzed from the beginning of dialysis but from a further moment, they offer an immediate picture of their status at the time of the study, but that picture cannot include those having died before having the possibility of being included into the study, and that presumably would have had higher morbidity and worse functional status, so that the situation described may have overestimated to some extent the real status of the patients. Besides, the cross-sectional design entails another drawback: the associations described, for instance between the level of anemia and daily living activities and functional status, or between serum albumin levels and place for hemodialysis, merely are associations but not causal relationships. In a cross-sectional study virtually never the causality direction can be known. These data do not inform about causal relationships, which might be of three kinds: it may be that appropriate management of anemia improves the functional status; it may happen the other way around, that worsening of the functional status makes anemia more severe through poorer feeding or other mechanisms; or, the most likely situation, it may happen that a third factor, such as baseline disease or comorbidity, affects both functional status and anemia, which would not have any direct causal relationship between them.</p><p class="elsevierStylePara">However, the fact that this study has not been based on registry data entails, nowadays, an advantage since it has allowed the authors gathering information about very important variables in the process of quality management in hemodialysis (anemia, phosphate-calcium metabolism, cardiovascular risk factors, dialysis adjustment, vascular access) that regrettably are not systematically collected in most of dialysis and transplant registries, which are currently focused on basic demographics. The process of creation of populationbased registries in Spain is not yet completed but will be done soon. Besides, in the future, registries will progressively incorporate dialysis quality indicators among other variables. At the present time, through the QUEST initiative,<span class="elsevierStyleSup">16-18</span> measures are being taken to define those variables of indicators that the European registry of the ERAEDTA would recommend for all national and regional registries within our setting in order to measure the implementation of the European good clinical practice guidelines.</p><p class="elsevierStylePara">We welcome these studies helping us to better know the situation of elderly patients on hemodialysis, this large group deserving the research focus of the nephrology scientific community. </p>" "pdfFichero" => "P-E-S-A529-EN.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "ERA-EDTA Registry. ERA-EDTA Registry 2005 Annual Report. 2007. Amsterdam, Holanda, Academic Medical Centre, Department of Medical Informatics. Disponible en http: //www.era-edta-reg.org/files/annualreports/pdf/AnnRep2005.pdf. Visualizado el 29 de noviembre de 2007." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "García López FJ, Robles R, Gentil MA, Lorenzo V, Clèries M, García Blasco MJ, Arrieta J, en representación del Grupo de Registros de Enfermos Renales de España. Comparación de la incidencia, prevalencia, modalidades de tratamiento y mortalidad en pacientes con tratamiento renal sustitutivo en cinco comunidades autónomas españolas en el periodo 1991-1996. Nefrología 19: 443-459, 1999." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Gilbertson DT, Liu J, Xue JL, Louis TA, Solid CA, Ebben JP, Collins AJ. Projecting the number of patients with end-stage renal disease in the United States to the year 2015. J Am Soc Nephrol 16: 3736-3741, 2005. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16267160" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Sociedad Española de Nefrología. Registro de Diálisis y Trasplante de la SEN 2007. 29-11-2007. Disponible en http://www.senefro.orgmodules.php?name=subsection&idsection=7&idsubsection=128. Visualizado el 29 de noviembre de 2007." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Foley RN, Collins AJ. End-stage renal disease in the United States: an update from the United States Renal Data System. J Am Soc Nephrol 18: 2644-2648, 2007. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17656472" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Ortega F, Gómez E, Baltar J, Rebollo P. Controversias en Nefrología: diálisis en el anciano. Nefrología 21: 332-336, 2001. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11816505" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Rebollo P, Ortega F, Baltar JM, Díaz-Corte C, Navascués RA, Naves M, Urena A, Badía X, Álvarez-Ude F, Álvarez-Grande J. Health-related quality of life (HRQOL) in end stage renal disease (ESRD) patients over 65 years. Geriatr Nephrol Urol 8: 85-94, 1998. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9893216" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Rebollo P, Ortega F, Baltar JM, Álvarez-Ude F, Álvarez Navascués R, Álvarez-Grande J. Is the loss of health-related quality of life during renal replacement therapy lower in elderly patients than in younger patients? Nephrol Dial Transplant 16: 1675-1680, 2001. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11477173" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "García-Mendoza M, Valdés C, Ortega T, Rebollo P, Ortega F. Differences in health-related quality of life between elderly and younger patients on hemodialysis. J Nephrol 19: 808-818, 2006. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17173256" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Kurella M, Covinsky KE, Collins AJ, Chertow GM. Octogenarians and nonagenarians starting dialysis in the United States. Ann Intern Med 146: 177-183, 2007. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17283348" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Couchoud C, Moranne O, Frimat L, Labeeuw M, Allot V, Stengel B. Associations between comorbidities, treatment choice and outcome in the elderly with endstage renal disease. Nephrol Dial Transplant 22: 3246-3254, 2007. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17616533" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Chan MR, Sánchez RJ, Young HN, Yevzlin AS. Vascular access outcomes in the elderly hemodialysis population: A USRDS study. Semin Dial 20: 606-610, 2007. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17991212" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Brunori G, Viola BF, Parrinello G, De Biase V, Como G, Franco V, Garibotto G, Zubani R, Cancarini GC. Efficacy and safety of a very-low-protein diet when postponing dialysis in the elderly: a prospective randomized multicenter controlled study. Am J Kidney Dis 49: 569-580, 2007. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17472838" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "De Biase V, Tobaldini O, Boaretti C, Abaterusso C, Pertica N, Loschiavo C, Trabucco G, Lupo A, Gambaro G. Prolonged conservative treatment for frail elderly patients with end-stage renal disease: the Verona experience. Nephrol Dial Transplant (doi: 10.1093/ndt/gfm772), 2007." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "de Francisco ALM, San Juan F, Foraster A, Fabado S, Carretero D, Santamaría C, Aguilera J, Alcalá ML, Aljama P. Estudio epidemiológico de pacientes ancianos con insuficiencia renal crónica en hemodiálisis. Nefrología 28 (1): 48-55, 2008. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18336131" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Jager KJ, Zoccali C. Clinical databases and the QUEST initiative. Blood Purif 25: 219- 220, 2007. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17384501" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Del Vecchio L, Locatelli F, Martins Prata M, Wauters JP, Debska-Slizien A, Mauri JM, Metsärinne K, Mircescu G, Siamopoulos KC, Stel VS, Will E, Van Biesen W, Jager KJ, Zoccali C, for the QUEST Anemia Study Group. The QUEST initiative anemia study in ESRD: rationale and study protocol. J Nephrol 20: 547-553, 2007. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17918139" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Van Biesen W, Locatelli F, Martins Prata M, Wauters JP, Debska-Slizien A, Mauri JM, Metsärinne K, Mircescu G, Siamopoulos KC, Stel VS, Will E, Del Vecchio L, Zoccali C, Jager KJ, for the QUEST Anemia Study Group. The QUEST initiative anemia study in transplant patients: rationale and study protocol. J Nephrol 20: 543-546, 2007. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17918138" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002800000001/v0_201502091616/X2013251408033448/v0_201502091616/en/main.assets" "Apartado" => array:4 [ "identificador" => "35428" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial Comments" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002800000001/v0_201502091616/X2013251408033448/v0_201502091616/en/P-E-S-A529-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251408033448?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 6 | 10 |
| 2024 October | 35 | 37 | 72 |
| 2024 September | 44 | 34 | 78 |
| 2024 August | 57 | 47 | 104 |
| 2024 July | 41 | 26 | 67 |
| 2024 June | 53 | 34 | 87 |
| 2024 May | 57 | 31 | 88 |
| 2024 April | 45 | 23 | 68 |
| 2024 March | 35 | 27 | 62 |
| 2024 February | 43 | 32 | 75 |
| 2024 January | 23 | 22 | 45 |
| 2023 December | 40 | 27 | 67 |
| 2023 November | 46 | 27 | 73 |
| 2023 October | 38 | 30 | 68 |
| 2023 September | 40 | 23 | 63 |
| 2023 August | 39 | 33 | 72 |
| 2023 July | 42 | 22 | 64 |
| 2023 June | 29 | 22 | 51 |
| 2023 May | 32 | 35 | 67 |
| 2023 April | 22 | 12 | 34 |
| 2023 March | 34 | 21 | 55 |
| 2023 February | 36 | 18 | 54 |
| 2023 January | 28 | 29 | 57 |
| 2022 December | 42 | 36 | 78 |
| 2022 November | 49 | 29 | 78 |
| 2022 October | 38 | 35 | 73 |
| 2022 September | 33 | 29 | 62 |
| 2022 August | 46 | 38 | 84 |
| 2022 July | 22 | 40 | 62 |
| 2022 June | 27 | 22 | 49 |
| 2022 May | 34 | 35 | 69 |
| 2022 April | 33 | 32 | 65 |
| 2022 March | 43 | 39 | 82 |
| 2022 February | 26 | 36 | 62 |
| 2022 January | 28 | 20 | 48 |
| 2021 December | 43 | 38 | 81 |
| 2021 November | 34 | 32 | 66 |
| 2021 October | 26 | 42 | 68 |
| 2021 September | 27 | 35 | 62 |
| 2021 August | 31 | 37 | 68 |
| 2021 July | 33 | 40 | 73 |
| 2021 June | 21 | 25 | 46 |
| 2021 May | 26 | 36 | 62 |
| 2021 April | 53 | 40 | 93 |
| 2021 March | 35 | 30 | 65 |
| 2021 February | 17 | 21 | 38 |
| 2021 January | 30 | 9 | 39 |
| 2020 December | 24 | 20 | 44 |
| 2020 November | 27 | 20 | 47 |
| 2020 October | 15 | 13 | 28 |
| 2020 September | 14 | 8 | 22 |
| 2020 August | 32 | 10 | 42 |
| 2020 July | 19 | 9 | 28 |
| 2020 June | 33 | 12 | 45 |
| 2020 May | 35 | 17 | 52 |
| 2020 April | 28 | 23 | 51 |
| 2020 March | 24 | 12 | 36 |
| 2020 February | 24 | 13 | 37 |
| 2020 January | 26 | 17 | 43 |
| 2019 December | 33 | 28 | 61 |
| 2019 November | 29 | 19 | 48 |
| 2019 October | 10 | 6 | 16 |
| 2019 September | 19 | 15 | 34 |
| 2019 August | 12 | 8 | 20 |
| 2019 July | 16 | 20 | 36 |
| 2019 June | 18 | 6 | 24 |
| 2019 May | 14 | 14 | 28 |
| 2019 April | 38 | 29 | 67 |
| 2019 March | 13 | 12 | 25 |
| 2019 February | 14 | 11 | 25 |
| 2019 January | 32 | 12 | 44 |
| 2018 December | 58 | 32 | 90 |
| 2018 November | 89 | 20 | 109 |
| 2018 October | 72 | 12 | 84 |
| 2018 September | 57 | 19 | 76 |
| 2018 August | 38 | 22 | 60 |
| 2018 July | 40 | 13 | 53 |
| 2018 June | 29 | 13 | 42 |
| 2018 May | 26 | 13 | 39 |
| 2018 April | 35 | 9 | 44 |
| 2018 March | 29 | 6 | 35 |
| 2018 February | 29 | 3 | 32 |
| 2018 January | 33 | 12 | 45 |
| 2017 December | 34 | 7 | 41 |
| 2017 November | 31 | 10 | 41 |
| 2017 October | 32 | 5 | 37 |
| 2017 September | 28 | 12 | 40 |
| 2017 August | 24 | 15 | 39 |
| 2017 July | 29 | 7 | 36 |
| 2017 June | 28 | 4 | 32 |
| 2017 May | 35 | 10 | 45 |
| 2017 April | 27 | 5 | 32 |
| 2017 March | 17 | 17 | 34 |
| 2017 February | 11 | 6 | 17 |
| 2017 January | 15 | 6 | 21 |
| 2016 December | 71 | 8 | 79 |
| 2016 November | 69 | 7 | 76 |
| 2016 October | 90 | 14 | 104 |
| 2016 September | 121 | 5 | 126 |
| 2016 August | 183 | 4 | 187 |
| 2016 July | 151 | 3 | 154 |
| 2016 June | 114 | 0 | 114 |
| 2016 May | 103 | 0 | 103 |
| 2016 April | 71 | 0 | 71 |
| 2016 March | 52 | 0 | 52 |
| 2016 February | 73 | 0 | 73 |
| 2016 January | 94 | 0 | 94 |
| 2015 December | 96 | 0 | 96 |
| 2015 November | 68 | 0 | 68 |
| 2015 October | 79 | 0 | 79 |
| 2015 September | 57 | 0 | 57 |
| 2015 August | 64 | 0 | 64 |
| 2015 July | 60 | 0 | 60 |
| 2015 June | 36 | 0 | 36 |
| 2015 May | 44 | 0 | 44 |
| 2015 April | 6 | 0 | 6 |
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