Statistics

 array:21 [
  "pii" => "X2013251413053245"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.pre2013.Sep.12179"
  "estado" => "S300"
  "fechaPublicacion" => "2013-11-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia (English Version). 2013;33:860-1"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 6525
    "formatos" => array:3 [
      "EPUB" => 325
      "HTML" => 5454
      "PDF" => 746
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699513053248"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.pre2013.Sep.12179"
      "estado" => "S300"
      "fechaPublicacion" => "2013-11-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2013;33:860-1"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 12174
        "formatos" => array:3 [
          "EPUB" => 344
          "HTML" => 10848
          "PDF" => 982
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "titulo" => "Nefrocalcinosis y acidosis tubular renal distal en síndrome de Sjögren"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "860"
            "paginaFinal" => "861"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Nephrocalcinosis and distal renal tubular acidosis in Sjögren's syndrome"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig1"
            "etiqueta" => "Fig. 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "copyright" => "Elsevier España"
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "12179_19904_48472_es_12179_f1.jpg"
                "Alto" => 460
                "Ancho" => 608
                "Tamanyo" => 196598
              ]
            ]
            "descripcion" => array:1 [
              "es" => "Ultrasonido renal con hiperecogenicidad medular sugestiva de calcificaciones."
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Nasser A. Polanco, M. Virgilia Soto-Abraham, Francisco E. Rodríguez-Castellanos"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Nasser A."
                "apellidos" => "Polanco"
              ]
              1 => array:2 [
                "nombre" => "M. Virgilia"
                "apellidos" => "Soto-Abraham"
              ]
              2 => array:2 [
                "nombre" => "Francisco E."
                "apellidos" => "Rodríguez-Castellanos"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251413053245"
          "doi" => "10.3265/Nefrologia.pre2013.Sep.12179"
          "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/X2013251413053245?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699513053248?idApp=UINPBA000064"
      "url" => "/02116995/0000003300000006/v0_201502091357/X0211699513053248/v0_201502091358/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X2013251413053237"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2013.Jul.12178"
    "estado" => "S300"
    "fechaPublicacion" => "2013-11-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2013;33:861-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 6456
      "formatos" => array:3 [
        "EPUB" => 351
        "HTML" => 5321
        "PDF" => 784
      ]
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "titulo" => "Kaposi's sarcoma in the early post-transplant period in a kidney transplant recipient"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "861"
          "paginaFinal" => "862"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig1"
          "etiqueta" => "Fig. 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "copyright" => "Elsevier España"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "12178_16025_48442_en_f112178.jpg"
              "Alto" => 478
              "Ancho" => 657
              "Tamanyo" => 226774
            ]
          ]
          "descripcion" => array:1 [
            "en" => "Arteriolar hyalinosis due to calcineurin inhibitor toxicity in a renal biopsy specimen."
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Zafer Ercan, Mehmet E. Demir, Ozgur Merhametsiz, Ozlem Yayar, Turgay Ulas, Mehmet D. Ayli"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Zafer"
              "apellidos" => "Ercan"
            ]
            1 => array:2 [
              "nombre" => "Mehmet E."
              "apellidos" => "Demir"
            ]
            2 => array:2 [
              "nombre" => "Ozgur"
              "apellidos" => "Merhametsiz"
            ]
            3 => array:2 [
              "nombre" => "Ozlem"
              "apellidos" => "Yayar"
            ]
            4 => array:2 [
              "nombre" => "Turgay"
              "apellidos" => "Ulas"
            ]
            5 => array:2 [
              "nombre" => "Mehmet D."
              "apellidos" => "Ayli"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "X021169951305323X"
        "doi" => "10.3265/Nefrologia.pre2013.Jul.12178"
        "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/X021169951305323X?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413053237?idApp=UINPBA000064"
    "url" => "/20132514/0000003300000006/v0_201502091623/X2013251413053237/v0_201502091624/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251413053253"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2013.Aug.11863"
    "estado" => "S300"
    "fechaPublicacion" => "2013-11-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2013;33:858-60"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 6107
      "formatos" => array:3 [
        "EPUB" => 303
        "HTML" => 5149
        "PDF" => 655
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Effect of allopurinol on smoking"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "858"
          "paginaFinal" => "860"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Efecto del alopurinol sobre el hábito tabáquico"
        ]
      ]
      "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" => "11863_16025_52968_en_t1118632.jpg"
              "Alto" => 227
              "Ancho" => 1428
              "Tamanyo" => 80424
            ]
          ]
          "descripcion" => array:1 [
            "en" => "Percentage of smoker and ex-smoker diabetic patients with kidney disease in accordance with their treatment with allopurinol"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Noemí Esparza-Martín, Santiago Suria-González, César García-Cantón, Ana Ramírez-Puga, Rita Guerra-Rodríguez, M. Dolores Checa-Andrés"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Noemí"
              "apellidos" => "Esparza-Martín"
            ]
            1 => array:2 [
              "nombre" => "Santiago"
              "apellidos" => "Suria-González"
            ]
            2 => array:2 [
              "nombre" => "César"
              "apellidos" => "García-Cantón"
            ]
            3 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Ramírez-Puga"
            ]
            4 => array:2 [
              "nombre" => "Rita"
              "apellidos" => "Guerra-Rodríguez"
            ]
            5 => array:2 [
              "nombre" => "M. Dolores"
              "apellidos" => "Checa-Andrés"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699513053256"
        "doi" => "10.3265/Nefrologia.pre2013.Aug.11863"
        "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/X0211699513053256?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413053253?idApp=UINPBA000064"
    "url" => "/20132514/0000003300000006/v0_201502091623/X2013251413053253/v0_201502091624/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "titulo" => "Nephrocalcinosis and distal renal tubular acidosis in Sjögren's syndrome"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "860"
        "paginaFinal" => "861"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Nasser A. Polanco, M. Virgilia Soto-Abraham, Francisco E. Rodríguez-Castellanos"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "Nasser A."
            "apellidos" => "Polanco"
            "email" => array:1 [
              0 => "nasser_abdel2000@yahoo.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46; Virgilia"
            "apellidos" => "Soto-Abraham"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Francisco E&#46;"
            "apellidos" => "Rodr&#237;guez-Castellanos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Servicio de Nefrología, Instituto Nacional de Cardiología Ignacio Chávez Ciudad de México,  México, "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Patología, Instituto Nacional de Cardiología &#147;Ignacio Chávez&#148;, Ciudad de México,  México, "
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Nefrología, Instituto Nacional de Cardiología &#147;Ignacio Chávez&#148;, Ciudad de México,  México, "
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "affc"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Nefrocalcinosis y acidosis tubular renal distal en s&#237;ndrome de Sj&#246;gren"
      ]
    ]
    "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" => "12179_16025_52986_en_f112179.jpg"
            "Alto" => 491
            "Ancho" => 654
            "Tamanyo" => 178843
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Renal ultrasound with medullary hyperechogenicity suggestive of calcifications&#46;"
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">To the Editor&#58; </span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">Distal renal tubular acidosis &#40;DRTA&#41; is an acid-base balance disorder defined by the inability of the kidneys to compensate for the production of acids from protein metabolism by eliminating them&#44; due to decreased glomerular filtration &#40;GF&#41;&#46;</p><p class="elsevierStylePara">We report the case of a 33-year-old male patient with a history of hypokalaemia without study two years previously&#44; who was admitted to the Emergency Department due to 10 days of progressive weakness in his limbs&#44; fatigue&#44; asthaenia and myalgia and he denied experiencing urinary symptoms&#46; He self-medicated with potassium salts with no improvement&#44; and as such he decided to seek medical assistance&#46; On examination&#44; he had blood pressure of 119&#47;66mmHg&#44; heart rate of 67 beats&#47;minute&#44; respiratory rate of 22 breaths&#47;min&#44; a temperature of 37&#176;C&#44; with 3&#47;5 weakness in 4 limbs and diminished tendon reflexes&#46; His laboratory tests on admission showed serum creatinine of 1&#46;36mg&#47;dl&#44; serum sodium of 137mEq&#47;l potassium of 3&#46;2mEq&#47;l&#44; chloride of 114mEq&#47;l&#44; calcium of 8&#46;8mg&#47;dl&#44; phosphorus of 3&#46;5mg&#47;dl&#44; magnesium of 2&#46;2mEq&#47;l&#44; bicarbonate of 19mEq&#47;l&#44; pCO<span class="elsevierStyleInf">2</span> of 30mmHg&#44; venous pH of 7&#46;36&#44; lactate of 0&#46;8mEq&#47;l&#44; serum albumin of 4&#46;1g&#47;dl&#44; urine with a pH of 6&#46;5 without glucosuria and urinary sediment with minimal erythrocyturia and leukocyturia&#44; without nitrites or bacteria apparent in the microscope and proteinuria of 550mg&#47;24 hours&#46; We obtained a urine culture&#59; normal complement levels&#44; negative viral profile for human immunodeficiency virus and hepatitis B and C&#46; A renal ultrasound was performed and there were hyperechogenic images suggestive of medullary calcification &#40;Figure 1&#41;&#44; calciuria of 4&#46;2mg&#47;kg&#47;day&#44; positive urinary anion gap &#40;sodium of 58mEq&#47;l&#44; potassium of 16mEq&#47;l&#44; chloride of 23mEq&#47;l&#41;&#44; fractional excretion of potassium of 12&#37;&#44; fractional excretion of bicarbonate of 7&#37;&#44; but a urinary pH that failed to decrease to &#60;5&#46;5 over a period of more than 8 hours and reduction of the urinary gap&#44; but without becoming negative &#40;sodium of 47mEq&#47;l&#44; potassium of 12mEq&#47;l&#44; chlorine of 43mEq&#47;l&#41; after oral administration of ammonium chloride&#44; and as such it was classified as distal renal tubular acidosis &#40;DRTA&#41; &#40;type 1&#41;&#46; The urine culture was negative and as such percutaneous renal biopsy was performed&#44; which reported chronic tubulointerstitial nephritis with interstitial and intratubular nephrocalcinosis &#40;Figure 2&#41;&#46; The patient was therefore treated with 1mg&#47;kg&#47;day of prednisone and 1mEq&#47;kg&#47;day of potassium citrate&#46; A week later&#44; given a reduction in leukocyturia&#44; immunological studies reported positive anti-nuclear antibodies&#44; with a titre of 1&#58;2560&#44; positive anti-SSA and anti-SSB&#46; We performed Schirmer&#8217;s test&#44; which was positive&#44; curiously without dry eye symptoms&#46; In the outpatient follow-up after 16 weeks on 5mg&#47;day of prednisone&#44; the patient had creatinine of 0&#46;88mg&#47;dl and a decreased potassium salt requirement&#44; maintaining normal levels of potassium&#44; urinary pH at around 5&#44; calciuria of 3&#46;9mg&#47;kg&#47;day&#44; negative urinary anion gap &#40;sodium of 21mEq&#47;l&#44; potassium of 8mEq&#47;l&#44; chlorine of 47mEq&#47;l&#41;&#44; with the absence of leukocyturia&#44; erythrocyturia and proteinuria&#46;</p><p class="elsevierStylePara">Renal manifestations classified as renal tubular acidosis usually occur with a variable proportion between 3&#46;6&#37; and 73&#46;1&#37; in the series of patients with Sj&#246;gren&#39;s syndrome &#40;SS&#41; studied&#46;<span class="elsevierStyleSup">1</span> Acute and&#47;or chronic tubulointerstitial nephritis is the most common histopathological form in 54&#37;-80&#37; of cases&#46;<span class="elsevierStyleSup">1-3</span></p><p class="elsevierStylePara">In DRTA&#44; or type 1&#44; hypercalciuria is usually multifactorial &#40;release of bone calcium&#44; suppression of the calcium-sensing receptor &#91;CaSR&#93;&#44; increased distal sodium load and acidosis&#41;&#44; which along with alkaline urine and hypocitraturia favours calculi and nephrocalcinosis&#46; Initially normal GF may decrease over time due to dehydration&#44; nephrocalcinosis&#44; obstructive calculi and&#47;or infection&#46;<span class="elsevierStyleSup">4&#44;5</span></p><p class="elsevierStylePara">The objective of its treatment should be to normalise calciuria and citraturia to prevent nephrocalcinosis and progressive renal damage&#46; As such&#44; the underlying acidosis must be corrected&#46;<span class="elsevierStyleSup">5</span> Nevertheless&#44; this treatment is a palliative measure when its cause is secondary&#44; such as in SS&#44; where corticosteroids and cyclophosphamide have been used in accordance with the severity of renal involvement&#44; with reports of stabilised renal function&#44; a reduction in proteinuria and reversibility of various clinical manifestations deriving from renal tubular acidosis&#44; therefore preventing the extension of nephrocalcinosis and reducing the risk of progression to end-stage chronic kidney disease&#46;<span class="elsevierStyleSup">1&#44;2</span>&#46; In our case&#44; we used prednisone&#44; which was gradually reduced&#44; with a remission of clinical manifestations being achieved when the autoimmune tubulointerstitial nephritis deriving from SS was controlled&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span>&#160;</p><p class="elsevierStylePara">The authors declare that they have no conflicts of interest related to the contents of this article&#46;</p><p class="elsevierStylePara"><a href="grande&#47;12179&#95;16025&#95;52986&#95;en&#95;f112179&#46;jpg" class="elsevierStyleCrossRefs"><img src="12179_16025_52986_en_f112179.jpg" alt="Renal ultrasound with medullary hyperechogenicity suggestive of calcifications&#46;"></img></a></p><p class="elsevierStylePara">Figure 1&#46; Renal ultrasound with medullary hyperechogenicity suggestive of calcifications&#46;</p><p class="elsevierStylePara"><a href="grande&#47;12179&#95;16025&#95;52989&#95;en&#95;f2121792&#46;jpg" class="elsevierStyleCrossRefs"><img src="12179_16025_52989_en_f2121792.jpg" alt="Renal histopathology showing tubulointerstitial lymphoplasmacytic infiltrate &#40;A&#41; and intratubular and interstitial nephrocalcinosis with Von Kossa stain &#40;B&#41;&#46; Images at 40X&#46;"></img></a></p><p class="elsevierStylePara">Figure 2&#46; Renal histopathology showing tubulointerstitial lymphoplasmacytic infiltrate &#40;A&#41; and intratubular and interstitial nephrocalcinosis with Von Kossa stain &#40;B&#41;&#46; Images at 40X&#46;</p>"
    "pdfFichero" => "P1-E562-S4415-A12179-EN.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:1 [
      "en" => array:3 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec439630"
          "palabras" => array:1 [
            0 => "Sj&#246;gren&#191;s syndrome"
          ]
        ]
        1 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec439632"
          "palabras" => array:1 [
            0 => "Distal renal tubular acidosis"
          ]
        ]
        2 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec439634"
          "palabras" => array:1 [
            0 => "Nephrocalcinosis"
          ]
        ]
      ]
    ]
    "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" => "12179_16025_52986_en_f112179.jpg"
            "Alto" => 491
            "Ancho" => 654
            "Tamanyo" => 178843
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Renal ultrasound with medullary hyperechogenicity suggestive of calcifications&#46;"
        ]
      ]
      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" => "12179_16025_52989_en_f2121792.jpg"
            "Alto" => 493
            "Ancho" => 1383
            "Tamanyo" => 477222
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Renal histopathology showing tubulointerstitial lymphoplasmacytic infiltrate &#40;A&#41; and intratubular and interstitial nephrocalcinosis with Von Kossa stain &#40;B&#41;&#46; Images at 40X&#46;"
        ]
      ]
    ]
    "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" => "Ren H, Wang WM, Chen XN, Zhang W, Pan XX, Wang XL, et al. Renal involvement and followup of 130 patients with primary Sjögren's syndrome. J Rheumatol 2008;35(2):278-84. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18085734" 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" => "Maripuri S, Grande JP, Osborn TG, Fervenza FC, Matteson EL, Donadio JV, et al. Renal involvement in primary Sjögren's syndrome: a clinicopathologic study. Clin J Am Soc Nephrol 2009;4(9):1423-31. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19679669" 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" => "Yang J, Li X, Huang Q. Renal involvement in primary Sjögren's syndrome: a clinicopathological study of 26 cases. Zhonghua Nei Ke Za Zhi 1997;36(1):28-31. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9812558" 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" => "Rodríguez Soriano J. Renal tubular acidosis: the clinical entity. J Am Soc Nephrol 2002;13:2160-70. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12138150" 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" => "Ariceta G, Aguirre M. Tubulopatías en la infancia que progresan hacia la enfermedad renal crónica. NefroPlus 2011;4(1):11-8."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003300000006/v0_201502091623/X2013251413053245/v0_201502091624/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "35437"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor - Brief Case Reports"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003300000006/v0_201502091623/X2013251413053245/v0_201502091624/en/P1-E562-S4415-A12179-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413053245?idApp=UINPBA000064"
]