array:21 [
  "pii" => "X2013251412000808"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.pre2011.Dec.11312"
  "estado" => "S300"
  "fechaPublicacion" => "2012-03-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia (English Version). 2012;32:250-1"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4017
    "formatos" => array:3 [
      "EPUB" => 290
      "HTML" => 3128
      "PDF" => 599
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699512000800"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.pre2011.Dec.11312"
      "estado" => "S300"
      "fechaPublicacion" => "2012-03-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2012;32:250-1"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 6492
        "formatos" => array:3 [
          "EPUB" => 281
          "HTML" => 5650
          "PDF" => 561
        ]
      ]
      "es" => array:9 [
        "idiomaDefecto" => true
        "titulo" => "Paricalcitol en la enfermedad renal crónica en etapas anteriores a la diálisis"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "250"
            "paginaFinal" => "251"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Paricalcitol for pre-dialysis stages of chronic kidney disease"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jaume Almirall, M. Isabel Bolos"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "Jaume"
                "apellidos" => "Almirall"
              ]
              1 => array:2 [
                "nombre" => "M. Isabel"
                "apellidos" => "Bolos"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251412000808"
          "doi" => "10.3265/Nefrologia.pre2011.Dec.11312"
          "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/X2013251412000808?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699512000800?idApp=UINPBA000064"
      "url" => "/02116995/0000003200000002/v0_201502091353/X0211699512000800/v0_201502091354/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X2013251412000793"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2012.Jan.11337"
    "estado" => "S300"
    "fechaPublicacion" => "2012-03-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2012;32:251-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4018
      "formatos" => array:3 [
        "EPUB" => 282
        "HTML" => 3121
        "PDF" => 615
      ]
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "titulo" => "Response to 'Paricalcitol for pre-dialysis stages of chronic kidney disease'"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "251"
          "paginaFinal" => "252"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Respuesta a "Paricalcitol en la enfermedad renal crónica en etapas anteriores a la diálisis""
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "José G. Hervás-Sánchez"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "José G."
              "apellidos" => "Hervás-Sánchez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699512000796"
        "doi" => "10.3265/Nefrologia.pre2012.Jan.11337"
        "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/X0211699512000796?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000793?idApp=UINPBA000064"
    "url" => "/20132514/0000003200000002/v0_201502091616/X2013251412000793/v0_201502091617/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251412000816"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2012.Jan.11342"
    "estado" => "S300"
    "fechaPublicacion" => "2012-03-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2012;32:249-50"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3733
      "formatos" => array:3 [
        "EPUB" => 273
        "HTML" => 2885
        "PDF" => 575
      ]
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "titulo" => "Costs of haemodialysis and peritoneal dialysis outsourcing agreements"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "249"
          "paginaFinal" => "250"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Costes de los conciertos de hemodiálisis y diálisis peritoneal"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "José M. Lamas-Barreiro, Mario Alonso-Suárez, Jesús Á. Saavedra-Alonso, Argimiro Gándara-Martínez"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "José M."
              "apellidos" => "Lamas-Barreiro"
            ]
            1 => array:2 [
              "nombre" => "Mario"
              "apellidos" => "Alonso-Suárez"
            ]
            2 => array:2 [
              "nombre" => "Jesús Á."
              "apellidos" => "Saavedra-Alonso"
            ]
            3 => array:2 [
              "nombre" => "Argimiro"
              "apellidos" => "Gándara-Martínez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699512000819"
        "doi" => "10.3265/Nefrologia.pre2012.Jan.11342"
        "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/X0211699512000819?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000816?idApp=UINPBA000064"
    "url" => "/20132514/0000003200000002/v0_201502091616/X2013251412000816/v0_201502091617/en/main.assets"
  ]
  "en" => array:10 [
    "idiomaDefecto" => true
    "titulo" => "Paricalcitol for pre-dialysis stages of chronic kidney disease"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "250"
        "paginaFinal" => "251"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Jaume Almirall, M. Isabel Bolos"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "Jaume"
            "apellidos" => "Almirall"
            "email" => array:1 [
              0 => "jalmirall@tauli.cat"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46; Isabel"
            "apellidos" => "Bolos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:3 [
            "entidad" => "Servicio de Nefrología, Corporació Sanitària i Univesitària Parc Taulí. Hospital de Sabadell. Univesitat Autònoma de Barcelona, Sabadell, Barcelona,  "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Paricalcitol en la enfermedad renal cr&#243;nica en etapas anteriores a la di&#225;lisis"
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">To the Editor&#44;</span></p><p class="elsevierStylePara">After having read the interesting article by Dr Herv&#225;s S&#225;nchez et al on the effectiveness of treatment with paricalcitol in patients with pre-dialysis chronic kidney disease&#44;<span class="elsevierStyleSup">1</span> we would like to take the time to make a few comments&#46;</p><p class="elsevierStylePara">This study correctly describes the results obtained in controlling hyperparathyroidism and meeting the calcium&#44; phosphorus and parathyroid hormone &#40;PTH&#41; target values recommended by the S&#46;E&#46;N&#46; and KDOQI guidelines&#46;<span class="elsevierStyleSup">2</span> The study was undertaken in normal clinical practice conditions with a retrospective analysis of 92 patients in stage 3 or 4 CKD&#44; and the conclusion was that treatment with paricalcitol was effective for meeting the target values&#46;</p><p class="elsevierStylePara">However&#44; the data analysis section includes a piece of information that the authors did not comment at all&#46; Levels of 25-OH vitamin D in their population were quite deficient&#44; as occurs frequently in such cohorts&#46;<span class="elsevierStyleSup">3</span> Mean recorded levels were 16&#46;2&#177;8ng&#47;ml and 75&#37; had levels below 21ng&#47;ml&#46;</p><p class="elsevierStylePara">We would like to issue a reminder that both the KDOQI and S&#46;E&#46;N&#46; 2011 guidelines recommend starting native vitamin D treatment if 25-OH D levels are below 30ng&#47;ml&#44; and they only indicate treatment with active vitamin D if PTH values exceed the established target once 25-OH D levels have been normalised&#46;</p><p class="elsevierStylePara">This aspect is relevant for two reasons&#58;</p><p class="elsevierStylePara">1&#46; From a clinical viewpoint&#44; it is important to reach the right plasma levels of 25-OH vitamin D&#46; By doing so&#44; we will achieve better control over hyperparathyroidism&#44; in addition to an array of other effects that we will not list in this brief discussion&#46; This is also true in stage 5 chronic kidney disease&#44;<span class="elsevierStyleSup">4</span> but it is especially relevant in earlier stages&#44; such as those in the study in question&#46; This does not mean that paricalcitol cannot be indicated as treatment for bone and mineral metabolism disorders&#44; but it should not be used as a first-line treatment&#46;</p><p class="elsevierStylePara">2&#46; The economic impact of this decision is considerable&#46; The estimate cost of treatment with native vitamin D is 20 to 30 Euros per patient per year&#44; while treatment with paricalcitol may be more than 1700 Euros yearly&#46; And in the range of different vitamin D receptor activators&#44; some options are much more economical and have also been shown to be equally effective&#46;<span class="elsevierStyleSup">3</span> This reflection is especially relevant now that the sustainability of our health system is a matter for concern&#44; in fact&#44; many editorial comments have been published on the subject&#44; both in Spain and internationally&#46;<span class="elsevierStyleSup">5</span></p><p class="elsevierStylePara">Without a doubt&#44; the most important consideration is benefit to the patient&#44; and to achieve this&#44; we should follow the recommendations in the guidelines&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">The authors affirm that they have no conflicts of interest related to the content of this article&#46;</p>"
    "pdfFichero" => "P1-E534-S3461-A11312-EN.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Hervás Sánchez JG, Prados Garrido MD, Polo Moyano A, Cerezo Morales S. Efectividad del tratamiento con paricalcitol por vía oral en pacientes con enfermedad renal crónica en etapas anteriores a la diálisis. Nefrologia 2011;31(6):697-706. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22130286" 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" => "Torregrosa JV, Cannata J, Bover J. Recomendaciones de la Sociedad Española de Nefrología para el manejo de las alteraciones del metabolismo óseo-mineral en los pacientes con enfermedad renal crónica. Nefrologia 2011;31 Supl 1:3-32."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Hansen D, Rasmussen K, Danielsen H, Meyer-Hofmann H, Bacevicius E, Lauridsen TG, et al. No difference between alfacalcidol and paricalcitol in the treatment of secondary hyperparathyroidism in hemodialysis patients: a randomized crossover trial. Kidney Int 2011;80(8):841-50. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21832979" 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" => "Jean G, Souberbielle JC, Chazot C. Monthly cholecalciferol administration in haemodialysis patients: a simple and efficient strategy for vitamin D supplementation. Nephrol Dial Transplant 2009;24:3799-805. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19622574" 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" => "Fuchs VR, Milstein A. The $640 billion question--why does cost-effective care diffuse so slowly?. N Engl J Med 2011;364(21):1985-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21591938" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003200000002/v0_201502091616/X2013251412000808/v0_201502091617/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/20132514/0000003200000002/v0_201502091616/X2013251412000808/v0_201502091617/en/P1-E534-S3461-A11312-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000808?idApp=UINPBA000064"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Paricalcitol for pre-dialysis stages of chronic kidney disease
Paricalcitol en la enfermedad renal crónica en etapas anteriores a la diálisis
Jaume Almiralla, M. Isabel Bolosa
a Servicio de Nefrología, Corporació Sanitària i Univesitària Parc Taulí. Hospital de Sabadell. Univesitat Autònoma de Barcelona, Sabadell, Barcelona,
Read
7135
Times
was read the article
2152
Total PDF
4983
Total HTML
Share statistics
 array:21 [
  "pii" => "X2013251412000808"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.pre2011.Dec.11312"
  "estado" => "S300"
  "fechaPublicacion" => "2012-03-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia &#40;English Version&#41;. 2012;32:250-1"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4017
    "formatos" => array:3 [
      "EPUB" => 290
      "HTML" => 3128
      "PDF" => 599
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699512000800"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.pre2011.Dec.11312"
      "estado" => "S300"
      "fechaPublicacion" => "2012-03-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2012;32:250-1"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 6492
        "formatos" => array:3 [
          "EPUB" => 281
          "HTML" => 5650
          "PDF" => 561
        ]
      ]
      "es" => array:9 [
        "idiomaDefecto" => true
        "titulo" => "Paricalcitol en la enfermedad renal cr&#243;nica en etapas anteriores a la di&#225;lisis"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "250"
            "paginaFinal" => "251"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Paricalcitol for pre-dialysis stages of chronic kidney disease"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jaume Almirall, M&#46; Isabel Bolos"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "Jaume"
                "apellidos" => "Almirall"
              ]
              1 => array:2 [
                "nombre" => "M&#46; Isabel"
                "apellidos" => "Bolos"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251412000808"
          "doi" => "10.3265/Nefrologia.pre2011.Dec.11312"
          "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/X2013251412000808?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699512000800?idApp=UINPBA000064"
      "url" => "/02116995/0000003200000002/v0_201502091353/X0211699512000800/v0_201502091354/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X2013251412000793"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2012.Jan.11337"
    "estado" => "S300"
    "fechaPublicacion" => "2012-03-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia &#40;English Version&#41;. 2012;32:251-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4018
      "formatos" => array:3 [
        "EPUB" => 282
        "HTML" => 3121
        "PDF" => 615
      ]
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "titulo" => "Response to &#39;Paricalcitol for pre-dialysis stages of chronic kidney disease&#39;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "251"
          "paginaFinal" => "252"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Respuesta a &#34;Paricalcitol en la enfermedad renal cr&#243;nica en etapas anteriores a la di&#225;lisis&#34;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jos&#233; G&#46; Herv&#225;s-S&#225;nchez"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "Jos&#233; G&#46;"
              "apellidos" => "Herv&#225;s-S&#225;nchez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699512000796"
        "doi" => "10.3265/Nefrologia.pre2012.Jan.11337"
        "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/X0211699512000796?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000793?idApp=UINPBA000064"
    "url" => "/20132514/0000003200000002/v0_201502091616/X2013251412000793/v0_201502091617/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251412000816"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2012.Jan.11342"
    "estado" => "S300"
    "fechaPublicacion" => "2012-03-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia &#40;English Version&#41;. 2012;32:249-50"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3733
      "formatos" => array:3 [
        "EPUB" => 273
        "HTML" => 2885
        "PDF" => 575
      ]
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "titulo" => "Costs of haemodialysis and peritoneal dialysis outsourcing agreements"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "249"
          "paginaFinal" => "250"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Costes de los conciertos de hemodi&#225;lisis y di&#225;lisis peritoneal"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jos&#233; M&#46; Lamas-Barreiro, Mario Alonso-Su&#225;rez, Jes&#250;s &#193;&#46; Saavedra-Alonso, Argimiro G&#225;ndara-Mart&#237;nez"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Jos&#233; M&#46;"
              "apellidos" => "Lamas-Barreiro"
            ]
            1 => array:2 [
              "nombre" => "Mario"
              "apellidos" => "Alonso-Su&#225;rez"
            ]
            2 => array:2 [
              "nombre" => "Jes&#250;s &#193;&#46;"
              "apellidos" => "Saavedra-Alonso"
            ]
            3 => array:2 [
              "nombre" => "Argimiro"
              "apellidos" => "G&#225;ndara-Mart&#237;nez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699512000819"
        "doi" => "10.3265/Nefrologia.pre2012.Jan.11342"
        "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/X0211699512000819?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000816?idApp=UINPBA000064"
    "url" => "/20132514/0000003200000002/v0_201502091616/X2013251412000816/v0_201502091617/en/main.assets"
  ]
  "en" => array:10 [
    "idiomaDefecto" => true
    "titulo" => "Paricalcitol for pre-dialysis stages of chronic kidney disease"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "250"
        "paginaFinal" => "251"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Jaume Almirall, M&#46; Isabel Bolos"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "Jaume"
            "apellidos" => "Almirall"
            "email" => array:1 [
              0 => "jalmirall&#64;tauli&#46;cat"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46; Isabel"
            "apellidos" => "Bolos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:3 [
            "entidad" => "Servicio de Nefrología, Corporació Sanitària i Univesitària Parc Taulí. Hospital de Sabadell. Univesitat Autònoma de Barcelona, Sabadell, Barcelona,  "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Paricalcitol en la enfermedad renal cr&#243;nica en etapas anteriores a la di&#225;lisis"
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">To the Editor&#44;</span></p><p class="elsevierStylePara">After having read the interesting article by Dr Herv&#225;s S&#225;nchez et al on the effectiveness of treatment with paricalcitol in patients with pre-dialysis chronic kidney disease&#44;<span class="elsevierStyleSup">1</span> we would like to take the time to make a few comments&#46;</p><p class="elsevierStylePara">This study correctly describes the results obtained in controlling hyperparathyroidism and meeting the calcium&#44; phosphorus and parathyroid hormone &#40;PTH&#41; target values recommended by the S&#46;E&#46;N&#46; and KDOQI guidelines&#46;<span class="elsevierStyleSup">2</span> The study was undertaken in normal clinical practice conditions with a retrospective analysis of 92 patients in stage 3 or 4 CKD&#44; and the conclusion was that treatment with paricalcitol was effective for meeting the target values&#46;</p><p class="elsevierStylePara">However&#44; the data analysis section includes a piece of information that the authors did not comment at all&#46; Levels of 25-OH vitamin D in their population were quite deficient&#44; as occurs frequently in such cohorts&#46;<span class="elsevierStyleSup">3</span> Mean recorded levels were 16&#46;2&#177;8ng&#47;ml and 75&#37; had levels below 21ng&#47;ml&#46;</p><p class="elsevierStylePara">We would like to issue a reminder that both the KDOQI and S&#46;E&#46;N&#46; 2011 guidelines recommend starting native vitamin D treatment if 25-OH D levels are below 30ng&#47;ml&#44; and they only indicate treatment with active vitamin D if PTH values exceed the established target once 25-OH D levels have been normalised&#46;</p><p class="elsevierStylePara">This aspect is relevant for two reasons&#58;</p><p class="elsevierStylePara">1&#46; From a clinical viewpoint&#44; it is important to reach the right plasma levels of 25-OH vitamin D&#46; By doing so&#44; we will achieve better control over hyperparathyroidism&#44; in addition to an array of other effects that we will not list in this brief discussion&#46; This is also true in stage 5 chronic kidney disease&#44;<span class="elsevierStyleSup">4</span> but it is especially relevant in earlier stages&#44; such as those in the study in question&#46; This does not mean that paricalcitol cannot be indicated as treatment for bone and mineral metabolism disorders&#44; but it should not be used as a first-line treatment&#46;</p><p class="elsevierStylePara">2&#46; The economic impact of this decision is considerable&#46; The estimate cost of treatment with native vitamin D is 20 to 30 Euros per patient per year&#44; while treatment with paricalcitol may be more than 1700 Euros yearly&#46; And in the range of different vitamin D receptor activators&#44; some options are much more economical and have also been shown to be equally effective&#46;<span class="elsevierStyleSup">3</span> This reflection is especially relevant now that the sustainability of our health system is a matter for concern&#44; in fact&#44; many editorial comments have been published on the subject&#44; both in Spain and internationally&#46;<span class="elsevierStyleSup">5</span></p><p class="elsevierStylePara">Without a doubt&#44; the most important consideration is benefit to the patient&#44; and to achieve this&#44; we should follow the recommendations in the guidelines&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">The authors affirm that they have no conflicts of interest related to the content of this article&#46;</p>"
    "pdfFichero" => "P1-E534-S3461-A11312-EN.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Hervás Sánchez JG, Prados Garrido MD, Polo Moyano A, Cerezo Morales S. Efectividad del tratamiento con paricalcitol por vía oral en pacientes con enfermedad renal crónica en etapas anteriores a la diálisis. Nefrologia 2011;31(6):697-706. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22130286" 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" => "Torregrosa JV, Cannata J, Bover J. Recomendaciones de la Sociedad Española de Nefrología para el manejo de las alteraciones del metabolismo óseo-mineral en los pacientes con enfermedad renal crónica. Nefrologia 2011;31 Supl 1:3-32."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Hansen D, Rasmussen K, Danielsen H, Meyer-Hofmann H, Bacevicius E, Lauridsen TG, et al. No difference between alfacalcidol and paricalcitol in the treatment of secondary hyperparathyroidism in hemodialysis patients: a randomized crossover trial. Kidney Int 2011;80(8):841-50. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21832979" 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" => "Jean G, Souberbielle JC, Chazot C. Monthly cholecalciferol administration in haemodialysis patients: a simple and efficient strategy for vitamin D supplementation. Nephrol Dial Transplant 2009;24:3799-805. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19622574" 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" => "Fuchs VR, Milstein A. The $640 billion question--why does cost-effective care diffuse so slowly?. N Engl J Med 2011;364(21):1985-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21591938" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003200000002/v0_201502091616/X2013251412000808/v0_201502091617/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/20132514/0000003200000002/v0_201502091616/X2013251412000808/v0_201502091617/en/P1-E534-S3461-A11312-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251412000808?idApp=UINPBA000064"
]
Article information
ISSN: 20132514
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 8 10 18
2024 October 41 52 93
2024 September 49 32 81
2024 August 58 50 108
2024 July 45 29 74
2024 June 43 37 80
2024 May 57 33 90
2024 April 50 39 89
2024 March 37 23 60
2024 February 24 34 58
2024 January 32 25 57
2023 December 21 23 44
2023 November 32 34 66
2023 October 34 26 60
2023 September 19 25 44
2023 August 35 20 55
2023 July 27 35 62
2023 June 23 27 50
2023 May 45 36 81
2023 April 20 13 33
2023 March 37 19 56
2023 February 24 21 45
2023 January 25 27 52
2022 December 41 25 66
2022 November 36 28 64
2022 October 28 44 72
2022 September 47 20 67
2022 August 35 33 68
2022 July 30 41 71
2022 June 26 27 53
2022 May 26 33 59
2022 April 30 42 72
2022 March 33 39 72
2022 February 30 40 70
2022 January 31 24 55
2021 December 32 35 67
2021 November 28 37 65
2021 October 31 35 66
2021 September 36 36 72
2021 August 27 34 61
2021 July 26 26 52
2021 June 20 22 42
2021 May 27 27 54
2021 April 69 54 123
2021 March 44 30 74
2021 February 32 10 42
2021 January 27 16 43
2020 December 23 13 36
2020 November 23 13 36
2020 October 18 18 36
2020 September 19 7 26
2020 August 44 11 55
2020 July 23 5 28
2020 June 31 14 45
2020 May 30 4 34
2020 April 17 18 35
2020 March 28 11 39
2020 February 36 19 55
2020 January 32 14 46
2019 December 46 23 69
2019 November 32 17 49
2019 October 11 6 17
2019 September 28 24 52
2019 August 15 8 23
2019 July 16 22 38
2019 June 24 16 40
2019 May 20 17 37
2019 April 35 25 60
2019 March 22 21 43
2019 February 21 20 41
2019 January 24 14 38
2018 December 73 31 104
2018 November 93 15 108
2018 October 75 14 89
2018 September 58 14 72
2018 August 44 16 60
2018 July 46 17 63
2018 June 45 7 52
2018 May 44 16 60
2018 April 55 12 67
2018 March 42 12 54
2018 February 45 10 55
2018 January 33 11 44
2017 December 43 10 53
2017 November 40 11 51
2017 October 33 7 40
2017 September 29 14 43
2017 August 29 7 36
2017 July 31 9 40
2017 June 32 8 40
2017 May 38 12 50
2017 April 35 15 50
2017 March 35 8 43
2017 February 15 18 33
2017 January 18 11 29
2016 December 36 4 40
2016 November 41 19 60
2016 October 79 8 87
2016 September 95 8 103
2016 August 128 6 134
2016 July 148 14 162
2016 June 117 0 117
2016 May 128 0 128
2016 April 99 0 99
2016 March 80 0 80
2016 February 95 0 95
2016 January 123 0 123
2015 December 122 0 122
2015 November 98 0 98
2015 October 76 0 76
2015 September 72 0 72
2015 August 64 0 64
2015 July 69 0 69
2015 June 35 0 35
2015 May 43 0 43
2015 April 8 0 8
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?