array:21 [
  "pii" => "X2013251412000448"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.pre2011.Dec.11235"
  "estado" => "S300"
  "fechaPublicacion" => "2012-01-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia (English Version). 2012;32:115-7"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 8308
    "formatos" => array:3 [
      "EPUB" => 389
      "HTML" => 7209
      "PDF" => 710
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699512000440"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.pre2011.Dec.11235"
      "estado" => "S300"
      "fechaPublicacion" => "2012-01-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2012;32:115-7"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 19386
        "formatos" => array:3 [
          "EPUB" => 286
          "HTML" => 18255
          "PDF" => 845
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "titulo" => "Estimación de la tasa de filtración glomerular para el ajuste posológico de los fármacos. Reina la confusión"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "115"
            "paginaFinal" => "117"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Estimating glomerular filtration rate in order to adjust drug doses: confusion abounds"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig1"
            "etiqueta" => "Tab.  1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "copyright" => "Elsevier España"
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "11235_108_23287_es_11235_t1.jpg"
                "Alto" => 179
                "Ancho" => 600
                "Tamanyo" => 100527
              ]
            ]
            "descripcion" => array:1 [
              "es" => "Recomendación de ajuste de dosis de dabigatrán según la tasa de filtración glomerular estimada por diferentes fórmulas"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Javier Peral-Aguirregoitia, Unax Lertxundi-Etxebarria, Ramon Saracho-Rotaeche, Sira Iturrizaga-Correcher, M. José Martínez-Bengoechea"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "Javier"
                "apellidos" => "Peral-Aguirregoitia"
              ]
              1 => array:2 [
                "nombre" => "Unax"
                "apellidos" => "Lertxundi-Etxebarria"
              ]
              2 => array:2 [
                "nombre" => "Ramon"
                "apellidos" => "Saracho-Rotaeche"
              ]
              3 => array:2 [
                "nombre" => "Sira"
                "apellidos" => "Iturrizaga-Correcher"
              ]
              4 => array:2 [
                "nombre" => "M. José"
                "apellidos" => "Martínez-Bengoechea"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251412000448"
          "doi" => "10.3265/Nefrologia.pre2011.Dec.11235"
          "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/X2013251412000448?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699512000440?idApp=UINPBA000064"
      "url" => "/02116995/0000003200000001/v0_201502091357/X0211699512000440/v0_201502091357/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X2013251412000421"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2011.Nov.11109"
    "estado" => "S300"
    "fechaPublicacion" => "2012-01-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2012;32:116-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5656
      "formatos" => array:3 [
        "EPUB" => 331
        "HTML" => 4680
        "PDF" => 645
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Serial ultrasound of the vascular access"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "116"
          "paginaFinal" => "118"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Ecografía seriada del acceso vascular"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig1"
          "etiqueta" => "Tab.  1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "copyright" => "Elsevier España"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "11109_16025_26372_en_11109_t1.jpg"
              "Alto" => 249
              "Ancho" => 1416
              "Tamanyo" => 168420
            ]
          ]
          "descripcion" => array:1 [
            "en" => "Changes in certain study parameters following percutaneous transluminal angioplasty of the arteriovenous fistula"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Juan A. Martín-Navarro, M. José Gutiérrez-Sánchez, Vladimir Petkov-Stoyanov"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Juan A."
              "apellidos" => "Martín-Navarro"
            ]
            1 => array:2 [
              "nombre" => "M. José"
              "apellidos" => "Gutiérrez-Sánchez"
            ]
            2 => array:2 [
              "nombre" => "Vladimir"
              "apellidos" => "Petkov-Stoyanov"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699512000424"
        "doi" => "10.3265/Nefrologia.pre2011.Nov.11109"
        "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/X0211699512000424?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000421?idApp=UINPBA000064"
    "url" => "/20132514/0000003200000001/v0_201502091620/X2013251412000421/v0_201502091620/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251412000464"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2012.Jan.11115"
    "estado" => "S300"
    "fechaPublicacion" => "2012-01-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2012;32:114"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4148
      "formatos" => array:3 [
        "EPUB" => 370
        "HTML" => 3165
        "PDF" => 613
      ]
    ]
    "en" => array:8 [
      "idiomaDefecto" => true
      "titulo" => "The role of interleukin 6 in the pathogenesis of hyponatremia associated with Guillain-Barré syndrome"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "114"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Se Jin Park, Ki Soo Pai, Ji Hong Kim, Jae II Shin"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Se Jin"
              "apellidos" => "Park"
            ]
            1 => array:2 [
              "nombre" => "Ki Soo"
              "apellidos" => "Pai"
            ]
            2 => array:2 [
              "nombre" => "Ji Hong"
              "apellidos" => "Kim"
            ]
            3 => array:2 [
              "nombre" => "Jae II"
              "apellidos" => "Shin"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "X0211699512000467"
        "doi" => "10.3265/Nefrologia.pre2012.Jan.11115"
        "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/X0211699512000467?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000464?idApp=UINPBA000064"
    "url" => "/20132514/0000003200000001/v0_201502091620/X2013251412000464/v0_201502091620/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "titulo" => "Estimating glomerular filtration rate in order to adjust drug doses: confusion abounds"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "115"
        "paginaFinal" => "117"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Javier Peral-Aguirregoitia, Unax Lertxundi-Etxebarria, Ramon Saracho-Rotaeche, Sira Iturrizaga-Correcher, M. José Martínez-Bengoechea"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "Javier"
            "apellidos" => "Peral-Aguirregoitia"
            "email" => array:1 [
              0 => "javier.peralaguirregoitia@osakidetza.net"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Unax"
            "apellidos" => "Lertxundi-Etxebarria"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Ramon"
            "apellidos" => "Saracho-Rotaeche"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Sira"
            "apellidos" => "Iturrizaga-Correcher"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "affd"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "M&#46; Jos&#233;"
            "apellidos" => "Mart&#237;nez-Bengoechea"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "affe"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:5 [
          0 => array:3 [
            "entidad" => "Servicio de Farmacia Hospitalaria, Hospital Galdakao-Usansolo, Galdakao, Vizcaya,  "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
          1 => array:3 [
            "entidad" => "Farmacéutico especialista en Farmacia Hospitalaria. Jefe de Servicio de Farmacia, Hospital Psiquiátrico de Álava, Vitoria-Gasteiz, Álava,  "
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Nefrología, Hospital Santiago Apóstol, Vitoria-Gasteiz, Álava,  "
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "affc"
          ]
          3 => array:3 [
            "entidad" => "Laboratorio de Análisis Clínicos, Hospital Txagorritxu, Vitoria-Gasteiz, Álava,  "
            "etiqueta" => "<span class="elsevierStyleSup">d</span>"
            "identificador" => "affd"
          ]
          4 => array:3 [
            "entidad" => "Farmacéutica especialista en Farmacia Hospitalaria. Jefa de Servicio de Farmacia, Hospital Galdakao-Usansolo, Galdakao, Vizcaya,  "
            "etiqueta" => "<span class="elsevierStyleSup">e</span>"
            "identificador" => "affe"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Estimaci&#243;n de la tasa de filtraci&#243;n glomerular para el ajuste posol&#243;gico de los f&#225;rmacos&#46; Reina la confusi&#243;n"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "11235_16025_26340_en_11235t1.jpg"
            "Alto" => 433
            "Ancho" => 1459
            "Tamanyo" => 215119
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Recommended dabigatran dose adjustments according to the glomerular filtration rate estimated by different equations"
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">To the Editor&#44;</span></p><p class="elsevierStylePara">Two recent events led to our writing this letter&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">One&#46; </span>For 2 or 3 years now&#44; our local biochemistry laboratories calculate the estimated glomerular filtration rate &#40;eGFR&#41; by means of the MDRD-IDMS formula &#40;formerly MDRD&#41; and the isolated creatinine value&#44; as per National Kidney Foundation recommendations&#46;<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">Yet in October 2011&#44; we still observe the following&#58;</p><p class="elsevierStylePara">- The constant used by some biochemistry laboratories for the MDRD-IDMS formula is 186&#44; when it should be 175 since the calculation for the serum creatinine value is standardised by IDMS&#46;</p><p class="elsevierStylePara">- Some laboratories deliver MDRD-IDMS results in ml&#47;min instead of ml&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span>&#46; Although it is dependent on an individual&#8217;s body surface area&#44; this could lead one to assume that the measurement is absolute&#44; which could have consequences when adjusting doses&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Two&#46; </span>While the new formula for measuring glomerular filtration rate &#40;GFR&#41;&#44;<span class="elsevierStyleSup">2</span> CKD-EPI&#44; seems to improve on the current MDRD-IDMS formula in both accuracy and precision&#44; it is likely to make things even more confusing when it comes to choosing an equation to adjust a drug dose&#46;</p><p class="elsevierStylePara">Furthermore&#44; an article recently published in this journal comparing the MDRD-IDMS and CKD-EPI formulas in a Spanish population<span class="elsevierStyleSup">3</span> contained what appears to be an erratum in Table 1&#44; which describes the formulas used to calculate CKD-EPI&#58; for males with creatinine levels &#62;80 micromoles&#47;litre&#44; it states to divide by 0&#46;7&#44; and we believe that it should be by 0&#46;9&#46;</p><p class="elsevierStylePara">In light of all of the above&#44; we would like to make the following observation&#58;</p><p class="elsevierStylePara">From the 1980s until quite recently&#44; GFR was estimated using the formula published by Cockcroft and Gault &#40;CG&#41; in 1976&#46;<span class="elsevierStyleSup">4</span> The result of this equation &#40;an estimation of creatinine clearance&#41; was used to evaluate renal function and adjust the doses of any drugs that so required&#46; We would like to stress that the value obtained by this formula is absolute&#46; This means that it accounts for the individual&#8217;s size &#40;since it includes weight among its variables&#41; and gives a result in ml&#47;min &#40;if the body surface area differs greatly from the mean&#44; using ideal rather than true weight is recommended&#46;&#41;</p><p class="elsevierStylePara">In 1999&#44; 23 years after the CG formula was published&#44; Levey published a new formula for estimating GFR&#58; the MDRD&#46;<span class="elsevierStyleSup">5</span> Shortly afterwards&#44; in 2002&#44; the KDOQI proposed using this formula for early detection and classification of chronic kidney disease so that patients in earlier stages would have better access to nephrology care&#46;<span class="elsevierStyleSup">1</span> The result given by this formula is dependent on body surface area &#40;ml&#47;min&#47;1&#46;73m<span class="elsevierStyleSup">2</span>&#41;&#44; as is also the case with the recently improved MDRD-IMDS and CKD-EPI formulas&#46;<span class="elsevierStyleSup">6&#44;2</span> Since the result is dependent on a surface area of 1&#46;73 m<span class="elsevierStyleSup">2</span>&#44; we only need the variables age&#44; sex&#44; serum creatinine and race&#46; This formula was recommended by such societies as the Spanish Society of Clinical Biochemistry and Molecular Pathology &#40;SEQC&#41; and the Spanish Society of Nephrology &#40;S&#46;E&#46;N&#41;&#46;<span class="elsevierStyleSup">7</span></p><p class="elsevierStylePara">Nevertheless&#44; although generalised use of the MDRD method seems appropriate for categorising individuals in different stages of chronic kidney disease&#44; it causes some problems in adjusting drug doses&#44; especially if the value given by the laboratories is interpreted as an absolute value&#46;</p><p class="elsevierStylePara">If we consider only the relative results &#40;ml&#47;min&#47;1&#46;73m<span class="elsevierStyleSup">2</span>&#41; given by MDRD&#44; MDRD-IMDS or CKD-EPI &#8211;those results given by biochemical laboratories&#8211; individuals with a body surface area &#62;1&#46;73m<span class="elsevierStyleSup">2</span> will have a higher absolute eGFR value&#46; This could lead to underdosing the patient&#46; If the patient&#8217;s body surface area is less than 1&#46;73m<span class="elsevierStyleSup">2</span>&#44; the absolute eGFR will be lower&#44; which could lead to overdosing the patient &#40;Tables 1 and 2&#41;&#46;</p><p class="elsevierStylePara">On the other hand&#44; the required dose of a certain drug may vary considerably depending on the equation used to estimate GFR&#44; and this may have clinical repercussions&#46;<span class="elsevierStyleSup">8</span> With this in mind&#44; most published drug adjustment guidelines recommend a dose and&#47;or drug interval according to the Cockcroft-Gault formula&#59; very few guidelines make use of MDRD&#46;<span class="elsevierStyleSup">9</span> In two recent examples&#44; regulatory authorities based their recommendations on the CG formula&#58;</p><p class="elsevierStylePara">- The Spanish Agency for Medicines and Health Products &#40;AEMPS&#41; followed the European Medicines Agency recommendation and modified the SmPC for Pradaxa&#174; &#40;dabigatran&#41; and issued an informative note on 27 October 2011 reminding doctors of the importance of checking renal function before and after treatment with this new drug&#46; They informed that before starting dabigatran treatment&#44; renal function must be assessed in all patients by calculating creatinine clearance &#40;CrCl&#41; in order to exclude patients with severe renal failure &#40;CrCl&#60;30ml&#47;min&#41;&#46;<span class="elsevierStyleSup">10</span></p><p class="elsevierStylePara">- The Food and Drug Administration &#40;FDA&#41;&#8217;s safety update of 1 September 2011 stated that the SmPC had been changed and issued a reminder that &#8220;Reclast should not be used &#40;is contraindicated&#41; in patients with creatinine clearance less than 35ml&#47;min&#8221;&#46;<span class="elsevierStyleSup">11</span></p><p class="elsevierStylePara">The FDA guidelines for the industry simply cite the CG and MDRD equations as being the most commonly used&#46;</p><p class="elsevierStylePara">However&#44; experts do not agree on which of the formulas should be used for adjusting doses in patients with renal failure&#46; Some advocate using the equation recommended by the pharmaceutical manufacturer&#44; particularly in the case of elderly patients&#44;<span class="elsevierStyleSup">12</span> while others<span class="elsevierStyleSup">13&#44;14</span> state that the MDRD and CG equations are completely interchangeable&#46;</p><p class="elsevierStylePara">In summary&#44; and as a general rule&#44; using the equation recommended by the pharmaceutical manufacturer &#40;mainly CG&#41; seems reasonable&#46; If there is no specific recommendation&#44; the most reliable method of estimating GFR in the target population should be should&#46;</p><p class="elsevierStylePara">Regardless of which equation is used&#44; we must remember that dose adjustments must be made using absolute GFR values&#44; especially for patients whose body surface area differs greatly from 1&#46;73m<span class="elsevierStyleSup">2</span>&#46;</p><p class="elsevierStylePara"><a href="grande&#47;11235&#95;16025&#95;26340&#95;en&#95;11235t1&#46;jpg" class="elsevierStyleCrossRefs"><img src="11235_16025_26340_en_11235t1.jpg" alt="Recommended dabigatran dose adjustments according to the glomerular filtration rate estimated by different equations"></img></a></p><p class="elsevierStylePara">Table 1&#46; Recommended dabigatran dose adjustments according to the glomerular filtration rate estimated by different equations</p><p class="elsevierStylePara"><a href="grande&#47;11235&#95;16025&#95;26341&#95;en&#95;11235t2&#46;jpg" class="elsevierStyleCrossRefs"><img src="11235_16025_26341_en_11235t2.jpg" alt="Recommended daptomycin dose adjustments according to the glomerular filtration rate estimated by different equations"></img></a></p><p class="elsevierStylePara">Table 2&#46; Recommended daptomycin dose adjustments according to the glomerular filtration rate estimated by different equations</p>"
    "pdfFichero" => "P1-E532-S3401-A11235-EN.pdf"
    "tienePdf" => true
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "11235_16025_26340_en_11235t1.jpg"
            "Alto" => 433
            "Ancho" => 1459
            "Tamanyo" => 215119
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Recommended dabigatran dose adjustments according to the glomerular filtration rate estimated by different equations"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig2"
        "etiqueta" => "Fig. 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "11235_16025_26341_en_11235t2.jpg"
            "Alto" => 420
            "Ancho" => 1437
            "Tamanyo" => 194391
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Recommended daptomycin dose adjustments according to the glomerular filtration rate estimated by different equations"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:14 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39(2 Suppl 1):S1-266. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11904577" 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" => "Levey AS,\u{A0}Stevens LA,\u{A0}Schmid CH,\u{A0}Zhang YL,\u{A0}Castro III AF,\u{A0}Feldman HI, et al., for the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med 2009;150(9):604-12. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19414839" 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" => "Montañés R, Bover J, Oliver A, Ballarín JA, Gracia S. Valoración de la nueva ecuación CKD-EPI para la estimación del filtrado glomerular. Nefrologia 2010;30(2):185-94. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20038962" 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" => "Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16(1):31-41. <a href="http://www.ncbi.nlm.nih.gov/pubmed/1244564" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130(6):461-70."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Levey AS, Coresh J, Greene T, Marsh J, Stevens LA, Kusek JW, et al. Expressing the Modification of Diet in Renal Disease Study equation for estimating glomerular filtration rate with standardized serum creatinine values. Clin Chem 2007;53(4):766-72. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17332152" 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" => "Gracia S, Montañés R, Bover J, Cases A, Deulofeu R, Martín de Francisco AL, et al. Recomendaciones sobre la utilización de ecuaciones para la estimación del filtrado glomerular en adultos. Nefrologia 2006;26:658-65. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17227242" 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" => "Denetclaw TH, Oshima N, Dowling TC. Dofetilide dose calculation errors in elderly associated with use of the modification of diet in renal disease equation. The Ann Pharmacother 2011;45:e44."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Dowling TC, Matzke GR, Murphy JE, Burckart GJ. Evaluation of renal drug dosing: prescribing information and clinical pharmacist approaches. Pharmacotherapy 2010;30(8):776-786. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20653353" 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" => "Nota informativa de la AEMPS, del 27 de octubre de 2011, sobre dabigatrán (Pradaxa®) y riesgo de hemorragia: nuevas recomendaciones de vigilancia de la función renal. Available at: http://www.aemps.gob.es/informa/notasInformativas/medicamentosUsoHumano/seguridad/2011/NI-MUH_21-2011.htm. [Accessed: Oct/31/2011]."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Comunicado de la FDA, del 1 de septiembre de 2011, sobre la seguridad de los medicamentos: Nueva contraindicación y advertencia actualizada sobre el deterioro renal causado por Reclast (ácido zoledrónico). Available at: http://www.fda.gov/Drugs/DrugSafety/ucm270199.htm#ref. [Accessed: Oct/31/2011]."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Corsonello A, Pedone C, Lattanzio F, Semeraro R, D'Andria F, Gigante M, et al. Agreement between equations estimating glomerular filtration rate in elderly nursing home residents and in hospitalised patients: implications for drug dosing. Age and Ageing 2011;40:583-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21398293" 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" => "Stevens LA, Nolin TD, Richardson MM, Feldman HI, Lewis JB, Rodby R, et al.,\u{A0}on behalf of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Comparison of drug dosing recommendations based on measured GFR and kidney function estimating equations. Am J Kidney Dis 2009;54:33-42. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19446939" 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" => "Jones G. Estimating renal function for drug dosing decisions. Clin Biochem Rev 2011;32:81-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21611081" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003200000001/v0_201502091620/X2013251412000448/v0_201502091620/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "35439"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor - Comments on published articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003200000001/v0_201502091620/X2013251412000448/v0_201502091620/en/P1-E532-S3401-A11235-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000448?idApp=UINPBA000064"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Estimating glomerular filtration rate in order to adjust drug doses: confusion abounds
Estimación de la tasa de filtración glomerular para el ajuste posológico de los fármacos. Reina la confusión
Javier Peral-Aguirregoitiaa, Unax Lertxundi-Etxebarriab, Ramon Saracho-Rotaechec, Sira Iturrizaga-Correcherd, M. José Martínez-Bengoecheae
a Servicio de Farmacia Hospitalaria, Hospital Galdakao-Usansolo, Galdakao, Vizcaya,
b Farmacéutico especialista en Farmacia Hospitalaria. Jefe de Servicio de Farmacia, Hospital Psiquiátrico de Álava, Vitoria-Gasteiz, Álava,
c Servicio de Nefrología, Hospital Santiago Apóstol, Vitoria-Gasteiz, Álava,
d Laboratorio de Análisis Clínicos, Hospital Txagorritxu, Vitoria-Gasteiz, Álava,
e Farmacéutica especialista en Farmacia Hospitalaria. Jefa de Servicio de Farmacia, Hospital Galdakao-Usansolo, Galdakao, Vizcaya,
Read
17368
Times
was read the article
2803
Total PDF
14565
Total HTML
Share statistics
 array:21 [
  "pii" => "X2013251412000448"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.pre2011.Dec.11235"
  "estado" => "S300"
  "fechaPublicacion" => "2012-01-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia &#40;English Version&#41;. 2012;32:115-7"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 8308
    "formatos" => array:3 [
      "EPUB" => 389
      "HTML" => 7209
      "PDF" => 710
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699512000440"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.pre2011.Dec.11235"
      "estado" => "S300"
      "fechaPublicacion" => "2012-01-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2012;32:115-7"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 19386
        "formatos" => array:3 [
          "EPUB" => 286
          "HTML" => 18255
          "PDF" => 845
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "titulo" => "Estimaci&#243;n de la tasa de filtraci&#243;n glomerular para el ajuste posol&#243;gico de los f&#225;rmacos&#46; Reina la confusi&#243;n"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "115"
            "paginaFinal" => "117"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Estimating glomerular filtration rate in order to adjust drug doses&#58; confusion abounds"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "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" => "11235_108_23287_es_11235_t1.jpg"
                "Alto" => 179
                "Ancho" => 600
                "Tamanyo" => 100527
              ]
            ]
            "descripcion" => array:1 [
              "es" => "Recomendaci&#243;n de ajuste de dosis de dabigatr&#225;n seg&#250;n la tasa de filtraci&#243;n glomerular estimada por diferentes f&#243;rmulas"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Javier Peral-Aguirregoitia, Unax Lertxundi-Etxebarria, Ramon Saracho-Rotaeche, Sira Iturrizaga-Correcher, M&#46; Jos&#233; Mart&#237;nez-Bengoechea"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "Javier"
                "apellidos" => "Peral-Aguirregoitia"
              ]
              1 => array:2 [
                "nombre" => "Unax"
                "apellidos" => "Lertxundi-Etxebarria"
              ]
              2 => array:2 [
                "nombre" => "Ramon"
                "apellidos" => "Saracho-Rotaeche"
              ]
              3 => array:2 [
                "nombre" => "Sira"
                "apellidos" => "Iturrizaga-Correcher"
              ]
              4 => array:2 [
                "nombre" => "M&#46; Jos&#233;"
                "apellidos" => "Mart&#237;nez-Bengoechea"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251412000448"
          "doi" => "10.3265/Nefrologia.pre2011.Dec.11235"
          "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/X2013251412000448?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699512000440?idApp=UINPBA000064"
      "url" => "/02116995/0000003200000001/v0_201502091357/X0211699512000440/v0_201502091357/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X2013251412000421"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2011.Nov.11109"
    "estado" => "S300"
    "fechaPublicacion" => "2012-01-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia &#40;English Version&#41;. 2012;32:116-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5656
      "formatos" => array:3 [
        "EPUB" => 331
        "HTML" => 4680
        "PDF" => 645
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Serial ultrasound of the vascular access"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "116"
          "paginaFinal" => "118"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Ecograf&#237;a seriada del acceso vascular"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "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" => "11109_16025_26372_en_11109_t1.jpg"
              "Alto" => 249
              "Ancho" => 1416
              "Tamanyo" => 168420
            ]
          ]
          "descripcion" => array:1 [
            "en" => "Changes in certain study parameters following percutaneous transluminal angioplasty of the arteriovenous fistula"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Juan A&#46; Mart&#237;n-Navarro, M&#46; Jos&#233; Guti&#233;rrez-S&#225;nchez, Vladimir Petkov-Stoyanov"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Juan A&#46;"
              "apellidos" => "Mart&#237;n-Navarro"
            ]
            1 => array:2 [
              "nombre" => "M&#46; Jos&#233;"
              "apellidos" => "Guti&#233;rrez-S&#225;nchez"
            ]
            2 => array:2 [
              "nombre" => "Vladimir"
              "apellidos" => "Petkov-Stoyanov"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699512000424"
        "doi" => "10.3265/Nefrologia.pre2011.Nov.11109"
        "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/X0211699512000424?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000421?idApp=UINPBA000064"
    "url" => "/20132514/0000003200000001/v0_201502091620/X2013251412000421/v0_201502091620/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251412000464"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2012.Jan.11115"
    "estado" => "S300"
    "fechaPublicacion" => "2012-01-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia &#40;English Version&#41;. 2012;32:114"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4148
      "formatos" => array:3 [
        "EPUB" => 370
        "HTML" => 3165
        "PDF" => 613
      ]
    ]
    "en" => array:8 [
      "idiomaDefecto" => true
      "titulo" => "The role of interleukin 6 in the pathogenesis of hyponatremia associated with Guillain-Barr&#233; syndrome"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "114"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Se Jin Park, Ki Soo Pai, Ji Hong Kim, Jae II Shin"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Se Jin"
              "apellidos" => "Park"
            ]
            1 => array:2 [
              "nombre" => "Ki Soo"
              "apellidos" => "Pai"
            ]
            2 => array:2 [
              "nombre" => "Ji Hong"
              "apellidos" => "Kim"
            ]
            3 => array:2 [
              "nombre" => "Jae II"
              "apellidos" => "Shin"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "X0211699512000467"
        "doi" => "10.3265/Nefrologia.pre2012.Jan.11115"
        "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/X0211699512000467?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000464?idApp=UINPBA000064"
    "url" => "/20132514/0000003200000001/v0_201502091620/X2013251412000464/v0_201502091620/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "titulo" => "Estimating glomerular filtration rate in order to adjust drug doses&#58; confusion abounds"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "115"
        "paginaFinal" => "117"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Javier Peral-Aguirregoitia, Unax Lertxundi-Etxebarria, Ramon Saracho-Rotaeche, Sira Iturrizaga-Correcher, M&#46; Jos&#233; Mart&#237;nez-Bengoechea"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "Javier"
            "apellidos" => "Peral-Aguirregoitia"
            "email" => array:1 [
              0 => "javier&#46;peralaguirregoitia&#64;osakidetza&#46;net"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Unax"
            "apellidos" => "Lertxundi-Etxebarria"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Ramon"
            "apellidos" => "Saracho-Rotaeche"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Sira"
            "apellidos" => "Iturrizaga-Correcher"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "affd"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "M&#46; Jos&#233;"
            "apellidos" => "Mart&#237;nez-Bengoechea"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "affe"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:5 [
          0 => array:3 [
            "entidad" => "Servicio de Farmacia Hospitalaria, Hospital Galdakao-Usansolo, Galdakao, Vizcaya,  "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
          1 => array:3 [
            "entidad" => "Farmacéutico especialista en Farmacia Hospitalaria. Jefe de Servicio de Farmacia, Hospital Psiquiátrico de Álava, Vitoria-Gasteiz, Álava,  "
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Nefrología, Hospital Santiago Apóstol, Vitoria-Gasteiz, Álava,  "
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "affc"
          ]
          3 => array:3 [
            "entidad" => "Laboratorio de Análisis Clínicos, Hospital Txagorritxu, Vitoria-Gasteiz, Álava,  "
            "etiqueta" => "<span class="elsevierStyleSup">d</span>"
            "identificador" => "affd"
          ]
          4 => array:3 [
            "entidad" => "Farmacéutica especialista en Farmacia Hospitalaria. Jefa de Servicio de Farmacia, Hospital Galdakao-Usansolo, Galdakao, Vizcaya,  "
            "etiqueta" => "<span class="elsevierStyleSup">e</span>"
            "identificador" => "affe"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Estimaci&#243;n de la tasa de filtraci&#243;n glomerular para el ajuste posol&#243;gico de los f&#225;rmacos&#46; Reina la confusi&#243;n"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "11235_16025_26340_en_11235t1.jpg"
            "Alto" => 433
            "Ancho" => 1459
            "Tamanyo" => 215119
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Recommended dabigatran dose adjustments according to the glomerular filtration rate estimated by different equations"
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">To the Editor&#44;</span></p><p class="elsevierStylePara">Two recent events led to our writing this letter&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">One&#46; </span>For 2 or 3 years now&#44; our local biochemistry laboratories calculate the estimated glomerular filtration rate &#40;eGFR&#41; by means of the MDRD-IDMS formula &#40;formerly MDRD&#41; and the isolated creatinine value&#44; as per National Kidney Foundation recommendations&#46;<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">Yet in October 2011&#44; we still observe the following&#58;</p><p class="elsevierStylePara">- The constant used by some biochemistry laboratories for the MDRD-IDMS formula is 186&#44; when it should be 175 since the calculation for the serum creatinine value is standardised by IDMS&#46;</p><p class="elsevierStylePara">- Some laboratories deliver MDRD-IDMS results in ml&#47;min instead of ml&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span>&#46; Although it is dependent on an individual&#8217;s body surface area&#44; this could lead one to assume that the measurement is absolute&#44; which could have consequences when adjusting doses&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Two&#46; </span>While the new formula for measuring glomerular filtration rate &#40;GFR&#41;&#44;<span class="elsevierStyleSup">2</span> CKD-EPI&#44; seems to improve on the current MDRD-IDMS formula in both accuracy and precision&#44; it is likely to make things even more confusing when it comes to choosing an equation to adjust a drug dose&#46;</p><p class="elsevierStylePara">Furthermore&#44; an article recently published in this journal comparing the MDRD-IDMS and CKD-EPI formulas in a Spanish population<span class="elsevierStyleSup">3</span> contained what appears to be an erratum in Table 1&#44; which describes the formulas used to calculate CKD-EPI&#58; for males with creatinine levels &#62;80 micromoles&#47;litre&#44; it states to divide by 0&#46;7&#44; and we believe that it should be by 0&#46;9&#46;</p><p class="elsevierStylePara">In light of all of the above&#44; we would like to make the following observation&#58;</p><p class="elsevierStylePara">From the 1980s until quite recently&#44; GFR was estimated using the formula published by Cockcroft and Gault &#40;CG&#41; in 1976&#46;<span class="elsevierStyleSup">4</span> The result of this equation &#40;an estimation of creatinine clearance&#41; was used to evaluate renal function and adjust the doses of any drugs that so required&#46; We would like to stress that the value obtained by this formula is absolute&#46; This means that it accounts for the individual&#8217;s size &#40;since it includes weight among its variables&#41; and gives a result in ml&#47;min &#40;if the body surface area differs greatly from the mean&#44; using ideal rather than true weight is recommended&#46;&#41;</p><p class="elsevierStylePara">In 1999&#44; 23 years after the CG formula was published&#44; Levey published a new formula for estimating GFR&#58; the MDRD&#46;<span class="elsevierStyleSup">5</span> Shortly afterwards&#44; in 2002&#44; the KDOQI proposed using this formula for early detection and classification of chronic kidney disease so that patients in earlier stages would have better access to nephrology care&#46;<span class="elsevierStyleSup">1</span> The result given by this formula is dependent on body surface area &#40;ml&#47;min&#47;1&#46;73m<span class="elsevierStyleSup">2</span>&#41;&#44; as is also the case with the recently improved MDRD-IMDS and CKD-EPI formulas&#46;<span class="elsevierStyleSup">6&#44;2</span> Since the result is dependent on a surface area of 1&#46;73 m<span class="elsevierStyleSup">2</span>&#44; we only need the variables age&#44; sex&#44; serum creatinine and race&#46; This formula was recommended by such societies as the Spanish Society of Clinical Biochemistry and Molecular Pathology &#40;SEQC&#41; and the Spanish Society of Nephrology &#40;S&#46;E&#46;N&#41;&#46;<span class="elsevierStyleSup">7</span></p><p class="elsevierStylePara">Nevertheless&#44; although generalised use of the MDRD method seems appropriate for categorising individuals in different stages of chronic kidney disease&#44; it causes some problems in adjusting drug doses&#44; especially if the value given by the laboratories is interpreted as an absolute value&#46;</p><p class="elsevierStylePara">If we consider only the relative results &#40;ml&#47;min&#47;1&#46;73m<span class="elsevierStyleSup">2</span>&#41; given by MDRD&#44; MDRD-IMDS or CKD-EPI &#8211;those results given by biochemical laboratories&#8211; individuals with a body surface area &#62;1&#46;73m<span class="elsevierStyleSup">2</span> will have a higher absolute eGFR value&#46; This could lead to underdosing the patient&#46; If the patient&#8217;s body surface area is less than 1&#46;73m<span class="elsevierStyleSup">2</span>&#44; the absolute eGFR will be lower&#44; which could lead to overdosing the patient &#40;Tables 1 and 2&#41;&#46;</p><p class="elsevierStylePara">On the other hand&#44; the required dose of a certain drug may vary considerably depending on the equation used to estimate GFR&#44; and this may have clinical repercussions&#46;<span class="elsevierStyleSup">8</span> With this in mind&#44; most published drug adjustment guidelines recommend a dose and&#47;or drug interval according to the Cockcroft-Gault formula&#59; very few guidelines make use of MDRD&#46;<span class="elsevierStyleSup">9</span> In two recent examples&#44; regulatory authorities based their recommendations on the CG formula&#58;</p><p class="elsevierStylePara">- The Spanish Agency for Medicines and Health Products &#40;AEMPS&#41; followed the European Medicines Agency recommendation and modified the SmPC for Pradaxa&#174; &#40;dabigatran&#41; and issued an informative note on 27 October 2011 reminding doctors of the importance of checking renal function before and after treatment with this new drug&#46; They informed that before starting dabigatran treatment&#44; renal function must be assessed in all patients by calculating creatinine clearance &#40;CrCl&#41; in order to exclude patients with severe renal failure &#40;CrCl&#60;30ml&#47;min&#41;&#46;<span class="elsevierStyleSup">10</span></p><p class="elsevierStylePara">- The Food and Drug Administration &#40;FDA&#41;&#8217;s safety update of 1 September 2011 stated that the SmPC had been changed and issued a reminder that &#8220;Reclast should not be used &#40;is contraindicated&#41; in patients with creatinine clearance less than 35ml&#47;min&#8221;&#46;<span class="elsevierStyleSup">11</span></p><p class="elsevierStylePara">The FDA guidelines for the industry simply cite the CG and MDRD equations as being the most commonly used&#46;</p><p class="elsevierStylePara">However&#44; experts do not agree on which of the formulas should be used for adjusting doses in patients with renal failure&#46; Some advocate using the equation recommended by the pharmaceutical manufacturer&#44; particularly in the case of elderly patients&#44;<span class="elsevierStyleSup">12</span> while others<span class="elsevierStyleSup">13&#44;14</span> state that the MDRD and CG equations are completely interchangeable&#46;</p><p class="elsevierStylePara">In summary&#44; and as a general rule&#44; using the equation recommended by the pharmaceutical manufacturer &#40;mainly CG&#41; seems reasonable&#46; If there is no specific recommendation&#44; the most reliable method of estimating GFR in the target population should be should&#46;</p><p class="elsevierStylePara">Regardless of which equation is used&#44; we must remember that dose adjustments must be made using absolute GFR values&#44; especially for patients whose body surface area differs greatly from 1&#46;73m<span class="elsevierStyleSup">2</span>&#46;</p><p class="elsevierStylePara"><a href="grande&#47;11235&#95;16025&#95;26340&#95;en&#95;11235t1&#46;jpg" class="elsevierStyleCrossRefs"><img src="11235_16025_26340_en_11235t1.jpg" alt="Recommended dabigatran dose adjustments according to the glomerular filtration rate estimated by different equations"></img></a></p><p class="elsevierStylePara">Table 1&#46; Recommended dabigatran dose adjustments according to the glomerular filtration rate estimated by different equations</p><p class="elsevierStylePara"><a href="grande&#47;11235&#95;16025&#95;26341&#95;en&#95;11235t2&#46;jpg" class="elsevierStyleCrossRefs"><img src="11235_16025_26341_en_11235t2.jpg" alt="Recommended daptomycin dose adjustments according to the glomerular filtration rate estimated by different equations"></img></a></p><p class="elsevierStylePara">Table 2&#46; Recommended daptomycin dose adjustments according to the glomerular filtration rate estimated by different equations</p>"
    "pdfFichero" => "P1-E532-S3401-A11235-EN.pdf"
    "tienePdf" => true
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "11235_16025_26340_en_11235t1.jpg"
            "Alto" => 433
            "Ancho" => 1459
            "Tamanyo" => 215119
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Recommended dabigatran dose adjustments according to the glomerular filtration rate estimated by different equations"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig2"
        "etiqueta" => "Fig. 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "11235_16025_26341_en_11235t2.jpg"
            "Alto" => 420
            "Ancho" => 1437
            "Tamanyo" => 194391
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Recommended daptomycin dose adjustments according to the glomerular filtration rate estimated by different equations"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:14 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39(2 Suppl 1):S1-266. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11904577" 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" => "Levey AS,\u{A0}Stevens LA,\u{A0}Schmid CH,\u{A0}Zhang YL,\u{A0}Castro III AF,\u{A0}Feldman HI, et al., for the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med 2009;150(9):604-12. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19414839" 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" => "Montañés R, Bover J, Oliver A, Ballarín JA, Gracia S. Valoración de la nueva ecuación CKD-EPI para la estimación del filtrado glomerular. Nefrologia 2010;30(2):185-94. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20038962" 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" => "Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16(1):31-41. <a href="http://www.ncbi.nlm.nih.gov/pubmed/1244564" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999;130(6):461-70."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Levey AS, Coresh J, Greene T, Marsh J, Stevens LA, Kusek JW, et al. Expressing the Modification of Diet in Renal Disease Study equation for estimating glomerular filtration rate with standardized serum creatinine values. Clin Chem 2007;53(4):766-72. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17332152" 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" => "Gracia S, Montañés R, Bover J, Cases A, Deulofeu R, Martín de Francisco AL, et al. Recomendaciones sobre la utilización de ecuaciones para la estimación del filtrado glomerular en adultos. Nefrologia 2006;26:658-65. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17227242" 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" => "Denetclaw TH, Oshima N, Dowling TC. Dofetilide dose calculation errors in elderly associated with use of the modification of diet in renal disease equation. The Ann Pharmacother 2011;45:e44."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Dowling TC, Matzke GR, Murphy JE, Burckart GJ. Evaluation of renal drug dosing: prescribing information and clinical pharmacist approaches. Pharmacotherapy 2010;30(8):776-786. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20653353" 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" => "Nota informativa de la AEMPS, del 27 de octubre de 2011, sobre dabigatrán (Pradaxa®) y riesgo de hemorragia: nuevas recomendaciones de vigilancia de la función renal. Available at: http://www.aemps.gob.es/informa/notasInformativas/medicamentosUsoHumano/seguridad/2011/NI-MUH_21-2011.htm. [Accessed: Oct/31/2011]."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Comunicado de la FDA, del 1 de septiembre de 2011, sobre la seguridad de los medicamentos: Nueva contraindicación y advertencia actualizada sobre el deterioro renal causado por Reclast (ácido zoledrónico). Available at: http://www.fda.gov/Drugs/DrugSafety/ucm270199.htm#ref. [Accessed: Oct/31/2011]."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Corsonello A, Pedone C, Lattanzio F, Semeraro R, D'Andria F, Gigante M, et al. Agreement between equations estimating glomerular filtration rate in elderly nursing home residents and in hospitalised patients: implications for drug dosing. Age and Ageing 2011;40:583-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21398293" 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" => "Stevens LA, Nolin TD, Richardson MM, Feldman HI, Lewis JB, Rodby R, et al.,\u{A0}on behalf of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Comparison of drug dosing recommendations based on measured GFR and kidney function estimating equations. Am J Kidney Dis 2009;54:33-42. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19446939" 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" => "Jones G. Estimating renal function for drug dosing decisions. Clin Biochem Rev 2011;32:81-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21611081" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003200000001/v0_201502091620/X2013251412000448/v0_201502091620/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "35439"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor - Comments on published articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003200000001/v0_201502091620/X2013251412000448/v0_201502091620/en/P1-E532-S3401-A11235-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000448?idApp=UINPBA000064"
]
Article information
ISSN: 20132514
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 11 6 17
2024 October 82 49 131
2024 September 72 41 113
2024 August 73 45 118
2024 July 73 36 109
2024 June 101 53 154
2024 May 103 48 151
2024 April 98 37 135
2024 March 90 21 111
2024 February 55 30 85
2024 January 87 29 116
2023 December 101 23 124
2023 November 121 35 156
2023 October 180 41 221
2023 September 126 39 165
2023 August 125 25 150
2023 July 197 37 234
2023 June 246 22 268
2023 May 176 46 222
2023 April 163 29 192
2023 March 126 22 148
2023 February 110 30 140
2023 January 81 32 113
2022 December 98 44 142
2022 November 113 44 157
2022 October 114 70 184
2022 September 108 55 163
2022 August 124 56 180
2022 July 94 47 141
2022 June 131 39 170
2022 May 125 36 161
2022 April 164 61 225
2022 March 106 59 165
2022 February 98 58 156
2022 January 126 35 161
2021 December 91 57 148
2021 November 119 39 158
2021 October 123 41 164
2021 September 94 42 136
2021 August 110 35 145
2021 July 143 34 177
2021 June 114 39 153
2021 May 172 50 222
2021 April 406 104 510
2021 March 299 41 340
2021 February 237 33 270
2021 January 162 26 188
2020 December 182 23 205
2020 November 91 14 105
2020 October 87 16 103
2020 September 144 19 163
2020 August 104 11 115
2020 July 111 10 121
2020 June 114 14 128
2020 May 142 22 164
2020 April 134 20 154
2020 March 121 10 131
2020 February 132 27 159
2020 January 140 21 161
2019 December 146 18 164
2019 November 92 29 121
2019 October 93 13 106
2019 September 141 20 161
2019 August 147 23 170
2019 July 154 21 175
2019 June 126 20 146
2019 May 225 35 260
2019 April 255 65 320
2019 March 155 31 186
2019 February 78 18 96
2019 January 121 21 142
2018 December 298 38 336
2018 November 302 16 318
2018 October 237 16 253
2018 September 210 25 235
2018 August 126 16 142
2018 July 109 13 122
2018 June 112 21 133
2018 May 126 23 149
2018 April 149 11 160
2018 March 109 5 114
2018 February 108 6 114
2018 January 106 6 112
2017 December 143 11 154
2017 November 89 10 99
2017 October 60 7 67
2017 September 71 11 82
2017 August 80 6 86
2017 July 62 14 76
2017 June 61 9 70
2017 May 107 17 124
2017 April 60 15 75
2017 March 47 9 56
2017 February 107 8 115
2017 January 44 14 58
2016 December 74 8 82
2016 November 98 7 105
2016 October 156 6 162
2016 September 176 4 180
2016 August 217 4 221
2016 July 183 5 188
2016 June 127 0 127
2016 May 147 0 147
2016 April 101 0 101
2016 March 90 0 90
2016 February 136 0 136
2016 January 136 0 136
2015 December 121 0 121
2015 November 104 0 104
2015 October 117 0 117
2015 September 69 0 69
2015 August 81 0 81
2015 July 86 0 86
2015 June 51 0 51
2015 May 63 0 63
2015 April 6 0 6
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?