Comment on 'Dehydration upon admission is a risk factor for incomplete recovery of renal function in children with haemolytic uremic syndrome'
Read
6710
Timeswas read the article
2028
Total PDF
4682
Total HTML
Share statistics
array:21 [ "pii" => "X2013251413053300" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2013.Aug.12194" "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;33:851" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3937 "formatos" => array:3 [ "EPUB" => 338 "HTML" => 3024 "PDF" => 575 ] ] "Traduccion" => array:1 [ "es" => array:17 [ "pii" => "X0211699513053303" "issn" => "02116995" "doi" => "10.3265/Nefrologia.pre2013.Aug.12194" "estado" => "S300" "fechaPublicacion" => "2013-11-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2013;33:851" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5274 "formatos" => array:3 [ "EPUB" => 299 "HTML" => 4279 "PDF" => 696 ] ] "es" => array:11 [ "idiomaDefecto" => true "titulo" => "Comentario a «La deshidratación al ingreso es un factor de riesgo para la recuperación incompleta de la función renal en niños con síndrome urémico hemolítico»" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "851" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Comment on ¿Dehydration upon admission is a risk factor for incomplete recovery of renal function in children with haemolytic uremic syndrome¿" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alejandro Balestracci, Sandra M. Martin, Ismael Toledo, Caupolican Alvarado, Raquel E. Wainsztein" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Balestracci" ] 1 => array:2 [ "nombre" => "Sandra M." "apellidos" => "Martin" ] 2 => array:2 [ "nombre" => "Ismael" "apellidos" => "Toledo" ] 3 => array:2 [ "nombre" => "Caupolican" "apellidos" => "Alvarado" ] 4 => array:2 [ "nombre" => "Raquel E." "apellidos" => "Wainsztein" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X2013251413053300" "doi" => "10.3265/Nefrologia.pre2013.Aug.12194" "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/X2013251413053300?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699513053303?idApp=UINPBA000064" "url" => "/02116995/0000003300000006/v0_201502091357/X0211699513053303/v0_201502091358/es/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "X2013251413053296" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2013.Feb.11842" "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;33:852" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3316 "formatos" => array:3 [ "EPUB" => 294 "HTML" => 2470 "PDF" => 552 ] ] "en" => array:9 [ "idiomaDefecto" => true "titulo" => "Comment on «Cardiac troponin I and creatine kinase MB isoenzyme in patients with chronic renal failure»" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "852" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X0211699513053299" "doi" => "10.3265/Nefrologia.pre2013.Feb.11842" "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/X0211699513053299?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413053296?idApp=UINPBA000064" "url" => "/20132514/0000003300000006/v0_201502091623/X2013251413053296/v0_201502091624/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "X2013251413053319" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2013.Jul.12207" "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;33:850-1" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4211 "formatos" => array:3 [ "EPUB" => 309 "HTML" => 3205 "PDF" => 697 ] ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "Response to the comment on 'Magnesium and chronic kidney disease'" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "850" "paginaFinal" => "851" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta al comentario sobre «Magnesio y enfermedad renal crónica»" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "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" => "12207_16025_53004_en_t112207.jpg" "Alto" => 313 "Ancho" => 1414 "Tamanyo" => 113936 ] ] "descripcion" => array:1 [ "en" => "Biochemical parameters in peritoneal dialysis patients treated with Ca-Mg" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ángel L. M. de Francisco, Mariano Rodríguez" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Ángel L." "apellidos" => "M. de Francisco" ] 1 => array:2 [ "nombre" => "Mariano" "apellidos" => "Rodríguez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "X0211699513053311" "doi" => "10.3265/Nefrologia.pre2013.Jul.12207" "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/X0211699513053311?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413053319?idApp=UINPBA000064" "url" => "/20132514/0000003300000006/v0_201502091623/X2013251413053319/v0_201502091624/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "titulo" => "Comment on 'Dehydration upon admission is a risk factor for incomplete recovery of renal function in children with haemolytic uremic syndrome'" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "851" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Alejandro Balestracci, Sandra M. Martin, Ismael Toledo, Caupolican Alvarado, Raquel E. Wainsztein" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Alejandro" "apellidos" => "Balestracci" "email" => array:1 [ 0 => "abalestracci@yahoo.com.ar" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Sandra M." "apellidos" => "Martin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 2 => array:3 [ "nombre" => "Ismael" "apellidos" => "Toledo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "nombre" => "Caupolican" "apellidos" => "Alvarado" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 4 => array:3 [ "nombre" => "Raquel E." "apellidos" => "Wainsztein" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Unidad de Nefrología, Hospital General de Niños Pedro de Elilzalde, Ciudad Autónoma de Buenos Aires, Argentina, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">To the Editor:</span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">We read with great interest the article by Ojeda et al. that was recently published in <span class="elsevierStyleItalic">Nefrología.</span><span class="elsevierStyleSup">1</span> In this study, the authors identified the presence of dehydration prior to admission as a risk factor for incomplete recovery of renal function during a follow-up on children with haemolytic uraemic syndrome associated with diarrhoea (D + HUS).</p><p class="elsevierStylePara">We previously reported that the presence of dehydration at diagnosis in children with D + HUS increases the likelihood that they will require dialysis in the acute stage. Additionally, we observed that the aforementioned patients had a significantly longer oligoanuric and dialysis phase than patients with normal hydration; nevertheless, our study focussed exclusively on the acute phase of the disease.<span class="elsevierStyleSup">2</span> By contrast, the present study aimed to identify whether certain clinical variables prior to hospitalisation allowed long-term renal involvement to be predicted. Although the authors found the only predictor of non-recovery of renal function to be the presence of dehydration at diagnosis, in the study discussion they maintained that their patients with long-term renal injury had a “more severe degree of acute deterioration” than patients without long-term renal involvement. Bearing in mind that the best predictor of non-recovery in patients with D+ HUS is the length of the oligoanuric period,<span class="elsevierStyleSup">3</span> we believe that reporting the duration of the latter in groups with and without long-term renal involvement, along with the statistical significance of this comparison, would allow for a more comprehensive explanation of the study. Likewise, the authors reported that patients with incomplete recovery of renal function required dialysis more often (12 out of 13 patients; 92.3%) than those with recovery (9 out of 23 patients; 39.1%), but the difference was not statistically significant (<span class="elsevierStyleItalic">P</span>=.2052). We were struck by the percentage difference between both groups (92.3% compared with 39.1%) and we re-calculated this comparison and obtained a <span class="elsevierStyleItalic">P</span> value of .0039 (Fisher’s exact test) with an odds ratio of 18.66, 95% confidence interval (2.05-169.34), which would mean, if our estimation is correct, that patients with long-term renal involvement required dialysis significantly more often. As a result, in the event that both the oligoanuric period and the requirement for dialysis were significantly greater in patients with long-term renal damage, we must ask the question whether the real predictor of non-recovery is initial dehydration or more severe renal dysfunction in the acute phase (possibly aggravated by concomitant volume depletion in dehydrated patients).</p><p class="elsevierStylePara">From our point of view, although not necessarily correct, dehydration determines greater renal injury in the acute phase and its severity, which is deduced by the dialysis requirement and the duration of the oligoanuric period, ultimately increases the risk of long-term renal involvement. We do not believe it is sufficient to associate dehydration on admission with the development of long-term renal damage without considering the acute phase of the disease. Nevertheless, we agree with the authors that, in order to obtain definitive conclusions in this regard, prospective studies should be conducted on a higher number of patients; in the meantime, we would like to highlight the importance of preventing volume depletion in patients at risk of developing D+ HUS.</p><p class="elsevierStylePara"> </p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">The authors declare that they have no conflicts of interest related to the contents of this article.</p>" "pdfFichero" => "P1-E562-S4416-A12194-EN.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:3 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec439598" "palabras" => array:1 [ 0 => "Children" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec439600" "palabras" => array:1 [ 0 => "Dehydration" ] ] 2 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec439602" "palabras" => array:1 [ 0 => "Haemolytic uraemic syndrome" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:1 [ "resumen" => "<p class="elsevierStylePara">Comments on:</p> <p class="elsevierStylePara"> </p> <p class="elsevierStylePara">Nefrologia 2013;33(3):372-6.</p> <p class="elsevierStylePara">PMID:23640118 [PubMed - in process</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Ojeda JM, Kohout I, Cuestas E. La deshidratación al ingreso es un factor de riesgo para la recuperación incompleta de la función renal en niños con síndrome urémico hemolítico. Nefrologia 2013;33(3):372-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/23640118" 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" => "Balestracci A, Martin SM, Toledo I, Alvarado C, Wainsztein RE. Dehydration at admission increased the need for dialysis in hemolytic uremic syndrome children. Pediatr Nephrol 2012;27(8):1407-10. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22476204" 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" => "Spinale JM, Ruebner RL, Copelovitch L, Kaplan BS. Long-term outcomes of Shiga toxin hemolytic uremic syndrome. Pediatr Nephrol 2013 Jan 4. [Epub ahead of print]." "contribucion" => array:1 [ 0 => null ] "host" => array:1 [ 0 => null ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003300000006/v0_201502091623/X2013251413053300/v0_201502091624/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/20132514/0000003300000006/v0_201502091623/X2013251413053300/v0_201502091624/en/P1-E562-S4416-A12194-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413053300?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 9 | 6 | 15 |
| 2024 October | 58 | 25 | 83 |
| 2024 September | 73 | 24 | 97 |
| 2024 August | 59 | 51 | 110 |
| 2024 July | 36 | 29 | 65 |
| 2024 June | 40 | 35 | 75 |
| 2024 May | 42 | 28 | 70 |
| 2024 April | 34 | 34 | 68 |
| 2024 March | 27 | 22 | 49 |
| 2024 February | 27 | 38 | 65 |
| 2024 January | 25 | 19 | 44 |
| 2023 December | 28 | 28 | 56 |
| 2023 November | 41 | 20 | 61 |
| 2023 October | 35 | 23 | 58 |
| 2023 September | 21 | 28 | 49 |
| 2023 August | 36 | 17 | 53 |
| 2023 July | 23 | 23 | 46 |
| 2023 June | 34 | 15 | 49 |
| 2023 May | 36 | 28 | 64 |
| 2023 April | 14 | 16 | 30 |
| 2023 March | 35 | 18 | 53 |
| 2023 February | 29 | 22 | 51 |
| 2023 January | 31 | 29 | 60 |
| 2022 December | 43 | 31 | 74 |
| 2022 November | 27 | 30 | 57 |
| 2022 October | 35 | 38 | 73 |
| 2022 September | 27 | 25 | 52 |
| 2022 August | 42 | 44 | 86 |
| 2022 July | 30 | 42 | 72 |
| 2022 June | 28 | 24 | 52 |
| 2022 May | 20 | 33 | 53 |
| 2022 April | 31 | 32 | 63 |
| 2022 March | 35 | 38 | 73 |
| 2022 February | 17 | 32 | 49 |
| 2022 January | 30 | 24 | 54 |
| 2021 December | 29 | 35 | 64 |
| 2021 November | 25 | 31 | 56 |
| 2021 October | 28 | 37 | 65 |
| 2021 September | 30 | 35 | 65 |
| 2021 August | 23 | 32 | 55 |
| 2021 July | 23 | 27 | 50 |
| 2021 June | 13 | 20 | 33 |
| 2021 May | 25 | 28 | 53 |
| 2021 April | 39 | 49 | 88 |
| 2021 March | 44 | 38 | 82 |
| 2021 February | 18 | 14 | 32 |
| 2021 January | 16 | 15 | 31 |
| 2020 December | 14 | 9 | 23 |
| 2020 November | 15 | 15 | 30 |
| 2020 October | 7 | 8 | 15 |
| 2020 September | 12 | 6 | 18 |
| 2020 August | 22 | 11 | 33 |
| 2020 July | 25 | 12 | 37 |
| 2020 June | 24 | 9 | 33 |
| 2020 May | 19 | 12 | 31 |
| 2020 April | 20 | 16 | 36 |
| 2020 March | 20 | 16 | 36 |
| 2020 February | 20 | 17 | 37 |
| 2020 January | 26 | 17 | 43 |
| 2019 December | 26 | 18 | 44 |
| 2019 November | 12 | 18 | 30 |
| 2019 October | 8 | 7 | 15 |
| 2019 September | 15 | 14 | 29 |
| 2019 August | 7 | 12 | 19 |
| 2019 July | 15 | 25 | 40 |
| 2019 June | 12 | 11 | 23 |
| 2019 May | 14 | 18 | 32 |
| 2019 April | 28 | 32 | 60 |
| 2019 March | 22 | 16 | 38 |
| 2019 February | 14 | 16 | 30 |
| 2019 January | 24 | 20 | 44 |
| 2018 December | 66 | 32 | 98 |
| 2018 November | 75 | 19 | 94 |
| 2018 October | 59 | 15 | 74 |
| 2018 September | 51 | 25 | 76 |
| 2018 August | 38 | 19 | 57 |
| 2018 July | 38 | 17 | 55 |
| 2018 June | 44 | 17 | 61 |
| 2018 May | 37 | 15 | 52 |
| 2018 April | 30 | 4 | 34 |
| 2018 March | 35 | 13 | 48 |
| 2018 February | 38 | 4 | 42 |
| 2018 January | 27 | 7 | 34 |
| 2017 December | 46 | 12 | 58 |
| 2017 November | 31 | 5 | 36 |
| 2017 October | 31 | 10 | 41 |
| 2017 September | 41 | 11 | 52 |
| 2017 August | 34 | 11 | 45 |
| 2017 July | 37 | 12 | 49 |
| 2017 June | 37 | 9 | 46 |
| 2017 May | 34 | 16 | 50 |
| 2017 April | 35 | 10 | 45 |
| 2017 March | 14 | 6 | 20 |
| 2017 February | 33 | 9 | 42 |
| 2017 January | 16 | 5 | 21 |
| 2016 December | 58 | 9 | 67 |
| 2016 November | 54 | 10 | 64 |
| 2016 October | 83 | 8 | 91 |
| 2016 September | 96 | 5 | 101 |
| 2016 August | 126 | 3 | 129 |
| 2016 July | 129 | 3 | 132 |
| 2016 June | 115 | 0 | 115 |
| 2016 May | 137 | 0 | 137 |
| 2016 April | 111 | 0 | 111 |
| 2016 March | 91 | 0 | 91 |
| 2016 February | 101 | 0 | 101 |
| 2016 January | 109 | 0 | 109 |
| 2015 December | 128 | 0 | 128 |
| 2015 November | 85 | 0 | 85 |
| 2015 October | 94 | 0 | 94 |
| 2015 September | 81 | 0 | 81 |
| 2015 August | 67 | 0 | 67 |
| 2015 July | 57 | 0 | 57 |
| 2015 June | 64 | 0 | 64 |
| 2015 May | 66 | 0 | 66 |
| 2015 April | 11 | 0 | 11 |
Show all
