Strategies to manage low-bone turnover
Read
5112
Timeswas read the article
964
Total PDF
4148
Total HTML
Share statistics
array:20 [ "pii" => "X2013251409003566" "issn" => "20132514" "doi" => "10.3265/Nefrologia.2009.29.4.5399.en.full" "estado" => "S300" "fechaPublicacion" => "2009-08-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2009;29:295-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3417 "formatos" => array:3 [ "EPUB" => 258 "HTML" => 2732 "PDF" => 427 ] ] "Traduccion" => array:1 [ "en" => array:17 [ "pii" => "X0211699509003569" "issn" => "02116995" "doi" => "10.3265/Nefrologia.2009.29.4.5399.en.full" "estado" => "S300" "fechaPublicacion" => "2009-08-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2009;29:295-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4780 "formatos" => array:3 [ "EPUB" => 269 "HTML" => 3808 "PDF" => 703 ] ] "en" => array:9 [ "idiomaDefecto" => true "titulo" => "Strategies to manage low-bone turnover" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "295" "paginaFinal" => "297" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Strategies to manage low-bone turnover" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "G. Spasovski" "autores" => array:1 [ 0 => array:2 [ "Iniciales" => "G." "apellidos" => "Spasovski" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X2013251409003566" "doi" => "10.3265/Nefrologia.2009.29.4.5399.en.full" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409003566?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699509003569?idApp=UINPBA000064" "url" => "/02116995/0000002900000004/v0_201502091407/X0211699509003569/v0_201502091407/en/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "X2013251409003558" "issn" => "20132514" "doi" => "10.3265/Nefrologia.2009.29.4.5344.en.full" "estado" => "S300" "fechaPublicacion" => "2009-08-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2009;29:298-303" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4728 "formatos" => array:3 [ "EPUB" => 244 "HTML" => 3928 "PDF" => 556 ] ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "Idiopathic retroperitoneal fibrosis: clinico-pathological characteristics" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "298" "paginaFinal" => "303" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FIBROSIS RETROPERITONEAL IDIOPÁTICA: CARACTERÍSTICAS CLINICOPATOLÓGICAS." ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10818078_f1_299.jpg" "Alto" => 283 "Ancho" => 397 "Tamanyo" => 27843 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "ANGEL RODRIGUEZ JORNET, FRANCISCO JAVIER ANDREU NAVARRO, RUTH ORELLANA FERNÁNDEZ, JOSÉ IBEAS LÓPEZ, MANUEL GARCIA GARCIA" "autores" => array:5 [ 0 => array:2 [ "nombre" => "ANGEL" "apellidos" => "RODRIGUEZ JORNET" ] 1 => array:2 [ "nombre" => "FRANCISCO JAVIER" "apellidos" => "ANDREU NAVARRO" ] 2 => array:2 [ "nombre" => "RUTH" "apellidos" => "ORELLANA FERNÁNDEZ" ] 3 => array:2 [ "nombre" => "JOSÉ" "apellidos" => "IBEAS LÓPEZ" ] 4 => array:2 [ "nombre" => "MANUEL" "apellidos" => "GARCIA GARCIA" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699509003550" "doi" => "10.3265/Nefrologia.2009.29.4.5344.en.full" "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/X0211699509003550?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409003558?idApp=UINPBA000064" "url" => "/20132514/0000002900000004/v0_201502091627/X2013251409003558/v0_201502091627/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "X2013251409003574" "issn" => "20132514" "doi" => "10.3265/Nefrologia.2009.29.4.5282.en.full" "estado" => "S300" "fechaPublicacion" => "2009-08-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2009;29:288-94" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5952 "formatos" => array:3 [ "EPUB" => 245 "HTML" => 5115 "PDF" => 592 ] ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "The clinical impact of the physiological effects of erythropoietin and erythropoietin-stimulating agents on the incidence of malignancy, thrombosis and hypertension: Beyond anaemia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "288" "paginaFinal" => "294" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El impacto clinico de los efectos fisiologicos de la eritropoietina(EPO) y de los agentes estimulantes de la eritropoietina en la incidencia de malignidad,trombosis e hipertension:mas alla de la anemia" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "10518078_f1_290.jpg" "Alto" => 578 "Ancho" => 823 "Tamanyo" => 53850 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis M Ortega, Gabriel Contreras" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Luis M" "apellidos" => "Ortega" ] 1 => array:2 [ "nombre" => "Gabriel" "apellidos" => "Contreras" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699509003577" "doi" => "10.3265/Nefrologia.2009.29.4.5282.en.full" "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/X0211699509003577?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409003574?idApp=UINPBA000064" "url" => "/20132514/0000002900000004/v0_201502091627/X2013251409003574/v0_201502091627/en/main.assets" ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Strategies to manage low-bone turnover" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "295" "paginaFinal" => "297" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "G. Spasovski" "autores" => array:1 [ 0 => array:4 [ "Iniciales" => "G." "apellidos" => "Spasovski" "email" => array:1 [ 0 => "gspas@sonet.com.mk" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Department of Nephrology, University of Skopje, Vodnjanska, Macedonia, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">INTRODUCTION </span></p><p class="elsevierStylePara">Many nephrologists are reluctant to perform bone biopsy, although it has been considered as golden standard and diagnostic tool in identifying the type of bone diseases in chronic kidney disease (CKD) – mineral and bone disordered patients<span class="elsevierStyleSup">1</span>. Four types of renal osteodystrophy can be distinguished: low turnover osteomalacia (OM) and adynamic bone disease (ABD), hyperparathyroid bone disease (HPTH) and mixed lesion (Mx), even before dialysis treatment is started<span class="elsevierStyleSup">2</span>. Over the last two decades the prevalence of ABD has been increased in dialysis and peritoneal dialysis patients, as well as in CKD populations, and nowadays represents the most frequent type of bone lesion<span class="elsevierStyleSup">3,4</span>. In addition to diabetes and older age of patients coming to dialysis as fixed factors, calcium-based binders, vitamin D analogues, and a high calcium dialysate are pointed out as important modifiable factors associated with development of ABD<span class="elsevierStyleSup">5</span>.<br></br><br></br> Indeed, the use of calcium-based binders in combination with vitamin D analogues, has been shown to lead to an oversuppression of parathyroid hormone (PTH) and development of low-bone turnover ABD<span class="elsevierStyleSup">6,7</span>. Thus, a change in paradigm occurred lately whereby not hypocalcemia but hypercalcemia and positive calcium balance were considered negative factors. The changing prevalence of various types of bone diseases from a high to low-bone turnover goes in line with the presence of increased risk for vascular calcification, morbidity and mortality in the dialysis population<span class="elsevierStyleSup">6,7</span>.<br></br><br></br> The attenuation of the previous great expectations in calciumbased phosphate binders and vitamin D-analogues entailed a new treatment strategy to preserve bone and vascular health.<br></br><br></br> Hence, a new treatment approach as prevention of complications of therapy in order to maintain mineral homeostasis and bone health was proposed<span class="elsevierStyleSup">8,9</span>. Furthermore, a new evidence for treatment of ABD with various types of non calcium based binders and low calcium dialysate is presented.<br></br><br></br><span class="elsevierStyleBold">SEVELAMER HYDROCHLORIDE IN TREATMENT OF ABD </span></p><p class="elsevierStylePara">In a post- hoc analysis of thoracic vertebral bone attenuation in patients treated for 1 year in the Treat-to-Goal study, there has been a significant decrease in trabecular bone attenuation in calcium-treated patients, and a trend towards increased bone attenuation in sevelamer-treated patients<span class="elsevierStyleSup">10</span>. The between-group differences in trabecular bone attenuation have been statistically significant <span class="elsevierStyleItalic">(P=</span>0.01). The lower time averaged PTH in association with higher concentrations of serum calcium achieved in calcium-treated subjects is a likely explanation for the changes observed in bone attenuation.<br></br><br></br> Recently, improved bone histology of ABD patients treated by sevelamer has been reported by Ferreira et al.<span class="elsevierStyleSup">11 </span>Although sevelamer treatment has failed to improve bone turnover or mineralization compared with calcium carbonate, bone formation has been significantly increased and trabecular architecture improved in the sevelamer group. This might be in line with the inert nature of ABD, in which, the bone histology needs a potent and sustained stimulus in order to get an improvement which occurs very slowly. However, changes in biochemical markers of bone turnover may forecast improvements in bone histology, as it was reported in the Japanese dialysis population with low PTH levels treated with sevelamer<span class="elsevierStyleSup">12</span>. The reduced serum calcium concentration and thereby increased PTH levels under sevelamer treatment has resulted in improvement of all markers of bone turnover. Hence, it might have been concluded that the administration of sevelamer might improve the bone remodelling activity even in hemodialysis patients with diabetes (n=14).<br></br><br></br><span class="elsevierStyleBold">LANTHANUM CARBONATE (LC) BENEFICIAL EFFECT ON ABD HISTOLOGY </span></p><p class="elsevierStylePara">A few study reports on treatment with lanthanum have shown its beneficial effect on bone histology. Namely, there has been a normalization of the bone histomorphometric parameters and almost no evolution toward low bone turnover after 1- year of treatment with lanthanum<span class="elsevierStyleSup">13</span>. An additional follow up in a subset of patients (n=20) showed there is a slow release of lanthanum from its bone deposits 2 years after discontinuation of the treatment, but no association with aluminium-like bone toxicity could have been observed<span class="elsevierStyleSup">14</span>.<br></br><br></br> Finally, a similar phosphate control with calcum vs.lanthanum has resulted in a higher bone turnover after 1 year and a higher bone volume after 2 years with LC. Bone turnover has been low in 58% of patients at baseline in the LC group and in 35.5% of patients after 1-year of treatment, while bone volume has been low at baseline in 28% of patients and in only 9.4% after completion of 2 years of LC therapy<span class="elsevierStyleSup">15</span>. In between group comparison, percentage of patients in the 1-year LC group with improvement in activation frequency and bone formation rate/bone surface has been significantly higher (p < 0.05) than in the calcium group (52.0 and 41.9%, respectively vs. 23.3 and 15.6%, respectively). Thus, there has been a substantial evidence to conclude lanthanum treatment might have been a preferable option in patients with adynamic bone disease.<br></br><br></br><span class="elsevierStyleBold">LOW CALCIUM DIALYSATE AS AN OPTION TO TREAT ABD </span></p><p class="elsevierStylePara">Assessing the effect of lowering dialysate calcium on episodes of hypercalcemia, serum PTH levels and bone turnover, 51 CAPD patients with bone biopsy-proven ABD were randomized to treatment with control calcium (1.62 mM), or low calcium (1.0 mM) dialysate fluid over a 16-month period<span class="elsevierStyleSup">16</span>. The low-calcium group has experienced a decrease in serum ionized calcium levels, reduced rate of hypercalcemic episodes, and 300% increase in serum iPTH values. Repeat bone biopsies after 16 months have shown that the low-calcium bath has led to a normalization of BFR and an improved ABD histology in 40% of patients at the end of the study. Yet, there has been a lack of biopsy proven evidence of low calcium dialysate treatment in ABD patients.<br></br><br></br> Nevertheless, an indirect effect as evolution towards parameters reflecting higher bone turnover in patients treated for 6 months with dialysate calcium of 1.25 mmol/l has been recently reported<span class="elsevierStyleSup">17</span>. It occurs most likely by prevention of a positive calcium balance and enabling sustained stimulation of PTH secretion, but it should be confirmed in a bone biopsy based studies.<br></br><br></br><span class="elsevierStyleBold">CONCLUSIONS </span></p><p class="elsevierStylePara">Reducing the number of calcium-based binders to only 1g per main meal/daily and a low calcium dialysate (1.25 mmol/l) should be an immediate preventive treatment in order to attenuate the indirect harmful effect of ABD on vascular calcification progression in dialysis patients. There is scarce evidence that this baseline therapeutical approach could even improve ABD histology. While waiting further biopsy based evidence in this regard, adoption of the non calcium-based binders should be reserved for ABD patients with a high risk of fractures and progression of vascular calcifications associated with increased morbidity and mortality.<br></br><br></br></p>" "tienePdf" => false "PalabrasClave" => array:2 [ "es" => array:4 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec439813" "palabras" => array:1 [ 0 => "Enfermedad ósea adinámica" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec439815" "palabras" => array:1 [ 0 => "Quelantes cálcicos de fósforo" ] ] 2 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec439817" "palabras" => array:1 [ 0 => "Hemodiálisis con calcio bajo" ] ] 3 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec439819" "palabras" => array:1 [ 0 => "Quelantes de fósforo que no contienen calcio" ] ] ] "en" => array:4 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec439814" "palabras" => array:1 [ 0 => "Adynamic bone disease" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec439816" "palabras" => array:1 [ 0 => "Calcium based phosphate binders" ] ] 2 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec439818" "palabras" => array:1 [ 0 => "Low calcium dialysate" ] ] 3 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec439820" "palabras" => array:1 [ 0 => "Non-calcium based phosphate binders" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<p class="elsevierStylePara">Recientemente se ha cambiado de parecer en cuanto al paradigma por el que la hipercalcemia, en lugar de la hipocalcemia, y el equilibrio positivo de calcio se consideraban factores negativos. En otras palabras, se ha demostrado que el uso de quelantes cálcicos junto con análogos de vitamina D conlleva una sobresupresión de la hormona paratiroidea (PTH) y la aparición de enfermedad ósea adinámica (EOA) o de bajo remodelado (EOBR). La prevalencia variable de los diferentes tipos de enfermedades óseas desde las de alto remodelado hasta las de bajo remodelado está alineada con la presencia de un mayor riesgo de calcificación vascular (CV), morbilidad y mortalidad en la población sometida a diálisis. La atenuación de las grandes expectativas anteriores en los quelantes cálcicos del fósforo y los análogos de vitamina D conlleva una nueva estrategia de tratamiento para mantener la salud ósea y vascular. De esta forma, se presenta una nueva justificación para el tratamiento de la EOA con diferentes tipos de quelantes que no contengan calcio y con hemodiálisis con calcio bajo. El tratamiento con Sevelamer ha reducido la concentración de calcio y aumentado los niveles de PTH, obteniendo como resultado la mejora de los marcadores de remodelado óseo, el aumento de la formación ósea y una mejora de la arquitectura trabecular, de forma que la progresión de CV se ralentiza aún más. Los datos sobre los beneficios del lantano en la histología de la EOA se han extraído de estudios clínicos a largo plazo. Aunque tras la interrupción del tratamiento, se produce una liberación lenta de lantano de los depósitos óseos y no existe relación con la toxicidad a nivel óseo similar a la del aluminio, el debate científico sobre su potencial tóxico a largo plazo sigue abierto. Finalmente, se ha demostrado que reducir el número de quelantes cálcicos y el nivel de calcio en la hemodiálisis (1,25 mmol/l) tiene repercusiones en la evolución hacia los marcadores que reflejan un remodelado óseo mayor. Por tanto, la adopción de quelantes que no contienen calcio debería reservarse a los pacientes con EOA de alto riesgo y progresión de calcificaciones vasculares asociadas con una mayor morbi-mortalidad.</p>" ] "en" => array:1 [ "resumen" => "<p class="elsevierStylePara"><span class="elsevierStyleItalic">A change in paradigm occurred lately whereby not hypocalcemia but hypercalcemia and positive calcium balance were considered negative factors. Namely, the use of calcium- based binders in combination with vitamin D analogues, has been shown to lead to an over-suppression of parathyroid hormone (PTH) and development of low-bone turnover adynamic bone disease (ABD). The changing prevalence of various types of bone diseases from a high to low-bone turnover goes in line with the presence of increased risk for vascular calcification (VC), morbidity and mortality in the dialysis population. The attenuation of the previous great expectations in calcium-based phosphate binders and vitamin D-analogues entailed a new treatment strategy to preserve bone and vascular health. Hence, a new evidence for treatment of ABD with various types of non calcium based binders and low calcium dialysate is presented. Sevelamer treatment has reduced calcium concentration and increased PTH levels, resulting in the improvement of markers of bone turnover, increased bone formation and improved trabecular architecture, providing a slower progression of VC. Data on lanthanum beneficial effect on ABD histology have been demonstrated in long-term clinical studies. Although there is a slow release of lanthanum from its bone deposits after discontinuation of the treatment and no association with aluminium- like bone toxicity, there is still an ongoing scientific debate about its long-term toxic potential. Finally, reducing the number of calcium based binders and low calcium dialysate (1.25 mmol/l) has been reported to have an impact on the evolution towards markers reflecting higher bone turnover. Then, adoption of the non calcium-based binders should be reserved to high risk patients with ABD and progression of vascular calcifications associated with increased morbidity and mortality.<br /> <br /> </span></p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:17 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Spasovski G. Bone biopsy as a diagnostic tool in the assessment of renal osteodrophy. Int J Artif Organs 2004; 27(11):918-23 <a href="http://www.ncbi.nlm.nih.gov/pubmed/15636048" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Spasovski G, Bervoets A, Behets G, et al. Spectrum of renal bone disease in end-stage renal failure patients not in dialysis yet. Nephrol Dial Transplant 2003; 18:1159-1166. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12748350" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Brandenburg VM & Floege J. Adynamic bone disease¿bone and beyond. NDT plus 2008; 3: 135¿147." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Malluche HH, Mawad H, Monier-Faugere MC. The importance of bone health in end-stage renal disease: out of the frying pan, into the fire? Nephrol Dial Transpl 2004; 19 Suppl 1: i9-13." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Spasovski G. Low turn-over bone disease in patients with chronic renal disease. Med Pregl 2007; 60 Suppl 2:21-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18928151" 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" => "Goodman WG, Goldin SJ, Kuizon BD, Yoon C, Gales B, Sider D, Wang Y, Chung J, Emerick A, Greaser L, Elashoff RM, Salusky IB. Coronary- artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 342: 1478-83, 2000. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10816185" 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" => "London GM, Guerin AP, Marchais SJ, Metivier F, Pannier B, Adda H. Arterial media calcification in end-stage renal disease: impact on allcause and cardiovascular mortality. Nephrol Dial Transplant 18(9): 1731¿40, 2003" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Spasovski G. New aspects of treatment of renal bone disease in dialysis patients. Prilozi 2007; 28(1):205-13. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17932468" 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" => "Spasovski G. Bone health and vascular calcification relationships in chronic kidney disease. Int Urol Nephrol 2007;39(4):1209-16. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17899431" 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" => "Raggi P, James G, Burke SK, Bommer J, Chasan-Taber S, Holzer H, Braun J, Chertow GM. Decrease in thoracic vertebral bone attenuation with calcium-based phosphate binders in haemodialysis. J Bone Miner Res. 2005;20(5):764-72. <a href="http://www.ncbi.nlm.nih.gov/pubmed/15824849" 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" => "Ferreira A, Frazao J et al. Effects of Sevelamer Hydrochloride and Calcium Carbonate on ROD in HD Patients. J Am Soc Nephrol 2008; 19: 405¿12." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Iwata Y et al. Effect of Sevelamer on Markers of Bone Turnover in Japanese HD Patients with Low iPTH Levels. Intern Med 2007; 46(8):447-52. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17443033" 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" => "D'Haese PC, Spasovski GB et al. A multicenter study on the effect of lanthanum carbonate and calcium carbonate on renal bone disease in dialysis patients. Kidney Int 2003; 63: Suppl 85:73-78." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Spasovski G, Sikole A, Gelev S, et al. Evolution of bone and plasma concentration of lanthanum in dialysis patients before, during 1-year treatment with lanthanum carbonate and after two years of follow up. Nephrol Dial Transplant 2006; 21(8):2217-24. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16595583" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Malluche H et al. Effects of Treatment of Renal Osteodystrophy on Bone Histology. Clin J Am Soc Nephrol 2008; 3: S157¿S163." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Haris A et al. Lowered Dialysate Calcium in PD: Increased PTH and Bone Formation. Kidney Int 2006; 70(5):931-7." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Spasovski G et al. Improvement of Bone and Mineral Parameters Related to Adynamic Bone Disease by Diminishing Dialysate Calcium. Bone 2007; 41: 698¿703." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002900000004/v0_201502091627/X2013251409003566/v0_201502091627/en/main.assets" "Apartado" => array:4 [ "identificador" => "35445" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Short Reviews" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409003566?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 0 | 2 |
| 2024 October | 30 | 0 | 30 |
| 2024 September | 45 | 0 | 45 |
| 2024 August | 53 | 0 | 53 |
| 2024 July | 33 | 0 | 33 |
| 2024 June | 32 | 0 | 32 |
| 2024 May | 40 | 0 | 40 |
| 2024 April | 42 | 0 | 42 |
| 2024 March | 21 | 3 | 24 |
| 2024 February | 25 | 14 | 39 |
| 2024 January | 26 | 7 | 33 |
| 2023 December | 17 | 14 | 31 |
| 2023 November | 24 | 7 | 31 |
| 2023 October | 26 | 9 | 35 |
| 2023 September | 19 | 8 | 27 |
| 2023 August | 17 | 6 | 23 |
| 2023 July | 22 | 7 | 29 |
| 2023 June | 32 | 4 | 36 |
| 2023 May | 30 | 12 | 42 |
| 2023 April | 21 | 6 | 27 |
| 2023 March | 18 | 8 | 26 |
| 2023 February | 24 | 11 | 35 |
| 2023 January | 34 | 14 | 48 |
| 2022 December | 31 | 10 | 41 |
| 2022 November | 24 | 7 | 31 |
| 2022 October | 36 | 22 | 58 |
| 2022 September | 27 | 10 | 37 |
| 2022 August | 29 | 18 | 47 |
| 2022 July | 24 | 22 | 46 |
| 2022 June | 28 | 14 | 42 |
| 2022 May | 17 | 13 | 30 |
| 2022 April | 25 | 13 | 38 |
| 2022 March | 24 | 20 | 44 |
| 2022 February | 31 | 17 | 48 |
| 2022 January | 22 | 12 | 34 |
| 2021 December | 28 | 29 | 57 |
| 2021 November | 18 | 11 | 29 |
| 2021 October | 30 | 11 | 41 |
| 2021 September | 26 | 20 | 46 |
| 2021 August | 18 | 8 | 26 |
| 2021 July | 23 | 12 | 35 |
| 2021 June | 22 | 6 | 28 |
| 2021 May | 20 | 10 | 30 |
| 2021 April | 50 | 29 | 79 |
| 2021 March | 26 | 8 | 34 |
| 2021 February | 20 | 11 | 31 |
| 2021 January | 12 | 6 | 18 |
| 2020 December | 7 | 10 | 17 |
| 2020 November | 28 | 7 | 35 |
| 2020 October | 14 | 8 | 22 |
| 2020 September | 7 | 3 | 10 |
| 2020 August | 19 | 1 | 20 |
| 2020 July | 16 | 3 | 19 |
| 2020 June | 10 | 8 | 18 |
| 2020 May | 19 | 4 | 23 |
| 2020 April | 20 | 11 | 31 |
| 2020 March | 17 | 5 | 22 |
| 2020 February | 24 | 13 | 37 |
| 2020 January | 27 | 10 | 37 |
| 2019 December | 20 | 10 | 30 |
| 2019 November | 15 | 4 | 19 |
| 2019 October | 9 | 5 | 14 |
| 2019 September | 13 | 6 | 19 |
| 2019 August | 10 | 8 | 18 |
| 2019 July | 15 | 16 | 31 |
| 2019 June | 12 | 3 | 15 |
| 2019 May | 6 | 4 | 10 |
| 2019 April | 29 | 13 | 42 |
| 2019 March | 16 | 11 | 27 |
| 2019 February | 9 | 10 | 19 |
| 2019 January | 25 | 10 | 35 |
| 2018 December | 35 | 28 | 63 |
| 2018 November | 37 | 6 | 43 |
| 2018 October | 41 | 17 | 58 |
| 2018 September | 46 | 11 | 57 |
| 2018 August | 21 | 6 | 27 |
| 2018 July | 26 | 28 | 54 |
| 2018 June | 24 | 9 | 33 |
| 2018 May | 32 | 12 | 44 |
| 2018 April | 31 | 7 | 38 |
| 2018 March | 33 | 5 | 38 |
| 2018 February | 38 | 7 | 45 |
| 2018 January | 18 | 7 | 25 |
| 2017 December | 45 | 8 | 53 |
| 2017 November | 22 | 5 | 27 |
| 2017 October | 26 | 5 | 31 |
| 2017 September | 32 | 33 | 65 |
| 2017 August | 27 | 7 | 34 |
| 2017 July | 26 | 5 | 31 |
| 2017 June | 31 | 5 | 36 |
| 2017 May | 31 | 2 | 33 |
| 2017 April | 37 | 25 | 62 |
| 2017 March | 15 | 6 | 21 |
| 2017 February | 26 | 23 | 49 |
| 2017 January | 13 | 2 | 15 |
| 2016 December | 63 | 3 | 66 |
| 2016 November | 72 | 8 | 80 |
| 2016 October | 92 | 24 | 116 |
| 2016 September | 119 | 8 | 127 |
| 2016 August | 176 | 0 | 176 |
| 2016 July | 155 | 0 | 155 |
| 2016 June | 113 | 0 | 113 |
| 2016 May | 101 | 0 | 101 |
| 2016 April | 92 | 0 | 92 |
| 2016 March | 66 | 0 | 66 |
| 2016 February | 119 | 0 | 119 |
| 2016 January | 82 | 0 | 82 |
| 2015 December | 104 | 0 | 104 |
| 2015 November | 73 | 0 | 73 |
| 2015 October | 65 | 0 | 65 |
| 2015 September | 73 | 0 | 73 |
| 2015 August | 69 | 0 | 69 |
| 2015 July | 49 | 0 | 49 |
| 2015 June | 32 | 0 | 32 |
| 2015 May | 78 | 0 | 78 |
| 2015 April | 11 | 0 | 11 |
Show all
