array:21 [
  "pii" => "X2013251409033618"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.2009.29.6.5463.en.full"
  "estado" => "S300"
  "fechaPublicacion" => "2009-12-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia (English Version). 2009;29:612"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3304
    "formatos" => array:3 [
      "EPUB" => 261
      "HTML" => 2564
      "PDF" => 479
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699509033610"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.2009.29.6.5463.en.full"
      "estado" => "S300"
      "fechaPublicacion" => "2009-12-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2009;29:612"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 4816
        "formatos" => array:3 [
          "EPUB" => 230
          "HTML" => 4158
          "PDF" => 428
        ]
      ]
      "es" => array:9 [
        "idiomaDefecto" => true
        "titulo" => "Fracaso renal agudo en un paciente con carcinoma renal tratado con Temsirolimus"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "612"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Acute renal failure in a patient with renal carcinoma treated with Temsirolimus"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Manuel Heras Benito, M.J. Fernández-Reyes, A. Rodríguez, A. Molina, F. Álvarez-Ude, B. Esteban"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Manuel"
                "apellidos" => "Heras Benito"
              ]
              1 => array:2 [
                "Iniciales" => "M.J."
                "apellidos" => "Fernández-Reyes"
              ]
              2 => array:2 [
                "Iniciales" => "A."
                "apellidos" => "Rodríguez"
              ]
              3 => array:2 [
                "Iniciales" => "A."
                "apellidos" => "Molina"
              ]
              4 => array:2 [
                "Iniciales" => "F."
                "apellidos" => "Álvarez-Ude"
              ]
              5 => array:2 [
                "Iniciales" => "B."
                "apellidos" => "Esteban"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251409033618"
          "doi" => "10.3265/Nefrologia.2009.29.6.5463.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/X2013251409033618?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699509033610?idApp=UINPBA000064"
      "url" => "/02116995/0000002900000006/v0_201502091341/X0211699509033610/v0_201502091342/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X201325140903360X"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.2009.29.6.5458.en.full"
    "estado" => "S300"
    "fechaPublicacion" => "2009-12-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2009;29:613"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3570
      "formatos" => array:3 [
        "EPUB" => 284
        "HTML" => 2758
        "PDF" => 528
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Hyperamylasaemia and bronchoaspiration associated with Lanthanum carbonate"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "613"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Hiperamilasemia y broncoaspiración asociadas a Carbonato de Lantano"
        ]
      ]
      "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" => "45718078_f1_p613.jpg"
              "Alto" => 318
              "Ancho" => 258
              "Tamanyo" => 15112
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Rosa Ramos Sánchez, M.A. Azancot, J. Bartolomé"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Rosa"
              "apellidos" => "Ramos Sánchez"
            ]
            1 => array:2 [
              "Iniciales" => "M.A."
              "apellidos" => "Azancot"
            ]
            2 => array:2 [
              "Iniciales" => "J."
              "apellidos" => "Bartolomé"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699509033602"
        "doi" => "10.3265/Nefrologia.2009.29.6.5458.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/X0211699509033602?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X201325140903360X?idApp=UINPBA000064"
    "url" => "/20132514/0000002900000006/v0_201502091611/X201325140903360X/v0_201502091612/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251409033626"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.2009.29.6.5492.en.full"
    "estado" => "S300"
    "fechaPublicacion" => "2009-12-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2009;29:610-1"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4328
      "formatos" => array:3 [
        "EPUB" => 253
        "HTML" => 3535
        "PDF" => 540
      ]
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "titulo" => "Acute renal failure associated with Pemetrexed (Alimta®)"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "610"
          "paginaFinal" => "611"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Fracaso renal agudo asociado a Pemetrexed (Alimta®)"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "José María Peña Porta, C. Vicente de Vera Floristán, P. Bueso Inglán, J. Florián Jericó"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "José María"
              "apellidos" => "Peña Porta"
            ]
            1 => array:2 [
              "Iniciales" => "C."
              "apellidos" => "Vicente de Vera Floristán"
            ]
            2 => array:2 [
              "Iniciales" => "P."
              "apellidos" => "Bueso Inglán"
            ]
            3 => array:2 [
              "Iniciales" => "J."
              "apellidos" => "Florián Jericó"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699509033629"
        "doi" => "10.3265/Nefrologia.2009.29.6.5492.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/X0211699509033629?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409033626?idApp=UINPBA000064"
    "url" => "/20132514/0000002900000006/v0_201502091611/X2013251409033626/v0_201502091612/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "titulo" => "Acute renal failure in a patient with renal carcinoma treated with Temsirolimus"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "612"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Manuel Heras Benito, M.J. Fernández-Reyes, A. Rodríguez, A. Molina, F. Álvarez-Ude, B. Esteban"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "Manuel"
            "apellidos" => "Heras Benito"
            "email" => array:1 [
              0 => "mheras@hgse.sacyl.es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "Iniciales" => "M.J."
            "apellidos" => "Fern&#225;ndez-Reyes"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          2 => array:3 [
            "Iniciales" => "A."
            "apellidos" => "Rodr&#237;guez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          3 => array:3 [
            "Iniciales" => "A."
            "apellidos" => "Molina"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          4 => array:3 [
            "Iniciales" => "F."
            "apellidos" => "&#193;lvarez-Ude"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          5 => array:3 [
            "Iniciales" => "B."
            "apellidos" => "Esteban"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Nefrología, Hospital General de Segovia, Segovia,  España, "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Oncología Médica, Hospital General de Segovia, Segovia,  España, "
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Fracaso renal agudo en un paciente con carcinoma renal tratado con Temsirolimus"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Tab.  1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "45618078_t1_p612.jpg"
            "Alto" => 86
            "Ancho" => 826
            "Tamanyo" => 16835
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Progress of the renal function before and after treatment with Temsirolimus"
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara">Dear Editor&#44;</p><p class="elsevierStylePara">Temsirolimus&#44; a new inhibitor of the mammalian target of rapamycin &#40;mTOR&#41;&#44; has shown to prolong the survival rate of patients with advanced renal carcinoma&#46;<span class="elsevierStyleSup">1</span>We report the case of a man who suffered from acute renal failure &#40;ARF&#41; during his treatment with this drug&#46;</p><p class="elsevierStylePara">A 63-year-old male with important medical history of ischaemic heart disease&#44; type 2 diabetes mellitus initially treated with gliclazide and hypertension treated with Carvedilol and Enalapril&#46; In June 2008&#44; he was diagnosed with left renal carcinoma with pulmonary metastasis&#44; for which it was decided to carry out a left nephrectomy and chemotherapy&#46; He was initially treated with Sunitinib from August to October 2008&#59; afterwards&#44; from November 2008 to March 2009&#44; he received Sorafenib&#46; Since May 2009&#44; due to the progression of his illness&#44; he began treatment with Temsirolimus at a dose of 25mg IV&#47;week&#46; The analytical progress of the pre-treatment and that following the administration of Temsirolimus is shown in Table 1&#46;</p><p class="elsevierStylePara">Before his scheduled visit to receive the sixth dose of Temsirolimus&#44; the patient mentioned fatigue&#44; a decrease in the ingestion of liquids and solids &#40;due to ulcers in the oral mucosa&#41; and a drop in urine volume&#46; He did not mention any other symptoms&#46;</p><p class="elsevierStylePara">During the physical examination&#44; the patient was in good general state&#44; was conscious and had clarity of mind&#44; had no temperature&#44; his blood pressure was 90&#47;50mmHg and had two ulcers in the oral mucosa&#46; There were no other pathological findings in the rest of the examination&#46;</p><p class="elsevierStylePara">The renal Doppler ultrasound showed a normal right kidney&#44; with good vascularisation&#46;</p><p class="elsevierStylePara">In detail&#44; Creatinine of 6&#46;5mg&#47;dl&#44; Sodium of 133mEq&#47;l&#44; Potassium of 5&#46;1mEq&#47;l&#44; Uric acid of 11mg&#47;dl&#44; Calcium of 10&#46;7mg&#47;dl and Haemoglobin of 13&#46;4g&#47;dl were found in the blood&#44; while the rest of the complete blood count and coagulation were within normal values&#46; Urine analysis&#58; Creatinine of 192mg&#47;dl and Sodium of 69mEq&#47;l&#46; Protein quantification in the 24-hour urine was negative&#46;</p><p class="elsevierStylePara">In the first 24 hours following admission&#44; the renal function continued to change with a creatinine of 7&#46;6mg&#47;dl&#44; despite adequate hydratation with a saline solution&#44; later improving without needing renal substitutive treatment and with creatinine levels of 2&#46;2mg&#47;dl at discharge&#46;</p><p class="elsevierStylePara">The treatment of advanced renal carcinoma with Temsirolimus was well-tolerated&#44; and the majority of the side effects reported were medically controlled&#46;<span class="elsevierStyleSup">2</span> Gerullis et al analysed the tolerance to Temsirolimus in 32 patients with advanced renal carcinoma&#44; with a slight increase in creatinine present in 40&#46;6&#37; of them&#44; without leading to ARF or the need for renal replacement therapy&#46;<span class="elsevierStyleSup">3</span> From the start of the treatment&#44; we also noticed in our patient a slight increase in the levels of plasma creatinine&#44; contributing to the lack of ingestion of solids and liquids&#46; This was linked with the consumption of angiotensin-converting enzyme inhibitors&#44; to which the patient presented a reversible ARF&#46; Although ARF is not described as a frequent side effect of Temsirolimus&#44; its nephrotoxic potential could be when considering this slight increase in creatinine&#44; which aggravated renal damage through other functional factors &#40;volume depletion&#44; NSAIDs&#44; etc&#46;&#41;&#44; as in the case of our patient&#46; Given the fact that the primary purpose of this drug is to treat advanced renal carcinoma&#44; when treating patients who have undergone nephrectomy&#44; thus with a greater susceptibility to renal deterioration&#44; the possible nephrotoxicity of Temsirolimus is of a particular interest in these patients&#46; It is advisable therefore to monitor their renal function&#46; <br></br></p><p class="elsevierStylePara"><a href="grande&#47;45618078&#95;t1&#95;p612&#46;jpg" class="elsevierStyleCrossRefs"><img src="45618078_t1_p612.jpg" alt="Progress of the renal function before and after treatment with Temsirolimus"></img></a></p><p class="elsevierStylePara">Table 1&#46; Progress of the renal function before and after treatment with Temsirolimus</p>"
    "pdfFichero" => "P-E-S-A456-EN.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Tab.  1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "45618078_t1_p612.jpg"
            "Alto" => 86
            "Ancho" => 826
            "Tamanyo" => 16835
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Progress of the renal function before and after treatment with Temsirolimus"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:3 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Bellmunt J, Szczylik C, Feingold J, Strahs A, Berkenblit A.Temsirolimus safety profile and management of toxic effects in patients with advanced renal cell carcinoma and poor prognostic features. Ann Oncol 2008;19:1387-92. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18385198" 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" => "Malizzia LJ, Hsu A. Temsirolimus, an mTOR inhibitor for treatment of patients with advanced renal carcinoma. Clin J Oncol Nurs 2008;12:639-46. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18676330" 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" => "Gerullis H, Bergmann L, Maute L, Eimer C, Otto T. Experiences and practical conclusions concerning Temsirolimus use and adverse event management in advanced renal cell carcinoma within a compassionate use program in Germany. Cancer Chemother Pharmacol 2009;63:1097-102.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/18818922" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000002900000006/v0_201502091611/X2013251409033618/v0_201502091612/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "35436"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002900000006/v0_201502091611/X2013251409033618/v0_201502091612/en/P-E-S-A456-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409033618?idApp=UINPBA000064"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Acute renal failure in a patient with renal carcinoma treated with Temsirolimus
Fracaso renal agudo en un paciente con carcinoma renal tratado con Temsirolimus
Manuel Heras Benitoa, M.J.. Fernández-Reyesa, A.. Rodrígueza, A.. Molinaa, F.. Álvarez-Udea, B.. Estebanb
a Servicio de Nefrología, Hospital General de Segovia, Segovia, España,
b Servicio de Oncología Médica, Hospital General de Segovia, Segovia, España,
Read
5967
Times
was read the article
1777
Total PDF
4190
Total HTML
Share statistics
 array:21 [
  "pii" => "X2013251409033618"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.2009.29.6.5463.en.full"
  "estado" => "S300"
  "fechaPublicacion" => "2009-12-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia &#40;English Version&#41;. 2009;29:612"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 3304
    "formatos" => array:3 [
      "EPUB" => 261
      "HTML" => 2564
      "PDF" => 479
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699509033610"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.2009.29.6.5463.en.full"
      "estado" => "S300"
      "fechaPublicacion" => "2009-12-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2009;29:612"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 4816
        "formatos" => array:3 [
          "EPUB" => 230
          "HTML" => 4158
          "PDF" => 428
        ]
      ]
      "es" => array:9 [
        "idiomaDefecto" => true
        "titulo" => "Fracaso renal agudo en un paciente con carcinoma renal tratado con Temsirolimus"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "612"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Acute renal failure in a patient with renal carcinoma treated with Temsirolimus"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Manuel Heras Benito, M.J. Fern&#225;ndez-Reyes, A. Rodr&#237;guez, A. Molina, F. &#193;lvarez-Ude, B. Esteban"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Manuel"
                "apellidos" => "Heras Benito"
              ]
              1 => array:2 [
                "Iniciales" => "M.J."
                "apellidos" => "Fern&#225;ndez-Reyes"
              ]
              2 => array:2 [
                "Iniciales" => "A."
                "apellidos" => "Rodr&#237;guez"
              ]
              3 => array:2 [
                "Iniciales" => "A."
                "apellidos" => "Molina"
              ]
              4 => array:2 [
                "Iniciales" => "F."
                "apellidos" => "&#193;lvarez-Ude"
              ]
              5 => array:2 [
                "Iniciales" => "B."
                "apellidos" => "Esteban"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251409033618"
          "doi" => "10.3265/Nefrologia.2009.29.6.5463.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/X2013251409033618?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699509033610?idApp=UINPBA000064"
      "url" => "/02116995/0000002900000006/v0_201502091341/X0211699509033610/v0_201502091342/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X201325140903360X"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.2009.29.6.5458.en.full"
    "estado" => "S300"
    "fechaPublicacion" => "2009-12-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia &#40;English Version&#41;. 2009;29:613"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3570
      "formatos" => array:3 [
        "EPUB" => 284
        "HTML" => 2758
        "PDF" => 528
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Hyperamylasaemia and bronchoaspiration associated with Lanthanum carbonate"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "613"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Hiperamilasemia y broncoaspiraci&#243;n asociadas a Carbonato de Lantano"
        ]
      ]
      "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 Espa&#241;a"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "45718078_f1_p613.jpg"
              "Alto" => 318
              "Ancho" => 258
              "Tamanyo" => 15112
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Rosa Ramos S&#225;nchez, M.A. Azancot, J. Bartolom&#233;"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Rosa"
              "apellidos" => "Ramos S&#225;nchez"
            ]
            1 => array:2 [
              "Iniciales" => "M.A."
              "apellidos" => "Azancot"
            ]
            2 => array:2 [
              "Iniciales" => "J."
              "apellidos" => "Bartolom&#233;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699509033602"
        "doi" => "10.3265/Nefrologia.2009.29.6.5458.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/X0211699509033602?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X201325140903360X?idApp=UINPBA000064"
    "url" => "/20132514/0000002900000006/v0_201502091611/X201325140903360X/v0_201502091612/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251409033626"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.2009.29.6.5492.en.full"
    "estado" => "S300"
    "fechaPublicacion" => "2009-12-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia &#40;English Version&#41;. 2009;29:610-1"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4328
      "formatos" => array:3 [
        "EPUB" => 253
        "HTML" => 3535
        "PDF" => 540
      ]
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "titulo" => "Acute renal failure associated with Pemetrexed &#40;Alimta&#174;&#41;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "610"
          "paginaFinal" => "611"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Fracaso renal agudo asociado a Pemetrexed &#40;Alimta&#174;&#41;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jos&#233; Mar&#237;a Pe&#241;a Porta, C. Vicente de Vera Florist&#225;n, P. Bueso Ingl&#225;n, J. Flori&#225;n Jeric&#243;"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Jos&#233; Mar&#237;a"
              "apellidos" => "Pe&#241;a Porta"
            ]
            1 => array:2 [
              "Iniciales" => "C."
              "apellidos" => "Vicente de Vera Florist&#225;n"
            ]
            2 => array:2 [
              "Iniciales" => "P."
              "apellidos" => "Bueso Ingl&#225;n"
            ]
            3 => array:2 [
              "Iniciales" => "J."
              "apellidos" => "Flori&#225;n Jeric&#243;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699509033629"
        "doi" => "10.3265/Nefrologia.2009.29.6.5492.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/X0211699509033629?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409033626?idApp=UINPBA000064"
    "url" => "/20132514/0000002900000006/v0_201502091611/X2013251409033626/v0_201502091612/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "titulo" => "Acute renal failure in a patient with renal carcinoma treated with Temsirolimus"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "612"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Manuel Heras Benito, M.J. Fern&#225;ndez-Reyes, A. Rodr&#237;guez, A. Molina, F. &#193;lvarez-Ude, B. Esteban"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "Manuel"
            "apellidos" => "Heras Benito"
            "email" => array:1 [
              0 => "mheras&#64;hgse&#46;sacyl&#46;es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "Iniciales" => "M.J."
            "apellidos" => "Fern&#225;ndez-Reyes"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          2 => array:3 [
            "Iniciales" => "A."
            "apellidos" => "Rodr&#237;guez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          3 => array:3 [
            "Iniciales" => "A."
            "apellidos" => "Molina"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          4 => array:3 [
            "Iniciales" => "F."
            "apellidos" => "&#193;lvarez-Ude"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          5 => array:3 [
            "Iniciales" => "B."
            "apellidos" => "Esteban"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Nefrología, Hospital General de Segovia, Segovia,  España, "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Oncología Médica, Hospital General de Segovia, Segovia,  España, "
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Fracaso renal agudo en un paciente con carcinoma renal tratado con Temsirolimus"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Tab.  1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "45618078_t1_p612.jpg"
            "Alto" => 86
            "Ancho" => 826
            "Tamanyo" => 16835
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Progress of the renal function before and after treatment with Temsirolimus"
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara">Dear Editor&#44;</p><p class="elsevierStylePara">Temsirolimus&#44; a new inhibitor of the mammalian target of rapamycin &#40;mTOR&#41;&#44; has shown to prolong the survival rate of patients with advanced renal carcinoma&#46;<span class="elsevierStyleSup">1</span>We report the case of a man who suffered from acute renal failure &#40;ARF&#41; during his treatment with this drug&#46;</p><p class="elsevierStylePara">A 63-year-old male with important medical history of ischaemic heart disease&#44; type 2 diabetes mellitus initially treated with gliclazide and hypertension treated with Carvedilol and Enalapril&#46; In June 2008&#44; he was diagnosed with left renal carcinoma with pulmonary metastasis&#44; for which it was decided to carry out a left nephrectomy and chemotherapy&#46; He was initially treated with Sunitinib from August to October 2008&#59; afterwards&#44; from November 2008 to March 2009&#44; he received Sorafenib&#46; Since May 2009&#44; due to the progression of his illness&#44; he began treatment with Temsirolimus at a dose of 25mg IV&#47;week&#46; The analytical progress of the pre-treatment and that following the administration of Temsirolimus is shown in Table 1&#46;</p><p class="elsevierStylePara">Before his scheduled visit to receive the sixth dose of Temsirolimus&#44; the patient mentioned fatigue&#44; a decrease in the ingestion of liquids and solids &#40;due to ulcers in the oral mucosa&#41; and a drop in urine volume&#46; He did not mention any other symptoms&#46;</p><p class="elsevierStylePara">During the physical examination&#44; the patient was in good general state&#44; was conscious and had clarity of mind&#44; had no temperature&#44; his blood pressure was 90&#47;50mmHg and had two ulcers in the oral mucosa&#46; There were no other pathological findings in the rest of the examination&#46;</p><p class="elsevierStylePara">The renal Doppler ultrasound showed a normal right kidney&#44; with good vascularisation&#46;</p><p class="elsevierStylePara">In detail&#44; Creatinine of 6&#46;5mg&#47;dl&#44; Sodium of 133mEq&#47;l&#44; Potassium of 5&#46;1mEq&#47;l&#44; Uric acid of 11mg&#47;dl&#44; Calcium of 10&#46;7mg&#47;dl and Haemoglobin of 13&#46;4g&#47;dl were found in the blood&#44; while the rest of the complete blood count and coagulation were within normal values&#46; Urine analysis&#58; Creatinine of 192mg&#47;dl and Sodium of 69mEq&#47;l&#46; Protein quantification in the 24-hour urine was negative&#46;</p><p class="elsevierStylePara">In the first 24 hours following admission&#44; the renal function continued to change with a creatinine of 7&#46;6mg&#47;dl&#44; despite adequate hydratation with a saline solution&#44; later improving without needing renal substitutive treatment and with creatinine levels of 2&#46;2mg&#47;dl at discharge&#46;</p><p class="elsevierStylePara">The treatment of advanced renal carcinoma with Temsirolimus was well-tolerated&#44; and the majority of the side effects reported were medically controlled&#46;<span class="elsevierStyleSup">2</span> Gerullis et al analysed the tolerance to Temsirolimus in 32 patients with advanced renal carcinoma&#44; with a slight increase in creatinine present in 40&#46;6&#37; of them&#44; without leading to ARF or the need for renal replacement therapy&#46;<span class="elsevierStyleSup">3</span> From the start of the treatment&#44; we also noticed in our patient a slight increase in the levels of plasma creatinine&#44; contributing to the lack of ingestion of solids and liquids&#46; This was linked with the consumption of angiotensin-converting enzyme inhibitors&#44; to which the patient presented a reversible ARF&#46; Although ARF is not described as a frequent side effect of Temsirolimus&#44; its nephrotoxic potential could be when considering this slight increase in creatinine&#44; which aggravated renal damage through other functional factors &#40;volume depletion&#44; NSAIDs&#44; etc&#46;&#41;&#44; as in the case of our patient&#46; Given the fact that the primary purpose of this drug is to treat advanced renal carcinoma&#44; when treating patients who have undergone nephrectomy&#44; thus with a greater susceptibility to renal deterioration&#44; the possible nephrotoxicity of Temsirolimus is of a particular interest in these patients&#46; It is advisable therefore to monitor their renal function&#46; <br></br></p><p class="elsevierStylePara"><a href="grande&#47;45618078&#95;t1&#95;p612&#46;jpg" class="elsevierStyleCrossRefs"><img src="45618078_t1_p612.jpg" alt="Progress of the renal function before and after treatment with Temsirolimus"></img></a></p><p class="elsevierStylePara">Table 1&#46; Progress of the renal function before and after treatment with Temsirolimus</p>"
    "pdfFichero" => "P-E-S-A456-EN.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Tab.  1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "45618078_t1_p612.jpg"
            "Alto" => 86
            "Ancho" => 826
            "Tamanyo" => 16835
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Progress of the renal function before and after treatment with Temsirolimus"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:3 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Bellmunt J, Szczylik C, Feingold J, Strahs A, Berkenblit A.Temsirolimus safety profile and management of toxic effects in patients with advanced renal cell carcinoma and poor prognostic features. Ann Oncol 2008;19:1387-92. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18385198" 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" => "Malizzia LJ, Hsu A. Temsirolimus, an mTOR inhibitor for treatment of patients with advanced renal carcinoma. Clin J Oncol Nurs 2008;12:639-46. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18676330" 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" => "Gerullis H, Bergmann L, Maute L, Eimer C, Otto T. Experiences and practical conclusions concerning Temsirolimus use and adverse event management in advanced renal cell carcinoma within a compassionate use program in Germany. Cancer Chemother Pharmacol 2009;63:1097-102.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/18818922" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000002900000006/v0_201502091611/X2013251409033618/v0_201502091612/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "35436"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002900000006/v0_201502091611/X2013251409033618/v0_201502091612/en/P-E-S-A456-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251409033618?idApp=UINPBA000064"
]
Article information
ISSN: 20132514
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 5 8 13
2024 October 45 28 73
2024 September 38 15 53
2024 August 50 58 108
2024 July 35 26 61
2024 June 43 35 78
2024 May 57 29 86
2024 April 50 33 83
2024 March 26 23 49
2024 February 35 34 69
2024 January 34 22 56
2023 December 16 23 39
2023 November 40 26 66
2023 October 27 26 53
2023 September 26 23 49
2023 August 33 30 63
2023 July 32 20 52
2023 June 38 17 55
2023 May 31 26 57
2023 April 13 16 29
2023 March 30 20 50
2023 February 20 17 37
2023 January 27 21 48
2022 December 28 25 53
2022 November 27 25 52
2022 October 30 28 58
2022 September 27 32 59
2022 August 33 46 79
2022 July 21 40 61
2022 June 28 23 51
2022 May 27 32 59
2022 April 24 34 58
2022 March 27 31 58
2022 February 31 33 64
2022 January 21 23 44
2021 December 24 29 53
2021 November 38 28 66
2021 October 19 34 53
2021 September 23 24 47
2021 August 31 28 59
2021 July 27 27 54
2021 June 14 15 29
2021 May 24 17 41
2021 April 42 37 79
2021 March 28 10 38
2021 February 31 11 42
2021 January 20 8 28
2020 December 22 13 35
2020 November 24 9 33
2020 October 10 6 16
2020 September 21 2 23
2020 August 28 7 35
2020 July 23 7 30
2020 June 18 4 22
2020 May 17 9 26
2020 April 24 9 33
2020 March 24 8 32
2020 February 37 17 54
2020 January 37 18 55
2019 December 28 17 45
2019 November 14 12 26
2019 October 12 11 23
2019 September 24 21 45
2019 August 11 3 14
2019 July 17 17 34
2019 June 16 14 30
2019 May 17 9 26
2019 April 57 20 77
2019 March 19 23 42
2019 February 15 10 25
2019 January 18 13 31
2018 December 49 29 78
2018 November 84 15 99
2018 October 76 12 88
2018 September 73 12 85
2018 August 47 22 69
2018 July 50 14 64
2018 June 44 12 56
2018 May 49 17 66
2018 April 46 3 49
2018 March 45 11 56
2018 February 38 8 46
2018 January 33 5 38
2017 December 39 12 51
2017 November 27 5 32
2017 October 25 6 31
2017 September 22 11 33
2017 August 24 6 30
2017 July 24 10 34
2017 June 27 4 31
2017 May 21 6 27
2017 April 14 15 29
2017 March 12 10 22
2017 February 18 7 25
2017 January 11 4 15
2016 December 36 6 42
2016 November 52 7 59
2016 October 55 7 62
2016 September 74 2 76
2016 August 132 4 136
2016 July 104 0 104
2016 June 83 0 83
2016 May 92 0 92
2016 April 76 0 76
2016 March 65 0 65
2016 February 69 0 69
2016 January 87 0 87
2015 December 98 0 98
2015 November 72 0 72
2015 October 51 0 51
2015 September 54 0 54
2015 August 44 0 44
2015 July 46 0 46
2015 June 30 0 30
2015 May 38 0 38
2015 April 5 0 5
Show all

Follow this link to access the full text of the article

Idiomas
Nefrología (English Edition)
es en

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

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