Overhydration prevalence in peritoneal dialysis – A 2 year longitudinal analysis

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"https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251415123574?idApp=UINPBA000064" "url" => "/20132514/0000003500000002/v0_201504231604/X2013251415123574/v0_201504231606/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "titulo" => "Overhydration prevalence in peritoneal dialysis – A 2 year longitudinal analysis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "189" "paginaFinal" => "196" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Pedro Ventura Aguiar, Olívia Santos, Laetitia Teixeira, Fernanda Silva, Pedro Azevedo, Joana Vidinha, Francisco Ferrer, Maria João Carvalho, António Cabrita, Anabela Rodrigues" "autores" => array:10 [ 0 => array:3 [ "nombre" => "Pedro" "apellidos" => "Ventura Aguiar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Olívia" "apellidos" => "Santos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => 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Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal) " "etiqueta" => "a" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "Instituto Ciencias Biomédicas Abel Salazar. Universidade Porto. Porto (Portugal)" "etiqueta" => "b" "identificador" => "affb" ] 2 => array:3 [ "entidad" => "Department of Nephrology. Hospital São Teotónio. Viseu (Portugal) " "etiqueta" => "c" "identificador" => "affc" ] 3 => array:3 [ "entidad" => "Department of Nephrology. Centro Hospitalar Medio-Tejo. Torres Novas (Portugal)" "etiqueta" => "d" "identificador" => "affd" ] 4 => array:3 [ "entidad" => "Department of Nephrology. Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal). Instituto Ciencias Biomédicas Abel Salazar. Universidade Porto. Porto (Portugal)" "etiqueta" => "e" "identificador" => "affe" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia de la sobrehidratación en la diálisis peritoneal: estudio longitudinal de 2 años" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "498v35n02-90412369fig2.jpg" "Alto" => 1504 "Ancho" => 1954 "Tamanyo" => 172162 ] ] "descripcion" => array:1 [ "en" => "– Relative overhydration over 2 years on PD. Hydration status remained fairly stable over the follow-up period, regardless of residual diuresis, PD vintage, or PD modality. The difference found on the first year evaluation (T1) between anuric and patients with diuresis >250 ml/day was normalized by the second year (T2)." ] ] ] "textoCompleto" => " Introduction Hypervolemia is a “traditional” independent risk factor for cardiovascular disease and death among end-stage renal disease patients. It is associated with ventricular hypertrophy,1 nutritional changes,2,3 and inflammation.4-6 Volume overload also promotes endothelial dysfunction7 and nightly non-dipping8 blood pressure in dialysis patients. The importance of adequacy beyond small solute clearances in the overall patient survival was highlighted by peritoneal dialysis landmark studies such as CANUSA,9 ADEMEX,10 and NECOSAD.11 Residual renal function (RRF) plays a determinant role in the outcome of peritoneal dialysis (PD) patients.11,12 Daily urine output over 250ml represents a 34% increase in survival benefit in peritoneal dialysis patients.9 A reduction in the risk of death,13 volume overload, and left ventricular dysfunction,14 has been observed with increased fluid removal in PD, alongside with sodium restriction. Nevertheless, the ADEMEX study failed to demonstrate mortality differences between anuric patients and the rest, either within and between groups.10 It has been postulated that euvolemia is harder to achieve in PD patients. Nonetheless, in a cross sectional study, Devolder and colleagues15 demonstrated that patients undergoing PD had a similar volume status when compared to equivalent hemodialysis ones. Determining euvolemia is a challenging task. Reliable evaluation of overhydration can be attained through multifrequency bioimpedance analysis (BIA). We have previously documented that overhydration (OH) in PD patients, defined as extra-cellular water (ECW)/total body water (TBW) over 15%, was associated with age and diabetes, but neither with PD vintage nor anuria.16 This study aimed to evaluate longitudinal changes in hydration status, and identify corporal composition trends in a PD population.Methods Population We conducted a 2 year (2009-2011) single centre prospective non-interventional observational study to determine the volume status among incident and prevalent peritoneal dialysis patients. Incident patients were defined as those with less than 6 months on dialysis. All patients over 18 years old were eligible to participate. Contraindication to bioimpedance evaluation – implanted electronic medical device or connection to an external electronic medical device (pacemaker or ICD), any kind of metal implants or metal artificial joints, amputations, pregnancy or in a lactation period, or refusal to participate, were the only exclusion criterion. Patients lost to follow-up were excluded from the analysis. All PD patients are treated with low glucose degradation product solut ions (Balance, Fresenius Medical Care; Physioneal, Baxter Healthcare). Some patients were also on icodextrin due to failure to achieve clinical euvolemia with dietary salt restriction and diuretics. Hypertonic solutions were used only by exception and for a short period of time.Measurements Body composition measurements were performed using multifrequency whole body bioimpedance assessment using the Body Composition Monitor (BCM, Fresenius Medical Care). Patients were in the recumbent position for 5 minutes, and all metal accessories removed. Fluid present in the trunk is not measured by bioimpedance spectroscopy and does not influence BIA results.17-19 Therefore, and for logistical reasons measurements were conducted with a full abdomen. Yearly measurements were performed, T0 representing baseline evaluation, T1 the first and T2 the second year determinations, respectively. Hydration status was evaluated according to parameters provided by the BCM software: 1) total overhydration (in litres), and 2) relative overhydration (rOH - in %) - calculated as the extra-cellular water (ECW) to total body water (TBW) relation. For statistical analysis, patients were categorized into normohydrated (rOH<6.8%) and severely overhydrated (rOH>15%), according to the definition of Wizemann et al.20 The remaining were assumed to be moderately overhydrated.6,8 Weight was assessed on a calibrated electronic weighing scale, with patients wearing only trousers and a light shirt. Blood pressure was defined as the mean of three measurements in a sitting position, using a standardized electronic device with brachial cuff adjusted to the patient’s arm circumference. Blood, urinary, and peritoneal analysis were performed on the day of BIA assessment. Peritoneal ultra-filtration was determined according to patients’ registry (or cyclers’, on APD) on the day previous to BCM assessment, and calculated as the difference between the sum of drained ultrafiltrate and the sum of infused solution in a 24h period.Statistical analysis Continuous variables are presented as means and standard deviations for parametric, and one-way ANOVA with post hoc Scheffé testing was used for group comparison. Non-parametric variables are presented as median and interquartile range, and group comparison was performed using Kruskal-Wallis analysis. General linear modelling was used for multivariate analysis, including all variables that were deemed relevant and avoiding parameters that were highly correlated with each other. All statistical analyses were performed using SPSS version 17 (SPSS Inc., Chicago, IL, USA).Results A total of 58 patients were evaluated during the study period. Twenty eight failed to complete 3 measurements, and were lost to follow up: 18 were submitted to transplant, 10 commuted to haemodialysis due to technique failure – 2 with chronic exit site infection, 3 with peritonitis, 2 with ultrafiltration failure, 2 due to abdominal surgical complications, and one patient lost the ability to perform auto-dialysis. Patients had a mean age of 56.9 years old, 63,3% were female, a PD vintage of 21.9 months, and three (10%) were diabetic. Half were on automated peritoneal dialysis (APD). Eleven were incident patients on PD at the time of the first evaluation. Patient demographics and baseline characteristics can be seen in Table 1.<img alt="Table 1 – Baseline characteristics" src="498v35n02-90412369fig1.jpg"></img> At baseline, only 40% were normohydrated (fluid overload <6.8%). Only 2 patients were overhydrated (relative OH>15%) - these were older (p<.05) and had higher Pro-BNP levels (p<.05). No differences were found on all the remaining parameters evaluated (p>.05). Yearly determinations were performed, with an inter-evaluation time lag of 10,3±3.0 and 12.8±2.7 months between T0-T1 and T1-T2, respectively. On longitudinal analysis no significant changes were found in bioimpedance hydration status in the global population (Fig. 1). Similar results (p>.05) were found on other hydration parameters, such as systolic blood pressure, and Pro-BNP, even though the latest presented a positive trend (supplement material – Table 2).<img alt="Figure 1 – Relative overhydration over 2 years on PD. Hydration status remained fairly stable over the follow-up period, regardless of residual diuresis, PD vintage, or PD modality. The difference found on the first year evaluation (T1) between anuric and patients with diuresis >250 ml/day was normalized by the second year (T2)." src="498v35n02-90412369fig2.jpg"></img>Figure 1 – Relative overhydration over 2 years on PD. Hydration status remained fairly stable over the follow-up period, regardless of residual diuresis, PD vintage, or PD modality. The difference found on the first year evaluation (T1) between anuric and patients with diuresis >250 ml/day was normalized by the second year (T2).<img alt="Table 2 – Longitudinal changes in overall population" src="498v35n02-90412369fig3.jpg"></img> Incident patients presented a non-significant reduction in overall hydration status from T0 to T1 and T2 (p>.05), and a trend toward a decline in GFR (6.4 vs 5.7 vs 3.7 ml/min, p>.05) – Table 3.<img alt="Table 3 – Longitudinal hydration status among incident and prevalent patients’" src="498v35n02-90412369fig4.jpg"></img> On the other hand, an inverse trend was found among prevalent patients, presenting an increase in the relative hydration status (7.8 vs 9.2 vs 10.2%, p>.05), regardless of maintaining stable total daily fluid removal (Table 2). Anuric patients (n=11, 82% on APD) presented at baseline a similar hydration status when compared to those with urine output >250 ml/day. Regardless of the significant difference on year 1 evaluation (p=.03), no differences were found on the 2nd year determination (p>.05) – Figure 1. Five of those patients (45%) performed a daily dwell with icodextrin at baseline, which increased to 7 patients (63%) two years later. Similar hydration status was found between APD and CAPD patients in every evaluations (p>.05) – Figure 1. Regarding nutritional parameters, clinical (BMI), biochemical (normalized protein catabolic rate (nPCR) and albumin), and BCM (lean tissue mass, fat tissue mass, and ICW) remained stable throughout the evaluation period (Fig. 2). Albumin, a marker of both nutrition2 and hydration status,21 was negatively correlated to hydration status at baseline, but failed to achieve statistical significance (p>.05). No differences were found in the posterior evaluations as well (p>.05).<img alt="Figure 2 – Nutritional changes over 2 years on PD. No major corporal composition trends were found trough the 2 years follow-up. Albumin, lower at baseline among incident patients, failed to reveal significant differences with PD vintage" src="498v35n02-90412369fig5.jpg"></img>Figure 2 – Nutritional changes over 2 years on PD. No major corporal composition trends were found trough the 2 years follow-up. Albumin, lower at baseline among incident patients, failed to reveal significant differences with PD vintageDiscussion Herein we present a longitudinal analysis on the hydration status of 30 PD patients, including prevalent and incident patients - at baseline only 6.7% patients were overhydrated and, more relevant, no significant changes were observed in the same population over a 2 year evaluation period. It is generally held belief that volume status is difficult to maintain in peritoneal dialysis (PD), and that these patients are persistently overhydrated - although data to support this view are scarce. Determining euvolemia has hampered either on expensive, invasive, and unpractical techniques, such as gold-standard dextran determination, or under imprecise clinical, biochemical, and ultrasound determinations. Clinical tools such as changes in body weight and blood pressure are unreliable for small differences. Multifrequency bioimpedance analysis (BIA) provides an objective determination of hydration,1,14,22 and nutritional status.2,23,24 Previous studies have demonstrated that decreasing ultra-filtration volumes negatively influences outcomes in PD, independent of the levels of small solute clearance.13 In the presented study, no correlation was found between ultrafiltration nor total fluid removal and overhydration at baseline determination. Additionally, on the longitudinal analysis, although there was a reduction in the daily urine output and a trend towards reduction in glomerular filtration rate, total fluid removal maintained stable. Added to the lack of increase in overhydration among the overall population, it reinforces the belief that individualization of PD strategies, with different solutions, dwells, and PD techniques (CAPD vs APD), enables PD patients to remain normohydrated. Regardless of these evidences, fear exist in the management of PD patients with daily urine output under 250 ml. Also, these patients have shorter technique survival.13 Though phosphorus and small solutes removal were not analysed here, anuric patients were not more overhydrated over time, nor did the ones who lost residual renal function during the study period. Interestingly, one should observe the inverted tendency observed among both incident and prevalent: in incident patients rOH decreased dispite decreasing diuresis, while it increased in prevalent ones. A possible explanation may rely on the regular use of icodextrin in the long dwells (as in night dwells on CAPD patients) at our centre, but may also reflect a patient’s better volume control and assimilation of the need to salt restriction. These results reinforce the need to continuously educate patients to maintain an adequate fluid balance. Devolder et al.15 have previously demonstrated that hydration status was not worse among PD patients when compared to HD ones, though it was a transversal single centre analysis. The results presented here add yet evidence that PD is able to prevent overhydration after 2 years of follow-up, regardless of urine output, age, BMI, or diabetes. Inclusion of prevalent and incident (<6 months on PD) in the same analysis conferred a false positive PD vintage. Though incident patients were included, PD vintage of prevalent patients at baseline was 2.5 years, and still no long-term changes regarding hydration status were found. Pro-brain natriuretic peptide (BNP) was once a promising marker of overhydration in dialysis patients and related to cardiovascular mortality.22,25,26 Though it failed to achieve statistical significance, we also found a positive correlation between BNP levels and hydration status. One of the main obstacles to BNP use in hydration status characterization is the lack of standardization and cut-off values. Still, it may be useful as a marker for volume variations in asymptomatic patients. Dialysis is associated with a catabolic state, and nutritional changes occur in these patients.2,27,28 PD vintage has been associated with increasing fat mass27 and protein-energy wasting due to chronic inflammation of the peritoneal membrane, abdominal distension, gastroesophageal reflux, and inadequate dialysis dose.2 Female gender, age, and diabetes, well established risk factors in the general population, have been described as risk factors for increasing fat tissue mass in PD patients, as determined by BIA.15 These results suggest that the measurements done with multifrequency bioimpedance can be reliable. A major finding from our study is the stable nutritional status observed during the 2 year evaluation period, regardless of the parameter evaluated (lean tissue index, fat tissue index, albumin, or nPCR). One may postulate this may be due to a short follow-up period (2 years), and a lower percentage of diabetics (10.5%) when compared to major survival studies.10,12 Nonetheless, an interquartile range PD vintage of 22.0-61.7months can barely be assumed as short. To the authors’ belief, more than the overall nutritional status, the failure to find relevant changes over time reveals that an adequate PD program may prevent malnourishment. Some explanations seem plausible. First, and likely most relevant, patients are regularly evaluated from a nutritionist. Also, low-AGE’s solutions, and focus on preservation of RRF are common practice at our centre. There are some limitations to this study. The major is the small sample size, underrating the analysis between incident and prevalent patients. Also, BIA determinations were performed with a full abdomen, which interference with results were believed to be marginal at the study initiation. Finally, the study represents the current practices and results from a single centre, and caution must be taken in when making further generalizations. Nevertheless, this is, to the authors, knowledge, the longer and larger longitudinal BIA analysis in a PD population, and the first to analyse incident and prevalent patients separately, highlighting that the results found are not likely to represent a positive selection bias. In conclusion, this study demonstrates that thorough attention to hydration status and current prescription strategies are able to prevent relevant overhydration in PD patients - at time of the first evaluation only 6.7% were overhydrated - regardless of RRF and urine output. Driving volume overload in PD patients may be related to centre practice patterns, and may explain differences in the over-hydration percentages among studies. Hopefully, the results of the EuroBCM19 and de ongoing multicentre IPOD study (NCT01285726) will either refute or corroborate the ones presented here.Funding Pedro Ventura Aguiar, by Abbott laboratory for conferences presentations.Conflict of interests The authors declare that they have no conflict of interests.<hr></hr> ☆ The results of this study have been presented at the 49th ERA-EDTA congress, on the 26th of May 2012. * Corresponding author. Pedro Ventura Aguiar, Servicio de Nefrología, Hospital de Santo António, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal. E-mail: <a href="mailto:pedro.ventura.aguiar@gmail.com" class="elsevierStyleCrossRefs">pedro.ventura.aguiar@gmail.com</a>" "pdfFichero" => "498v35n02a90412369pdf001.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec503499" "palabras" => array:8 [ 0 => "Bioimpedancia" 1 => "Sobrehidratación" 2 => "Diálisis" 3 => "Peritoneal" 4 => "Volumen" 5 => "Nutrición" 6 => "Prescripción" 7 => "Hipertensión" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec503500" "palabras" => array:7 [ 0 => "Multifrequency bioimpedance" 1 => "Overhydration" 2 => "Peritoneal dialysis" 3 => "Volume status" 4 => "Nutritional status" 5 => "Prescribed dialysis dose" 6 => "Hypertension" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => " Antecedentes y objetivos: La hipervolemia constituye un gran problema en los pacientes de diálisis, y se asocia a un incremento del riesgo cardiovascular y muerte. Los análisis transversales han demostrado previamente que los pacientes de diálisis peritoneal (DP) no sufren de sobrehidratación, en comparación a los pacientes de hemodiálisis. Este estudio fue diseñado para evaluar las tendencias longitudinales de composición corporal e hidratación en una población de pacientes de DP. Métodos: Realizamos un estudio observacional prospectivo de dos años a 58 pacientes de DP de un único centro. Se incluyó pacientes incidentales y prevalentes. Se realizaron mediciones anuales utilizando bioimpedancia eléctrica de multi-frecuencia. La sobrehidratación se definió como el ratio agua extra-celular (ECW)/agua corporal total (ACT) superior al 15%. También se exploraron variables clínicas y bioquímicas. Resultados: Un total de 30 pacientes completarán el estudio (mujeres: 63,3%, edad media 56,9 años, IMC 25,0 kg/m2, diabetes 10,0%, DPA-50,0%). La antigüedad media de DP fue de 21,9 meses, y el 36,7% padecía anuria. Al inicio, el 6,7% padecía sobrehidratación. En los análisis longitudinales no se hallaron cambios en cuanto a hidratación, presión sanguínea sistólica, pro-BNP, o niveles de albúmina. Se hallaron resultados similares entre los pacientes incidentales (n = 11; APD- 45,5%; anuria- 9,1%) y prevalentes (n = 19; DPA- 52,6%; anuria- 52,6%) (p > 0,05). Sin embargo, al segundo año, los pacientes prevalentes estaban moderadamente sobrehidratados en comparación con los incidentales (media 10,2% frente a 3,5%; p = 0,009). En cambio, no se observó una diferencia estadística en cuanto a adecuación, ACT, o ECW. Además, los parámetros nutricionales permanecieron estables. Conclusiones: La prevalencia de la diálisis peritoneal sin incremento de volumen ni alteración de los índices de composición corporal es factible si se aplican estrategias terapéuticas prudentes. La aplicación longitudinal de BIA puede constituir una herramienta clínica para evaluar la adecuación por encima de Kt/V." ] "en" => array:1 [ "resumen" => " Background and objectives: Hypervolemia is a major concern in dialysis patients, and is associated with increased cardiovascular risk and death. Cross sectional analysis have previously demonstrated that peritoneal dialysis (PD) patients are not more overhydrated when compared to haemodialysis´ ones. This study was designed to evaluate longitudinal trends in hydration status and corporal composition in a PD population. Methods: We conducted a 2 year prospective observational study of 58 PD patients from a single centre. Incident and prevalent patients were included. Yearly measurements were performed using multifrequency electric bioimpedance. Overhydration (OH) was defined as an extra-cellular water (ECW)/total body water (TBW) over 15%. Clinical and biochemical variables were also explored. Results: A total of 30 patients completed evaluation (female 63.3%, mean age 56.9 years, BMI 25.0 kg/m2, diabetes 10.0%, APD-50.0%). Median PD vintage was 21.9 months, and 36.7% were anuric. At baseline 6.7% were overhydrated. On longitudinal analysis no significant changes were found in hydration status, systolic blood pressure, pro-BNP, nor albumin levels. Similar results were found among incident (n=11; APD-45.5%; anuric- 9.1%) and prevalent (n=19; APD- 52.6%; anuric- 52.6%) patients (p>.05). However, at the second year, prevalent patients were moderately overhydrated compared to incident ones (median 10.2% vs 3.5%; p=.009). Nonetheless, no statistical difference was observed considering adequacy, TBW, or ECW. Moreover, nutritional parameters remained stable. Conclusions: Peritoneal dialysis maintenance without increasing volume status, nor major deleterious corporal composition trends, is feasible under careful therapy strategies. Longitudinal application of BIA may be a useful clinical tool to evaluate adequacy beyond Kt/V." ] ] "multimedia" => array:5 [ 0 => array:8 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "498v35n02-90412369fig1.jpg" "imagenAlto" => 1745 "imagenAncho" => 2133 "imagenTamanyo" => 474619 ] ] ] ] ] "descripcion" => array:1 [ "en" => "– Baseline characteristics" ] ] 1 => array:8 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "498v35n02-90412369fig2.jpg" "Alto" => 1504 "Ancho" => 1954 "Tamanyo" => 172162 ] ] "descripcion" => array:1 [ "en" => "– Relative overhydration over 2 years on PD. Hydration status remained fairly stable over the follow-up period, regardless of residual diuresis, PD vintage, or PD modality. The difference found on the first year evaluation (T1) between anuric and patients with diuresis >250 ml/day was normalized by the second year (T2)." ] ] 2 => array:8 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "498v35n02-90412369fig3.jpg" "imagenAlto" => 1087 "imagenAncho" => 2116 "imagenTamanyo" => 299358 ] ] ] ] ] "descripcion" => array:1 [ "en" => "– Longitudinal changes in overall population" ] ] 3 => array:8 [ "identificador" => "tbl3" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tablaImagen" => array:1 [ 0 => array:4 [ "imagenFichero" => "498v35n02-90412369fig4.jpg" "imagenAlto" => 1091 "imagenAncho" => 2116 "imagenTamanyo" => 277512 ] ] ] ] ] "descripcion" => array:1 [ "en" => "– Longitudinal hydration status among incident and prevalent patients’" ] ] 4 => array:8 [ "identificador" => "fig2" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "498v35n02-90412369fig5.jpg" "Alto" => 1483 "Ancho" => 2129 "Tamanyo" => 140808 ] ] "descripcion" => array:1 [ "en" => "– Nutritional changes over 2 years on PD. No major corporal composition trends were found trough the 2 years follow-up. Albumin, lower at baseline among incident patients, failed to reveal significant differences with PD vintage" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Echocardiographic impact of hydration status in dialysis patients. Nefrologia. 2012;32:94-102. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22240880" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Echocardiographic impact of hydration status in dialysis patients." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Juan-García I" 1 => "Puchades MJ" 2 => "Sanjuán R" 3 => "Torregrosa I" 4 => "Solís MÁ" 5 => "González M" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2011.Nov.10867" "Revista" => array:6 [ "tituloSerie" => "Nefrologia. " "fecha" => "2012" "volumen" => "32" "paginaInicial" => "94" "paginaFinal" => "102" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22240880" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Assessment and monitoring of nutrition status in pediatric peritoneal dialysis patients. Perit Dial Int. 2009;29 Suppl 2:S176-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19270211" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Assessment and monitoring of nutrition status in pediatric peritoneal dialysis patients." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Edefonti A" 1 => "Mastrangelo A" 2 => "Paglialonga F." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Perit Dial Int. " "fecha" => "2009" "volumen" => "29 Suppl 2" "paginaInicial" => "S176" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19270211" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Dialysis and Nutrition in Continuous Dialysis: Association with Clinical Outcomes. J Am Soc Nephrol. 1996; 7:198-207. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8785388" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Dialysis and Nutrition in Continuous Dialysis: Association with Clinical Outcomes." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Keshaviah R" 1 => "Louise M" 2 => "Jindal K" 3 => "Wayne D" 4 => "Thorpe E" 5 => "Bargman M" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol. " "fecha" => "1996" "volumen" => "7" "paginaInicial" => "198" "paginaFinal" => "207" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8785388" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Malnutrition and its association with inflammation and vascular disease in children on maintenance dialysis. Pediatr Nephrol. 2013;28:2149-56. <a href="http://www.ncbi.nlm.nih.gov/pubmed/23765444" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Malnutrition and its association with inflammation and vascular disease in children on maintenance dialysis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Canpolat N" 1 => "Caliskan S" 2 => "Sever L" 3 => "Tasdemir M" 4 => "Ekmekci OB" 5 => "Pehlivan G" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00467-013-2527-3" "Revista" => array:6 [ "tituloSerie" => "Pediatr Nephrol. " "fecha" => "2013" "volumen" => "28" "paginaInicial" => "2149" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23765444" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Association between inflammation and changes in residual renal function and peritoneal transport rate during the first year of dialysis. Nephrol Dial Transplant. 2001;16:2240-5. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11682675" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Association between inflammation and changes in residual renal function and peritoneal transport rate during the first year of dialysis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Chung SH" 1 => "Heimbürger O" 2 => "Stenvinkel P" 3 => "Bergström J" 4 => "Lindholm B." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant. " "fecha" => "2001" "volumen" => "16" "paginaInicial" => "2240" "paginaFinal" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11682675" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Association between residual renal function, inflammation and patient survival in new peritoneal dialysis patients. Nephrol Dial Transplant. 2003;18:590-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12584284" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Association between residual renal function, inflammation and patient survival in new peritoneal dialysis patients." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Chung SH" 1 => "Heimbürger O" 2 => "Stenvinkel P" 3 => "Qureshi AR" 4 => "Lindholm B." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant. " "fecha" => "2003" "volumen" => "18" "paginaInicial" => "590" "paginaFinal" => "7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12584284" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Factors contributing to formation of edema in volume overloaded continuous ambulatory peritoneal dialysis patients. Perit Dial Int. 2011; 31:160-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21282372" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Factors contributing to formation of edema in volume overloaded continuous ambulatory peritoneal dialysis patients." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Tang W" 1 => "Xue T" 2 => "Lu XH" 3 => "Luo YJ" 4 => "Wang T." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3747/pdi.2010.00055" "Revista" => array:6 [ "tituloSerie" => "Perit Dial Int. " "fecha" => "2011" "volumen" => "31" "paginaInicial" => "160" "paginaFinal" => "7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21282372" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Role of twenty-four-hour ambulatory blood pressure monitoring in children on dialysis. Clin J Am Soc Nephrol. 2011;6:870-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21273374" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Role of twenty-four-hour ambulatory blood pressure monitoring in children on dialysis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Chaudhuri A" 1 => "Sutherland SM" 2 => "Begin B" 3 => "Salsbery K" 4 => "McCabe L" 5 => "Potter D" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2215/CJN.07960910" "Revista" => array:6 [ "tituloSerie" => "Clin J Am Soc Nephrol. " "fecha" => "2011" "volumen" => "6" "paginaInicial" => "870" "paginaFinal" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21273374" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis : A reanalysis of the CANUSA Study. J Am Soc Nephrol. 2001;12:2158-62. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11562415" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis : A reanalysis of the CANUSA Study." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Bargman JM" 1 => "Thorpe KE" 2 => "Churchill DN." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol. " "fecha" => "2001" "volumen" => "12" "paginaInicial" => "2158" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11562415" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMEX, a prospective, randomized, controlled trial. J Am Soc Nephrol. 2002;13:1307-20. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11961019" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMEX, a prospective, randomized, controlled trial." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Paniagua R" 1 => "Amato D" 2 => "Vonesh E" 3 => "Correa-Rotter R" 4 => "Ramos A" 5 => "Moran J" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol. " "fecha" => "2002" "volumen" => "13" "paginaInicial" => "1307" "paginaFinal" => "20" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11961019" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life: an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2. Am J Kidney Dis. 2003;41:1293-302. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12776283" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life: an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Termorshuizen F" 1 => "Korevaar JC" 2 => "Dekker FW" 3 => "van Manen JG" 4 => "Boeschoten EW" 5 => "Krediet RT." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis. " "fecha" => "2003" "volumen" => "41" "paginaInicial" => "1293" "paginaFinal" => "302" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12776283" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Implications of the Canada-USA (CANUSA) study of the adequacy of dialysis on peritoneal dialysis schedule. Nephrol Dial Transplant. 1998;13:158-63. <a href="http://www.ncbi.nlm.nih.gov/pubmed/9719224" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Implications of the Canada-USA (CANUSA) study of the adequacy of dialysis on peritoneal dialysis schedule." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Churchill DN." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant. " "fecha" => "1998" "volumen" => "13" "paginaInicial" => "158" "paginaFinal" => "63" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9719224" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis: The European APD Outcome Study. J Am Soc Nephrol. 2003;14:2948-57. <a href="http://www.ncbi.nlm.nih.gov/pubmed/14569106" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis: The European APD Outcome Study." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Brown EA" 1 => "Davies SJ" 2 => "Rutherford P" 3 => "Meeus F" 4 => "Borras B" 5 => "Riegel W" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol. " "fecha" => "2003" "volumen" => "14" "paginaInicial" => "2948" "paginaFinal" => "57" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14569106" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "A ward-based procedure for assessment of fluid status in peritoneal dialysis patients using bioimpedance spectroscopy. Perit Dial Int. 2005;25(Suppl_3):S46-48. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "A ward-based procedure for assessment of fluid status in peritoneal dialysis patients using bioimpedance spectroscopy." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Lindley E" 1 => "Devine Y" 2 => "Hall L" 3 => "Cullen M" 4 => "Cuthbert S" 5 => "Woodrow G" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Perit Dial Int. " "fecha" => "2005" "volumen" => "25" "paginaInicial" => "S46" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16048255" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Body composition, hydration, and related parameters in hemodialysis versus peritoneal dialysis patients. Perit Dial Int. 2010;30:208-14. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20081049" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Body composition, hydration, and related parameters in hemodialysis versus peritoneal dialysis patients." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Devolder I" 1 => "Verleysen A" 2 => "Vijt D" 3 => "Vanholder R" 4 => "Van Biesen W." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3747/pdi.2008.00284" "Revista" => array:6 [ "tituloSerie" => "Perit Dial Int. " "fecha" => "2010" "volumen" => "30" "paginaInicial" => "208" "paginaFinal" => "14" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20081049" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Ferrer, M.J. Carvalho, L. Oliveira, O. Santos, A. Rodrigues AC. Multifrequency bioimpedance assessment of hydration status in peritoneal dialysis and factors associated with fluid overload. Nephrol Dial Transplant Plus. 2010;3(Supplement 3):iii275-iii547. " "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Ferrer, M.J. Carvalho, L. Oliveira, O. Santos, A. Rodrigues AC. Multifrequency bioimpedance assessment of hydration status in peritoneal dialysis and factors associated with fluid overload." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transplant Plus. " "fecha" => "2010" "volumen" => "3" "paginaInicial" => "iii275" "paginaFinal" => "iii547" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Comparing different methods of assessing body composition in end-stage renal failure. Kidney Int. 2000;58:408-16. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10886589" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Comparing different methods of assessing body composition in end-stage renal failure." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Cooper BA" 1 => "Aslani A" 2 => "Ryan M" 3 => "Zhu FY" 4 => "Ibels LS" 5 => "Allen BJ" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1523-1755.2000.00180.x" "Revista" => array:6 [ "tituloSerie" => "Kidney Int. " "fecha" => "2000" "volumen" => "58" "paginaInicial" => "408" "paginaFinal" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10886589" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Influence of peritoneal dialysis solution on measurements of fluid status by bioimpedance spectroscopy. Int Urol Nephrol. 2013;45:229-32. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22710970" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Influence of peritoneal dialysis solution on measurements of fluid status by bioimpedance spectroscopy." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Parmentier SP" 1 => "Schirutschke H" 2 => "Schmitt B" 3 => "Schewe J" 4 => "Herbrig K" 5 => "Pistrosch F" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11255-012-0216-y" "Revista" => array:6 [ "tituloSerie" => "Int Urol Nephrol. " "fecha" => "2013" "volumen" => "45" "paginaInicial" => "229" "paginaFinal" => "32" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22710970" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Fluid status in peritoneal dialysis patients: the European Body Composition Monitoring (EuroBCM) study cohort. PLoS One. 2011;6:e17148. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21390320" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Fluid status in peritoneal dialysis patients: the European Body Composition Monitoring (EuroBCM) study cohort." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Van Biesen W" 1 => "Williams JD" 2 => "Covic AC" 3 => "Fan S" 4 => "Claes K" 5 => "Lichodziejewska-Niemierko M" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0017148" "Revista" => array:5 [ "tituloSerie" => "PLoS One. " "fecha" => "2011" "volumen" => "6" "paginaInicial" => "e17148" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21390320" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The mortality risk of overhydration in haemodialysis patients. Nephrol Dial Transplant. 2009;24:1574-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19131355" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The mortality risk of overhydration in haemodialysis patients." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Wizemann V" 1 => "Wabel P" 2 => "Chamney P" 3 => "Zaluska W" 4 => "Moissl U" 5 => "Rode C" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndt/gfn707" "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant. " "fecha" => "2009" "volumen" => "24" "paginaInicial" => "1574" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19131355" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Plasma volume, albumin, and fluid status in peritoneal dialysis patients. Clin J Am Soc Nephrol. 2010;5:1463-70. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20538836" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Plasma volume, albumin, and fluid status in peritoneal dialysis patients." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "John B" 1 => "Tan BK" 2 => "Dainty S" 3 => "Spanel P" 4 => "Smith D" 5 => "Davies SJ." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2215/CJN.09411209" "Revista" => array:6 [ "tituloSerie" => "Clin J Am Soc Nephrol. " "fecha" => "2010" "volumen" => "5" "paginaInicial" => "1463" "paginaFinal" => "70" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20538836" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Comparison of body fluid distribution between chronic haemodialysis and peritoneal dialysis patients as assessed by biophysical and biochemical methods. Nephrol Dial Transplant. 2001;16:2378-85. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11733630" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Comparison of body fluid distribution between chronic haemodialysis and peritoneal dialysis patients as assessed by biophysical and biochemical methods." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Plum J." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant. " "fecha" => "2001" "volumen" => "16" "paginaInicial" => "2378" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11733630" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Does peritoneal dialysate affect body composition assessments using multi-frequency bioimpedance in peritoneal dialysis patients? Eur J Clin Nutr. 2013;67:223-5. <a href="http://www.ncbi.nlm.nih.gov/pubmed/23249878" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Does peritoneal dialysate affect body composition assessments using multi-frequency bioimpedance in peritoneal dialysis patients? Eur J Clin Nutr." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Davenport A." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "fecha" => "2013" "volumen" => "67" "paginaInicial" => "223" "paginaFinal" => "5" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Assessment of body composition in peritoneal dialysis patients using bioelectrical impedance and dual-energy X-ray absorptiometry. Am J Nephrol. 2011; 33:150-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21293116" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Assessment of body composition in peritoneal dialysis patients using bioelectrical impedance and dual-energy X-ray absorptiometry." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Fürstenberg A" 1 => "Davenport A." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000324111" "Revista" => array:6 [ "tituloSerie" => "Am J Nephrol. " "fecha" => "2011" "volumen" => "33" "paginaInicial" => "150" "paginaFinal" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21293116" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Predictive value of brain natriuretic peptides in patients on peritoneal dialysis: Results from the ADEMEX Trial. Clin J Am Soc Nephrol. 2008;3:407-15. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18199844" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Predictive value of brain natriuretic peptides in patients on peritoneal dialysis: Results from the ADEMEX Trial." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Paniagua R" 1 => "Amato D" 2 => "Mujais S" 3 => "Vonesh E" 4 => "Ramos A" 5 => "Correa-Rotter R" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2215/CJN.03820907" "Revista" => array:6 [ "tituloSerie" => "Clin J Am Soc Nephrol. " "fecha" => "2008" "volumen" => "3" "paginaInicial" => "407" "paginaFinal" => "15" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18199844" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Volume excess in chronic haemodialysis patients–effects of treatment frequency and treatment spacing. Nephrol Dial Transplant. 2013;28:170-5. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22167596" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Volume excess in chronic haemodialysis patients–effects of treatment frequency and treatment spacing." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Stockinger J" 1 => "Ribitsch W" 2 => "Schneditz D." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndt/gfr673" "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant. " "fecha" => "2013" "volumen" => "28" "paginaInicial" => "170" "paginaFinal" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22167596" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Changes in body composition parameters in patients on haemodialysis and peritoneal dialysis. Nefrologia. 2012;32:108-13. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22294009" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Changes in body composition parameters in patients on haemodialysis and peritoneal dialysis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Di-Gioia MC" 1 => "Gallar P" 2 => "Rodríguez I" 3 => "Laso N" 4 => "Callejas R" 5 => "Ortega O" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2011.Oct.10938" "Revista" => array:6 [ "tituloSerie" => "Nefrologia. " "fecha" => "2012" "volumen" => "32" "paginaInicial" => "108" "paginaFinal" => "13" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22294009" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "European best practice guidelines for peritoneal dialysis. 2 The initiation of dialysis. Nephrol Dial Transplant. 2005;20 Suppl 9:ix3-ix7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16263750" target="_blank">[Pubmed]</a>" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "European best practice guidelines for peritoneal dialysis. 2 The initiation of dialysis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Dombros N" 1 => "Dratwa M" 2 => "Feriani M" 3 => "Gokal R" 4 => "Heimbürger O" 5 => "Krediet R" 6 => "et al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndt/gfi1116" "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant. " "fecha" => "2005" "volumen" => "20 Suppl 9" "paginaInicial" => "ix3" "paginaFinal" => "ix7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16263750" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000003500000002/v0_201504231604/X2013251415123699/v0_201504231606/en/main.assets" "Apartado" => array:4 [ "identificador" => "38708" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originals" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003500000002/v0_201504231604/X2013251415123699/v0_201504231606/en/498v35n02a90412369pdf001.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251415123699?idApp=UINPBA000064"]

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Prevalencia de la sobrehidratación en la diálisis peritoneal: estudio longitudinal de 2 años

Pedro Ventura Aguiara, Olívia Santosa, Laetitia Teixeirab, Fernanda Silvaa, Pedro Azevedoa, Joana Vidinhac, Francisco Ferrerd, Maria João Carvalhoe, António Cabritaa, Anabela Rodriguese

a Department of Nephrology. Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal)

b Instituto Ciencias Biomédicas Abel Salazar. Universidade Porto. Porto (Portugal)

c Department of Nephrology. Hospital São Teotónio. Viseu (Portugal)

d Department of Nephrology. Centro Hospitalar Medio-Tejo. Torres Novas (Portugal)

e Department of Nephrology. Hospital de Santo António. Centro Hospitalar do Porto. Porto (Portugal). Instituto Ciencias Biomédicas Abel Salazar. Universidade Porto. Porto (Portugal)

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    "textoCompleto" => "<p class="elsevierStylePara"> </p><span class="elsevierStyleBold">Introduction </span><p class="elsevierStylePara"> Hypervolemia is a &#8220;traditional&#8221; independent risk factor for cardiovascular disease and death among end-stage renal disease patients&#46; It is associated with ventricular hypertrophy&#44;<span class="elsevierStyleSup">1</span> nutritional changes&#44;<span class="elsevierStyleSup">2&#44;3</span> and inflammation&#46;<span class="elsevierStyleSup">4-6</span> Volume overload also promotes endothelial dysfunction<span class="elsevierStyleSup">7</span> and nightly non-dipping<span class="elsevierStyleSup">8</span> blood pressure in dialysis patients&#46;</p><p class="elsevierStylePara"> The importance of adequacy beyond small solute clearances in the overall patient survival was highlighted by peritoneal dialysis landmark studies such as CANUSA&#44;<span class="elsevierStyleSup">9</span> ADEMEX&#44;<span class="elsevierStyleSup">10</span> and NECOSAD&#46;<span class="elsevierStyleSup">11</span></p><p class="elsevierStylePara"> Residual renal function &#40;RRF&#41; plays a determinant role in the outcome of peritoneal dialysis &#40;PD&#41; patients&#46;<span class="elsevierStyleSup">11&#44;12</span> Daily urine output over 250ml represents a 34&#37; increase in survival benefit in peritoneal dialysis patients&#46;<span class="elsevierStyleSup">9</span> A reduction in the risk of death&#44;<span class="elsevierStyleSup">13</span> volume overload&#44; and left ventricular dysfunction&#44;<span class="elsevierStyleSup">14</span> has been observed with increased fluid removal in PD&#44; alongside with sodium restriction&#46; Nevertheless&#44; the ADEMEX study failed to demonstrate mortality differences between anuric patients and the rest&#44; either within and between groups&#46;<span class="elsevierStyleSup">10</span></p><p class="elsevierStylePara"> It has been postulated that euvolemia is harder to achieve in PD patients&#46; Nonetheless&#44; in a cross sectional study&#44; Devolder and colleagues<span class="elsevierStyleSup">15</span> demonstrated that patients undergoing PD had a similar volume status when compared to equivalent hemodialysis ones&#46;</p><p class="elsevierStylePara"> Determining euvolemia is a challenging task&#46; Reliable evaluation of overhydration can be attained through multifrequency bioimpedance analysis &#40;BIA&#41;&#46; We have previously documented that overhydration &#40;OH&#41; in PD patients&#44; defined as extra-cellular water &#40;ECW&#41;&#47;total body water &#40;TBW&#41; over 15&#37;&#44; was associated with age and diabetes&#44; but neither with PD vintage nor anuria&#46;<span class="elsevierStyleSup">16</span></p><p class="elsevierStylePara"> This study aimed to evaluate longitudinal changes in hydration status&#44; and identify corporal composition trends in a PD population&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Methods </span></p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Population </span></p><p class="elsevierStylePara"> We conducted a 2 year &#40;2009-2011&#41; single centre prospective non-interventional observational study to determine the volume status among incident and prevalent peritoneal dialysis patients&#46; Incident patients were defined as those with less than 6 months on dialysis&#46; All patients over 18 years old were eligible to participate&#46; Contraindication to bioimpedance evaluation &#8211; implanted electronic medical device or connection to an external electronic medical device &#40;pacemaker or ICD&#41;&#44; any kind of metal implants or metal artificial joints&#44; amputations&#44; pregnancy or in a lactation period&#44; or refusal to participate&#44; were the only exclusion criterion&#46; Patients lost to follow-up were excluded from the analysis&#46;</p><p class="elsevierStylePara"> All PD patients are treated with low glucose degradation product solut ions &#40;Balance&#44; Fresenius Medical Care&#59; Physioneal&#44; Baxter Healthcare&#41;&#46; Some patients were also on icodextrin due to failure to achieve clinical euvolemia with dietary salt restriction and diuretics&#46; Hypertonic solutions were used only by exception and for a short period of time&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Measurements </span></p><p class="elsevierStylePara"> Body composition measurements were performed using multifrequency whole body bioimpedance assessment using the Body Composition Monitor &#40;BCM&#44; Fresenius Medical Care&#41;&#46; Patients were in the recumbent position for 5 minutes&#44; and all metal accessories removed&#46; Fluid present in the trunk is not measured by bioimpedance spectroscopy and does not influence BIA results&#46;<span class="elsevierStyleSup">17-19</span> Therefore&#44; and for logistical reasons measurements were conducted with a full abdomen&#46; Yearly measurements were performed&#44; T0 representing baseline evaluation&#44; T1 the first and T2 the second year determinations&#44; respectively&#46;</p><p class="elsevierStylePara"> Hydration status was evaluated according to parameters provided by the BCM software&#58; 1&#41; total overhydration &#40;in litres&#41;&#44; and 2&#41; relative overhydration &#40;rOH - in &#37;&#41; - calculated as the extra-cellular water &#40;ECW&#41; to total body water &#40;TBW&#41; relation&#46;</p><p class="elsevierStylePara"> For statistical analysis&#44; patients were categorized into normohydrated &#40;rOH&#60;6&#46;8&#37;&#41; and severely overhydrated &#40;rOH&#62;15&#37;&#41;&#44; according to the definition of Wizemann et al&#46;<span class="elsevierStyleSup">20</span> The remaining were assumed to be moderately overhydrated&#46;<span class="elsevierStyleSup">6&#44;8</span></p><p class="elsevierStylePara"> Weight was assessed on a calibrated electronic weighing scale&#44; with patients wearing only trousers and a light shirt&#46; Blood pressure was defined as the mean of three measurements in a sitting position&#44; using a standardized electronic device with brachial cuff adjusted to the patient&#8217;s arm circumference&#46; Blood&#44; urinary&#44; and peritoneal analysis were performed on the day of BIA assessment&#46; Peritoneal ultra-filtration was determined according to patients&#8217; registry &#40;or cyclers&#8217;&#44; on APD&#41; on the day previous to BCM assessment&#44; and calculated as the difference between the sum of drained ultrafiltrate and the sum of infused solution in a 24h period&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Statistical analysis </span></p><p class="elsevierStylePara"> Continuous variables are presented as means and standard deviations for parametric&#44; and one-way ANOVA with post hoc Scheff&#233; testing was used for group comparison&#46; Non-parametric variables are presented as median and interquartile range&#44; and group comparison was performed using Kruskal-Wallis analysis&#46; General linear modelling was used for multivariate analysis&#44; including all variables that were deemed relevant and avoiding parameters that were highly correlated with each other&#46;</p><p class="elsevierStylePara"> All statistical analyses were performed using SPSS version 17 &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#44; USA&#41;&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Results </span></p><p class="elsevierStylePara"> A total of 58 patients were evaluated during the study period&#46; Twenty eight failed to complete 3 measurements&#44; and were lost to follow up&#58; 18 were submitted to transplant&#44; 10 commuted to haemodialysis due to technique failure &#8211; 2 with chronic exit site infection&#44; 3 with peritonitis&#44; 2 with ultrafiltration failure&#44; 2 due to abdominal surgical complications&#44; and one patient lost the ability to perform auto-dialysis&#46;</p><p class="elsevierStylePara"> Patients had a mean age of 56&#46;9 years old&#44; 63&#44;3&#37; were female&#44; a PD vintage of 21&#46;9 months&#44; and three &#40;10&#37;&#41; were diabetic&#46; Half were on automated peritoneal dialysis &#40;APD&#41;&#46; Eleven were incident patients on PD at the time of the first evaluation&#46; Patient demographics and baseline characteristics can be seen in Table 1&#46;</p><p class="elsevierStylePara"><img alt="Table 1 – Baseline characteristics" src="498v35n02-90412369fig1.jpg"></img></p><p class="elsevierStylePara"> At baseline&#44; only 40&#37; were normohydrated &#40;fluid overload &#60;6&#46;8&#37;&#41;&#46; Only 2 patients were overhydrated &#40;relative OH&#62;15&#37;&#41; - these were older &#40;p&#60;&#46;05&#41; and had higher Pro-BNP levels &#40;p&#60;&#46;05&#41;&#46; No differences were found on all the remaining parameters evaluated &#40;p&#62;&#46;05&#41;&#46;</p><p class="elsevierStylePara"> Yearly determinations were performed&#44; with an inter-evaluation time lag of 10&#44;3&#177;3&#46;0 and 12&#46;8&#177;2&#46;7 months between T0-T1 and T1-T2&#44; respectively&#46;</p><p class="elsevierStylePara"> On longitudinal analysis no significant changes were found in bioimpedance hydration status in the global population &#40;Fig&#46; 1&#41;&#46; Similar results &#40;p&#62;&#46;05&#41; were found on other hydration parameters&#44; such as systolic blood pressure&#44; and Pro-BNP&#44; even though the latest presented a positive trend &#40;supplement material &#8211; Table 2&#41;&#46;</p><p class="elsevierStylePara"><img alt="Figure 1 – Relative overhydration over 2 years on PD&#46; Hydration status remained fairly stable over the follow-up period&#44; regardless of residual diuresis&#44; PD vintage&#44; or PD modality&#46; The difference found on the first year evaluation &#40;T1&#41; between anuric and patients with diuresis &#62;250 ml&#47;day was normalized by the second year &#40;T2&#41;&#46;" src="498v35n02-90412369fig2.jpg"></img></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Figure 1 &#8211; Relative overhydration over 2 years on PD&#46; Hydration status remained fairly stable over the follow-up period&#44; regardless of residual diuresis&#44; PD vintage&#44; or PD modality&#46; The difference found on the first year evaluation &#40;T1&#41; between anuric and patients with diuresis &#62;250 ml&#47;day was normalized by the second year &#40;T2&#41;&#46;</span></p><p class="elsevierStylePara"><img alt="Table 2 – Longitudinal changes in overall population" src="498v35n02-90412369fig3.jpg"></img></p><p class="elsevierStylePara"> Incident patients presented a non-significant reduction in overall hydration status from T0 to T1 and T2 &#40;p&#62;&#46;05&#41;&#44; and a trend toward a decline in GFR &#40;6&#46;4 vs 5&#46;7 vs 3&#46;7 ml&#47;min&#44; p&#62;&#46;05&#41; &#8211; Table 3&#46;</p><p class="elsevierStylePara"><img alt="Table 3 – Longitudinal hydration status among incident and prevalent patients’" src="498v35n02-90412369fig4.jpg"></img></p><p class="elsevierStylePara"> On the other hand&#44; an inverse trend was found among prevalent patients&#44; presenting an increase in the relative hydration status &#40;7&#46;8 vs 9&#46;2 vs 10&#46;2&#37;&#44; p&#62;&#46;05&#41;&#44; regardless of maintaining stable total daily fluid removal &#40;Table 2&#41;&#46;</p><p class="elsevierStylePara"> Anuric patients &#40;n&#61;11&#44; 82&#37; on APD&#41; presented at baseline a similar hydration status when compared to those with urine output &#62;250 ml&#47;day&#46; Regardless of the significant difference on year 1 evaluation &#40;p&#61;&#46;03&#41;&#44; no differences were found on the 2nd year determination &#40;p&#62;&#46;05&#41; &#8211; Figure 1&#46; Five of those patients &#40;45&#37;&#41; performed a daily dwell with icodextrin at baseline&#44; which increased to 7 patients &#40;63&#37;&#41; two years later&#46;</p><p class="elsevierStylePara"> Similar hydration status was found between APD and CAPD patients in every evaluations &#40;p&#62;&#46;05&#41; &#8211; Figure 1&#46;</p><p class="elsevierStylePara"> Regarding nutritional parameters&#44; clinical &#40;BMI&#41;&#44; biochemical &#40;normalized protein catabolic rate &#40;nPCR&#41; and albumin&#41;&#44; and BCM &#40;lean tissue mass&#44; fat tissue mass&#44; and ICW&#41; remained stable throughout the evaluation period &#40;Fig&#46; 2&#41;&#46; Albumin&#44; a marker of both nutrition<span class="elsevierStyleSup">2</span> and hydration status&#44;21 was negatively correlated to hydration status at baseline&#44; but failed to achieve statistical significance &#40;p&#62;&#46;05&#41;&#46; No differences were found in the posterior evaluations as well &#40;p&#62;&#46;05&#41;&#46;</p><p class="elsevierStylePara"><img alt="Figure 2 – Nutritional changes over 2 years on PD&#46; No major corporal composition trends were found trough the 2 years follow-up&#46; Albumin&#44; lower at baseline among incident patients&#44; failed to reveal significant differences with PD vintage" src="498v35n02-90412369fig5.jpg"></img></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Figure 2 &#8211; Nutritional changes over 2 years on PD&#46; No major corporal composition trends were found trough the 2 years follow-up&#46; Albumin&#44; lower at baseline among incident patients&#44; failed to reveal significant differences with PD vintage</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Discussion </span></p><p class="elsevierStylePara"> Herein we present a longitudinal analysis on the hydration status of 30 PD patients&#44; including prevalent and incident patients - at baseline only 6&#46;7&#37; patients were overhydrated and&#44; more relevant&#44; no significant changes were observed in the same population over a 2 year evaluation period&#46;</p><p class="elsevierStylePara"> It is generally held belief that volume status is difficult to maintain in peritoneal dialysis &#40;PD&#41;&#44; and that these patients are persistently overhydrated - although data to support this view are scarce&#46; Determining euvolemia has hampered either on expensive&#44; invasive&#44; and unpractical techniques&#44; such as gold-standard dextran determination&#44; or under imprecise clinical&#44; biochemical&#44; and ultrasound determinations&#46; Clinical tools such as changes in body weight and blood pressure are unreliable for small differences&#46; Multifrequency bioimpedance analysis &#40;BIA&#41; provides an objective determination of hydration&#44;<span class="elsevierStyleSup">1&#44;14&#44;22</span> and nutritional status&#46;<span class="elsevierStyleSup">2&#44;23&#44;24</span></p><p class="elsevierStylePara"> Previous studies have demonstrated that decreasing ultra-filtration volumes negatively influences outcomes in PD&#44; independent of the levels of small solute clearance&#46;<span class="elsevierStyleSup">13</span> In the presented study&#44; no correlation was found between ultrafiltration nor total fluid removal and overhydration at baseline determination&#46; Additionally&#44; on the longitudinal analysis&#44; although there was a reduction in the daily urine output and a trend towards reduction in glomerular filtration rate&#44; total fluid removal maintained stable&#46; Added to the lack of increase in overhydration among the overall population&#44; it reinforces the belief that individualization of PD strategies&#44; with different solutions&#44; dwells&#44; and PD techniques &#40;CAPD vs APD&#41;&#44; enables PD patients to remain normohydrated&#46;</p><p class="elsevierStylePara"> Regardless of these evidences&#44; fear exist in the management of PD patients with daily urine output under 250 ml&#46; Also&#44; these patients have shorter technique survival&#46;<span class="elsevierStyleSup">13</span> Though phosphorus and small solutes removal were not analysed here&#44; anuric patients were not more overhydrated over time&#44; nor did the ones who lost residual renal function during the study period&#46; Interestingly&#44; one should observe the inverted tendency observed among both incident and prevalent&#58; in incident patients rOH decreased dispite decreasing diuresis&#44; while it increased in prevalent ones&#46; A possible explanation may rely on the regular use of icodextrin in the long dwells &#40;as in night dwells on CAPD patients&#41; at our centre&#44; but may also reflect a patient&#8217;s better volume control and assimilation of the need to salt restriction&#46; These results reinforce the need to continuously educate patients to maintain an adequate fluid balance&#46;</p><p class="elsevierStylePara"> Devolder et al&#46;<span class="elsevierStyleSup">15</span> have previously demonstrated that hydration status was not worse among PD patients when compared to HD ones&#44; though it was a transversal single centre analysis&#46; The results presented here add yet evidence that PD is able to prevent overhydration after 2 years of follow-up&#44; regardless of urine output&#44; age&#44; BMI&#44; or diabetes&#46; Inclusion of prevalent and incident &#40;&#60;6 months on PD&#41; in the same analysis conferred a false positive PD vintage&#46; Though incident patients were included&#44; PD vintage of prevalent patients at baseline was 2&#46;5&#160;years&#44; and still no long-term changes regarding hydration status were found&#46;</p><p class="elsevierStylePara"> Pro-brain natriuretic peptide &#40;BNP&#41; was once a promising marker of overhydration in dialysis patients and related to cardiovascular mortality&#46;<span class="elsevierStyleSup">22&#44;25&#44;26</span> Though it failed to achieve statistical significance&#44; we also found a positive correlation between BNP levels and hydration status&#46; One of the main obstacles to&#160;BNP use in hydration status characterization is the lack of standardization and cut-off values&#46; Still&#44; it may be useful as a marker for volume variations in asymptomatic patients&#46;</p><p class="elsevierStylePara"> Dialysis is associated with a catabolic state&#44; and nutritional changes occur in these patients&#46;<span class="elsevierStyleSup">2&#44;27&#44;28</span> PD vintage has been associated with increasing fat mass<span class="elsevierStyleSup">27</span> and protein-energy wasting due to chronic inflammation of the peritoneal membrane&#44; abdominal distension&#44; gastroesophageal reflux&#44; and inadequate dialysis dose&#46;<span class="elsevierStyleSup">2</span></p><p class="elsevierStylePara"> Female gender&#44; age&#44; and diabetes&#44; well established risk factors in the general population&#44; have been described as&#160;risk factors for increasing fat tissue mass in PD patients&#44; as determined by BIA&#46;<span class="elsevierStyleSup">15</span> These results suggest that the measurements done with multifrequency bioimpedance can be reliable&#46;</p><p class="elsevierStylePara"> A major finding from our study is the stable nutritional status observed during the 2 year evaluation period&#44; regardless of the parameter evaluated &#40;lean tissue index&#44; fat tissue index&#44; albumin&#44; or nPCR&#41;&#46; One may postulate this may be due to a short follow-up period &#40;2 years&#41;&#44; and a lower percentage of diabetics &#40;10&#46;5&#37;&#41; when compared to major survival studies&#46;<span class="elsevierStyleSup">10&#44;12</span> Nonetheless&#44; an interquartile range PD vintage of 22&#46;0-61&#46;7months can barely be assumed as short&#46;</p><p class="elsevierStylePara"> To the authors&#8217; belief&#44; more than the overall nutritional status&#44; the failure to find relevant changes over time reveals that an adequate PD program may prevent malnourishment&#46; Some explanations seem plausible&#46; First&#44; and likely most relevant&#44; patients are regularly evaluated from a nutritionist&#46; Also&#44; low-AGE&#8217;s solutions&#44; and focus on preservation of RRF are common practice at our centre&#46;</p><p class="elsevierStylePara"> There are some limitations to this study&#46; The major is the small sample size&#44; underrating the analysis between incident and prevalent patients&#46; Also&#44; BIA determinations were performed with a full abdomen&#44; which interference with results were believed to be marginal at the study initiation&#46; Finally&#44; the study represents the current practices and results from a single centre&#44; and caution must be taken in when making further generalizations&#46;</p><p class="elsevierStylePara"> Nevertheless&#44; this is&#44; to the authors&#44; knowledge&#44; the longer and larger longitudinal BIA analysis in a PD population&#44; and the first to analyse incident and prevalent patients separately&#44; highlighting that the results found are not likely to represent a positive selection bias&#46;</p><p class="elsevierStylePara"> In conclusion&#44; this study demonstrates that thorough attention to hydration status and current prescription strategies are able to prevent relevant overhydration in PD patients - at time of the first evaluation only 6&#46;7&#37; were overhydrated - regardless of RRF and urine output&#46; Driving volume overload in PD patients may be related to centre practice patterns&#44; and may explain differences in the over-hydration percentages among studies&#46; Hopefully&#44; the results of the EuroBCM<span class="elsevierStyleSup">19</span> and de ongoing multicentre IPOD study &#40;NCT01285726&#41; will either refute or corroborate the ones presented here&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Funding </span></p><p class="elsevierStylePara"> Pedro Ventura Aguiar&#44; by Abbott laboratory for conferences presentations&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflict of interests </span></p><p class="elsevierStylePara"> The authors declare that they have no conflict of interests&#46;</p><hr></hr><p class="elsevierStylePara"> &#9734; The results of this study have been presented at the 49th ERA-EDTA congress&#44; on the 26th of May 2012&#46;</p><p class="elsevierStylePara"> &#42; <span class="elsevierStyleItalic">Corresponding author</span>&#46;<br></br> Pedro Ventura Aguiar&#44; Servicio de Nefrolog&#237;a&#44; <br></br> Hospital de Santo Ant&#243;nio&#44; Centro Hospitalar do Porto&#44; <br></br> Largo Professor Abel Salazar&#44; 4099-001&#44; Porto&#44; Portugal&#46;<br></br><span class="elsevierStyleItalic">E-mail&#58; </span><a href="mailto&#58;pedro&#46;ventura&#46;aguiar&#64;gmail&#46;com" class="elsevierStyleCrossRefs">pedro&#46;ventura&#46;aguiar&#64;gmail&#46;com</a></p>"
    "pdfFichero" => "498v35n02a90412369pdf001.pdf"
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          "palabras" => array:8 [
            0 => "Bioimpedancia"
            1 => "Sobrehidrataci&#243;n"
            2 => "Di&#225;lisis"
            3 => "Peritoneal"
            4 => "Volumen"
            5 => "Nutrici&#243;n"
            6 => "Prescripci&#243;n"
            7 => "Hipertensi&#243;n"
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            0 => "Multifrequency bioimpedance"
            1 => "Overhydration"
            2 => "Peritoneal dialysis"
            3 => "Volume status"
            4 => "Nutritional status"
            5 => "Prescribed dialysis dose"
            6 => "Hypertension"
          ]
        ]
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        "resumen" => "<p class="elsevierStylePara"> <span class="elsevierStyleItalic">Antecedentes y objetivos&#58;</span> La hipervolemia constituye un gran problema en los pacientes de di&#225;lisis&#44; y se asocia a un incremento del riesgo cardiovascular y muerte&#46; Los an&#225;lisis transversales han demostrado previamente que los pacientes de di&#225;lisis peritoneal &#40;DP&#41; no sufren de sobrehidrataci&#243;n&#44; en comparaci&#243;n a los pacientes de hemodi&#225;lisis&#46; Este estudio fue dise&#241;ado para evaluar las tendencias longitudinales de composici&#243;n corporal e hidrataci&#243;n en una poblaci&#243;n de pacientes de DP&#46;</p> <p class="elsevierStylePara"> <span class="elsevierStyleItalic">M&#233;todos&#58;</span> Realizamos un estudio observacional prospectivo de dos a&#241;os a 58 pacientes de DP de un &#250;nico centro&#46; Se incluy&#243; pacientes incidentales y prevalentes&#46; Se realizaron mediciones anuales utilizando bioimpedancia el&#233;ctrica de multi-frecuencia&#46; La sobrehidrataci&#243;n se defini&#243; como el ratio agua extra-celular &#40;ECW&#41;&#47;agua corporal total &#40;ACT&#41; superior al 15&#37;&#46; Tambi&#233;n se exploraron variables cl&#237;nicas y bioqu&#237;micas&#46;</p> <p class="elsevierStylePara"> <span class="elsevierStyleItalic">Resultados&#58;</span> Un total de 30 pacientes completar&#225;n el estudio &#40;mujeres&#58; 63&#44;3&#37;&#44; edad media 56&#44;9 a&#241;os&#44; IMC 25&#44;0 kg&#47;m<span class="elsevierStyleSup">2</span>&#44; diabetes 10&#44;0&#37;&#44; DPA-50&#44;0&#37;&#41;&#46; La antig&#252;edad media de DP fue de 21&#44;9 meses&#44; y el 36&#44;7&#37; padec&#237;a anuria&#46; Al inicio&#44; el 6&#44;7&#37; padec&#237;a sobrehidrataci&#243;n&#46;</p> <p class="elsevierStylePara"> En los an&#225;lisis longitudinales no se hallaron cambios en cuanto a hidrataci&#243;n&#44; presi&#243;n sangu&#237;nea sist&#243;lica&#44; pro-BNP&#44; o niveles de alb&#250;mina&#46; Se hallaron resultados similares entre los pacientes incidentales &#40;n &#61; 11&#59; APD- 45&#44;5&#37;&#59; anuria- 9&#44;1&#37;&#41; y prevalentes &#40;n &#61; 19&#59; DPA- 52&#44;6&#37;&#59; anuria- 52&#44;6&#37;&#41; &#40;p &#62; 0&#44;05&#41;&#46; Sin embargo&#44; al segundo a&#241;o&#44; los pacientes prevalentes estaban moderadamente sobrehidratados en comparaci&#243;n con los incidentales &#40;media 10&#44;2&#37; frente a 3&#44;5&#37;&#59; p &#61; 0&#44;009&#41;&#46; En cambio&#44; no se observ&#243; una diferencia estad&#237;stica en cuanto a adecuaci&#243;n&#44; ACT&#44; o ECW&#46; Adem&#225;s&#44; los par&#225;metros nutricionales permanecieron estables&#46;</p> <p class="elsevierStylePara"> <span class="elsevierStyleItalic">Conclusiones&#58;</span> La prevalencia de la di&#225;lisis peritoneal sin incremento de volumen ni alteraci&#243;n de los &#237;ndices de composici&#243;n corporal es factible si se aplican estrategias terap&#233;uticas prudentes&#46; La aplicaci&#243;n longitudinal de BIA puede constituir una herramienta cl&#237;nica para evaluar la adecuaci&#243;n por encima de Kt&#47;V&#46;</p>"
      ]
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        "resumen" => "<p class="elsevierStylePara"> <span class="elsevierStyleItalic">Background and objectives&#58;</span> Hypervolemia is a major concern in dialysis patients&#44; and is associated with increased cardiovascular risk and death&#46; Cross sectional analysis have previously demonstrated that peritoneal dialysis &#40;PD&#41; patients are not more overhydrated when compared to haemodialysis&#180; ones&#46; This study was designed to evaluate longitudinal trends in hydration status and corporal composition in a PD population&#46;</p> <p class="elsevierStylePara"> <span class="elsevierStyleItalic">Methods&#58;</span> We conducted a 2 year prospective observational study of 58 PD patients from a single centre&#46; Incident and prevalent patients were included&#46; Yearly measurements were performed using multifrequency electric bioimpedance&#46; Overhydration &#40;OH&#41; was defined as an extra-cellular water &#40;ECW&#41;&#47;total body water &#40;TBW&#41; over 15&#37;&#46; Clinical and biochemical variables were also explored&#46;</p> <p class="elsevierStylePara"> <span class="elsevierStyleItalic">Results&#58;</span> A total of 30 patients completed evaluation &#40;female 63&#46;3&#37;&#44; mean age 56&#46;9 years&#44; BMI 25&#46;0 kg&#47;m<span class="elsevierStyleSup">2</span>&#44; diabetes 10&#46;0&#37;&#44; APD-50&#46;0&#37;&#41;&#46; Median PD vintage was 21&#46;9 months&#44; and 36&#46;7&#37; were anuric&#46; At baseline 6&#46;7&#37; were overhydrated&#46;</p> <p class="elsevierStylePara"> On longitudinal analysis no significant changes were found in hydration status&#44; systolic blood pressure&#44; pro-BNP&#44; nor albumin levels&#46; Similar results were found among incident &#40;n&#61;11&#59; APD-45&#46;5&#37;&#59; anuric- 9&#46;1&#37;&#41; and prevalent &#40;n&#61;19&#59; APD- 52&#46;6&#37;&#59; anuric- 52&#46;6&#37;&#41; patients &#40;p&#62;&#46;05&#41;&#46; However&#44; at the second year&#44; prevalent patients were moderately overhydrated compared to incident ones &#40;median 10&#46;2&#37; vs 3&#46;5&#37;&#59; p&#61;&#46;009&#41;&#46; Nonetheless&#44; no statistical difference was observed considering adequacy&#44; TBW&#44; or ECW&#46; Moreover&#44; nutritional parameters remained stable&#46;</p> <p class="elsevierStylePara"> <span class="elsevierStyleItalic">Conclusions&#58; </span>Peritoneal dialysis maintenance without increasing volume status&#44; nor major deleterious corporal composition trends&#44; is feasible under careful therapy strategies&#46; Longitudinal application of BIA may be a useful clinical tool to evaluate adequacy beyond Kt&#47;V&#46;</p>"
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          "en" => "– Relative overhydration over 2 years on PD&#46; Hydration status remained fairly stable over the follow-up period&#44; regardless of residual diuresis&#44; PD vintage&#44; or PD modality&#46; The difference found on the first year evaluation &#40;T1&#41; between anuric and patients with diuresis &#62;250 ml&#47;day was normalized by the second year &#40;T2&#41;&#46;"
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          "en" => "– Nutritional changes over 2 years on PD&#46; No major corporal composition trends were found trough the 2 years follow-up&#46; Albumin&#44; lower at baseline among incident patients&#44; failed to reveal significant differences with PD vintage"
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              "etiqueta" => "1"
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                0 => array:3 [
                  "referenciaCompleta" => "Echocardiographic impact of hydration status in dialysis patients. Nefrologia. 2012;32:94-102.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/22240880" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Echocardiographic impact of hydration status in dialysis patients&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Juan-Garc&#237;a I"
                            1 => "Puchades MJ"
                            2 => "Sanju&#225;n R"
                            3 => "Torregrosa I"
                            4 => "Sol&#237;s M&#193;"
                            5 => "Gonz&#225;lez M"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3265/Nefrologia.pre2011.Nov.10867"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nefrologia. "
                        "fecha" => "2012"
                        "volumen" => "32"
                        "paginaInicial" => "94"
                        "paginaFinal" => "102"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22240880"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Assessment and monitoring of nutrition status in pediatric peritoneal dialysis patients. Perit Dial Int. 2009;29 Suppl 2:S176-9.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/19270211" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Assessment and monitoring of nutrition status in pediatric peritoneal dialysis patients&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Edefonti A"
                            1 => "Mastrangelo A"
                            2 => "Paglialonga F&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Perit Dial Int. "
                        "fecha" => "2009"
                        "volumen" => "29 Suppl 2"
                        "paginaInicial" => "S176"
                        "paginaFinal" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19270211"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Dialysis and Nutrition in Continuous Dialysis: Association with Clinical Outcomes. J Am Soc Nephrol. 1996; 7:198-207.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/8785388" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Dialysis and Nutrition in Continuous Dialysis&#58; Association with Clinical Outcomes&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Keshaviah R"
                            1 => "Louise M"
                            2 => "Jindal K"
                            3 => "Wayne D"
                            4 => "Thorpe E"
                            5 => "Bargman M"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Nephrol. "
                        "fecha" => "1996"
                        "volumen" => "7"
                        "paginaInicial" => "198"
                        "paginaFinal" => "207"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8785388"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Malnutrition and its association with inflammation and vascular disease in children on maintenance dialysis. Pediatr Nephrol. 2013;28:2149-56.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/23765444" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Malnutrition and its association with inflammation and vascular disease in children on maintenance dialysis&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Canpolat N"
                            1 => "Caliskan S"
                            2 => "Sever L"
                            3 => "Tasdemir M"
                            4 => "Ekmekci OB"
                            5 => "Pehlivan G"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00467-013-2527-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Nephrol. "
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "2149"
                        "paginaFinal" => "56"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23765444"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Association between inflammation and changes in residual renal function and peritoneal transport rate during the first year of dialysis. Nephrol Dial Transplant. 2001;16:2240-5.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/11682675" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Association between inflammation and changes in residual renal function and peritoneal transport rate during the first year of dialysis&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Chung SH"
                            1 => "Heimb&#252;rger O"
                            2 => "Stenvinkel P"
                            3 => "Bergstr&#246;m J"
                            4 => "Lindholm B&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrol Dial Transplant. "
                        "fecha" => "2001"
                        "volumen" => "16"
                        "paginaInicial" => "2240"
                        "paginaFinal" => "5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11682675"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Association between residual renal function, inflammation and patient survival in new peritoneal dialysis patients. Nephrol Dial Transplant. 2003;18:590-7.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/12584284" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Association between residual renal function&#44; inflammation and patient survival in new peritoneal dialysis patients&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Chung SH"
                            1 => "Heimb&#252;rger O"
                            2 => "Stenvinkel P"
                            3 => "Qureshi AR"
                            4 => "Lindholm B&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrol Dial Transplant. "
                        "fecha" => "2003"
                        "volumen" => "18"
                        "paginaInicial" => "590"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12584284"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Factors contributing to formation of edema in volume overloaded continuous ambulatory peritoneal dialysis patients. Perit Dial Int. 2011; 31:160-7.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/21282372" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Factors contributing to formation of edema in volume overloaded continuous ambulatory peritoneal dialysis patients&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Tang W"
                            1 => "Xue T"
                            2 => "Lu XH"
                            3 => "Luo YJ"
                            4 => "Wang T&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3747/pdi.2010.00055"
                      "Revista" => array:6 [
                        "tituloSerie" => "Perit Dial Int. "
                        "fecha" => "2011"
                        "volumen" => "31"
                        "paginaInicial" => "160"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21282372"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Role of twenty-four-hour ambulatory blood pressure monitoring in children on dialysis. Clin J Am Soc Nephrol. 2011;6:870-6.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/21273374" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Role of twenty-four-hour ambulatory blood pressure monitoring in children on dialysis&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Chaudhuri A"
                            1 => "Sutherland SM"
                            2 => "Begin B"
                            3 => "Salsbery K"
                            4 => "McCabe L"
                            5 => "Potter D"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2215/CJN.07960910"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin J Am Soc Nephrol. "
                        "fecha" => "2011"
                        "volumen" => "6"
                        "paginaInicial" => "870"
                        "paginaFinal" => "6"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21273374"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis : A reanalysis of the CANUSA Study. J Am Soc Nephrol. 2001;12:2158-62.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/11562415" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Relative contribution of residual renal function and peritoneal clearance to adequacy of dialysis &#58; A reanalysis of the CANUSA Study&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Bargman JM"
                            1 => "Thorpe KE"
                            2 => "Churchill DN&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Nephrol. "
                        "fecha" => "2001"
                        "volumen" => "12"
                        "paginaInicial" => "2158"
                        "paginaFinal" => "62"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11562415"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMEX, a prospective, randomized, controlled trial. J Am Soc Nephrol. 2002;13:1307-20.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/11961019" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis&#58; ADEMEX&#44; a prospective&#44; randomized&#44; controlled trial&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Paniagua R"
                            1 => "Amato D"
                            2 => "Vonesh E"
                            3 => "Correa-Rotter R"
                            4 => "Ramos A"
                            5 => "Moran J"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Nephrol. "
                        "fecha" => "2002"
                        "volumen" => "13"
                        "paginaInicial" => "1307"
                        "paginaFinal" => "20"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11961019"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life: an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2. Am J Kidney Dis. 2003;41:1293-302.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/12776283" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life&#58; an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis &#40;NECOSAD&#41;-2&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Termorshuizen F"
                            1 => "Korevaar JC"
                            2 => "Dekker FW"
                            3 => "van Manen JG"
                            4 => "Boeschoten EW"
                            5 => "Krediet RT&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Kidney Dis. "
                        "fecha" => "2003"
                        "volumen" => "41"
                        "paginaInicial" => "1293"
                        "paginaFinal" => "302"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12776283"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Implications of the Canada-USA (CANUSA) study of the adequacy of dialysis on peritoneal dialysis schedule. Nephrol Dial Transplant. 1998;13:158-63.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/9719224" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Implications of the Canada-USA &#40;CANUSA&#41; study of the adequacy of dialysis on peritoneal dialysis schedule&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Churchill DN&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrol Dial Transplant. "
                        "fecha" => "1998"
                        "volumen" => "13"
                        "paginaInicial" => "158"
                        "paginaFinal" => "63"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9719224"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis: The European APD Outcome Study. J Am Soc Nephrol. 2003;14:2948-57.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/14569106" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Survival of Functionally Anuric Patients on Automated Peritoneal Dialysis&#58; The European APD Outcome Study&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Brown EA"
                            1 => "Davies SJ"
                            2 => "Rutherford P"
                            3 => "Meeus F"
                            4 => "Borras B"
                            5 => "Riegel W"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Nephrol. "
                        "fecha" => "2003"
                        "volumen" => "14"
                        "paginaInicial" => "2948"
                        "paginaFinal" => "57"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14569106"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "A ward-based procedure for assessment of fluid status in peritoneal dialysis patients using bioimpedance spectroscopy. Perit Dial Int. 2005;25(Suppl_3):S46-48. "
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "A ward-based procedure for assessment of fluid status in peritoneal dialysis patients using bioimpedance spectroscopy&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Lindley E"
                            1 => "Devine Y"
                            2 => "Hall L"
                            3 => "Cullen M"
                            4 => "Cuthbert S"
                            5 => "Woodrow G"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Perit Dial Int. "
                        "fecha" => "2005"
                        "volumen" => "25"
                        "paginaInicial" => "S46"
                        "paginaFinal" => "48"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16048255"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Body composition, hydration, and related parameters in hemodialysis versus peritoneal dialysis patients. Perit Dial Int. 2010;30:208-14.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/20081049" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Body composition&#44; hydration&#44; and related parameters in hemodialysis versus peritoneal dialysis patients&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Devolder I"
                            1 => "Verleysen A"
                            2 => "Vijt D"
                            3 => "Vanholder R"
                            4 => "Van Biesen W&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3747/pdi.2008.00284"
                      "Revista" => array:6 [
                        "tituloSerie" => "Perit Dial Int. "
                        "fecha" => "2010"
                        "volumen" => "30"
                        "paginaInicial" => "208"
                        "paginaFinal" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20081049"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Ferrer, M.J. Carvalho, L. Oliveira, O. Santos, A. Rodrigues AC. Multifrequency bioimpedance assessment of hydration status in peritoneal dialysis and factors associated with fluid overload. Nephrol Dial Transplant Plus. 2010;3(Supplement 3):iii275-iii547. "
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Ferrer&#44; M&#46;J&#46; Carvalho&#44; L&#46; Oliveira&#44; O&#46; Santos&#44; A&#46; Rodrigues AC&#46; Multifrequency bioimpedance assessment of hydration status in peritoneal dialysis and factors associated with fluid overload&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Nephrol Dial Transplant Plus. "
                        "fecha" => "2010"
                        "volumen" => "3"
                        "paginaInicial" => "iii275"
                        "paginaFinal" => "iii547"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Comparing different methods of assessing body composition in end-stage renal failure. Kidney Int. 2000;58:408-16.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/10886589" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Comparing different methods of assessing body composition in end-stage renal failure&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Cooper BA"
                            1 => "Aslani A"
                            2 => "Ryan M"
                            3 => "Zhu FY"
                            4 => "Ibels LS"
                            5 => "Allen BJ"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1523-1755.2000.00180.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Kidney Int. "
                        "fecha" => "2000"
                        "volumen" => "58"
                        "paginaInicial" => "408"
                        "paginaFinal" => "16"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10886589"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Influence of peritoneal dialysis solution on measurements of fluid status by bioimpedance spectroscopy. Int Urol Nephrol. 2013;45:229-32.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/22710970" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Influence of peritoneal dialysis solution on measurements of fluid status by bioimpedance spectroscopy&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Parmentier SP"
                            1 => "Schirutschke H"
                            2 => "Schmitt B"
                            3 => "Schewe J"
                            4 => "Herbrig K"
                            5 => "Pistrosch F"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11255-012-0216-y"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Urol Nephrol. "
                        "fecha" => "2013"
                        "volumen" => "45"
                        "paginaInicial" => "229"
                        "paginaFinal" => "32"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22710970"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Fluid status in peritoneal dialysis patients: the European Body Composition Monitoring (EuroBCM) study cohort. PLoS One. 2011;6:e17148.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/21390320" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Fluid status in peritoneal dialysis patients&#58; the European Body Composition Monitoring &#40;EuroBCM&#41; study cohort&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Van Biesen W"
                            1 => "Williams JD"
                            2 => "Covic AC"
                            3 => "Fan S"
                            4 => "Claes K"
                            5 => "Lichodziejewska-Niemierko M"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0017148"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS One. "
                        "fecha" => "2011"
                        "volumen" => "6"
                        "paginaInicial" => "e17148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21390320"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "The mortality risk of overhydration in haemodialysis patients. Nephrol Dial Transplant. 2009;24:1574-9.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/19131355" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "The mortality risk of overhydration in haemodialysis patients&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Wizemann V"
                            1 => "Wabel P"
                            2 => "Chamney P"
                            3 => "Zaluska W"
                            4 => "Moissl U"
                            5 => "Rode C"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ndt/gfn707"
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                        "tituloSerie" => "Nephrol Dial Transplant. "
                        "fecha" => "2009"
                        "volumen" => "24"
                        "paginaInicial" => "1574"
                        "paginaFinal" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19131355"
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                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Plasma volume, albumin, and fluid status in peritoneal dialysis patients. Clin J Am Soc Nephrol. 2010;5:1463-70.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/20538836" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Plasma volume&#44; albumin&#44; and fluid status in peritoneal dialysis patients&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "John B"
                            1 => "Tan BK"
                            2 => "Dainty S"
                            3 => "Spanel P"
                            4 => "Smith D"
                            5 => "Davies SJ&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2215/CJN.09411209"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin J Am Soc Nephrol. "
                        "fecha" => "2010"
                        "volumen" => "5"
                        "paginaInicial" => "1463"
                        "paginaFinal" => "70"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20538836"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Comparison of body fluid distribution between chronic haemodialysis and peritoneal dialysis patients as assessed by biophysical and biochemical methods. Nephrol Dial Transplant. 2001;16:2378-85.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/11733630" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Comparison of body fluid distribution between chronic haemodialysis and peritoneal dialysis patients as assessed by biophysical and biochemical methods&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Plum J&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrol Dial Transplant. "
                        "fecha" => "2001"
                        "volumen" => "16"
                        "paginaInicial" => "2378"
                        "paginaFinal" => "85"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11733630"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Does peritoneal dialysate affect body composition assessments using multi-frequency bioimpedance in peritoneal dialysis patients? Eur J Clin Nutr. 2013;67:223-5.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/23249878" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Does peritoneal dialysate affect body composition assessments using multi-frequency bioimpedance in peritoneal dialysis patients&#63; Eur J Clin Nutr&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Davenport A&#46;"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "fecha" => "2013"
                        "volumen" => "67"
                        "paginaInicial" => "223"
                        "paginaFinal" => "5"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Assessment of body composition in peritoneal dialysis patients using bioelectrical impedance and dual-energy X-ray absorptiometry. Am J Nephrol. 2011; 33:150-6.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/21293116" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Assessment of body composition in peritoneal dialysis patients using bioelectrical impedance and dual-energy X-ray absorptiometry&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000324111"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Nephrol. "
                        "fecha" => "2011"
                        "volumen" => "33"
                        "paginaInicial" => "150"
                        "paginaFinal" => "6"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21293116"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
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              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Predictive value of brain natriuretic peptides in patients on peritoneal dialysis: Results from the ADEMEX Trial. Clin J Am Soc Nephrol. 2008;3:407-15.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/18199844" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Predictive value of brain natriuretic peptides in patients on peritoneal dialysis&#58; Results from the ADEMEX Trial&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Paniagua R"
                            1 => "Amato D"
                            2 => "Mujais S"
                            3 => "Vonesh E"
                            4 => "Ramos A"
                            5 => "Correa-Rotter R"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2215/CJN.03820907"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin J Am Soc Nephrol. "
                        "fecha" => "2008"
                        "volumen" => "3"
                        "paginaInicial" => "407"
                        "paginaFinal" => "15"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18199844"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Volume excess in chronic haemodialysis patients–effects of treatment frequency and treatment spacing. Nephrol Dial Transplant. 2013;28:170-5.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/22167596" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Volume excess in chronic haemodialysis patients–effects of treatment frequency and treatment spacing&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Stockinger J"
                            1 => "Ribitsch W"
                            2 => "Schneditz D&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ndt/gfr673"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephrol Dial Transplant. "
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "170"
                        "paginaFinal" => "5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22167596"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Changes in body composition parameters in patients on haemodialysis and peritoneal dialysis. Nefrologia. 2012;32:108-13.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/22294009" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "Changes in body composition parameters in patients on haemodialysis and peritoneal dialysis&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Di-Gioia MC"
                            1 => "Gallar P"
                            2 => "Rodr&#237;guez I"
                            3 => "Laso N"
                            4 => "Callejas R"
                            5 => "Ortega O"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3265/Nefrologia.pre2011.Oct.10938"
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                        "tituloSerie" => "Nefrologia. "
                        "fecha" => "2012"
                        "volumen" => "32"
                        "paginaInicial" => "108"
                        "paginaFinal" => "13"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22294009"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "European best practice guidelines for peritoneal dialysis. 2 The initiation of dialysis. Nephrol Dial Transplant. 2005;20 Suppl 9:ix3-ix7.  <a href="http://www.ncbi.nlm.nih.gov/pubmed/16263750" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => array:3 [
                      "titulo" => "European best practice guidelines for peritoneal dialysis&#46; 2 The initiation of dialysis&#46;"
                      "idioma" => "en"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "Dombros N"
                            1 => "Dratwa M"
                            2 => "Feriani M"
                            3 => "Gokal R"
                            4 => "Heimb&#252;rger O"
                            5 => "Krediet R"
                            6 => "et al&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ndt/gfi1116"
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                        "tituloSerie" => "Nephrol Dial Transplant. "
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                        "volumen" => "20 Suppl 9"
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                        "paginaFinal" => "ix7"
                        "link" => array:1 [
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Article information

ISSN: 20132514
Original language: English

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	18	5	23
2024 October	77	26	103
2024 September	92	23	115
2024 August	84	46	130
2024 July	83	20	103
2024 June	69	33	102
2024 May	81	28	109
2024 April	64	34	98
2024 March	81	24	105
2024 February	43	33	76
2024 January	45	28	73
2023 December	28	23	51
2023 November	55	33	88
2023 October	63	32	95
2023 September	52	32	84
2023 August	52	25	77
2023 July	60	35	95
2023 June	82	30	112
2023 May	96	36	132
2023 April	63	28	91
2023 March	66	24	90
2023 February	51	18	69
2023 January	58	38	96
2022 December	81	47	128
2022 November	75	42	117
2022 October	88	58	146
2022 September	59	35	94
2022 August	57	44	101
2022 July	55	53	108
2022 June	58	34	92
2022 May	41	31	72
2022 April	54	39	93
2022 March	67	63	130
2022 February	52	44	96
2022 January	53	41	94
2021 December	43	35	78
2021 November	41	34	75
2021 October	31	37	68
2021 September	35	27	62
2021 August	28	31	59
2021 July	33	29	62
2021 June	20	19	39
2021 May	26	33	59
2021 April	72	84	156
2021 March	53	32	85
2021 February	33	11	44
2021 January	41	16	57
2020 December	28	11	39
2020 November	31	16	47
2020 October	20	16	36
2020 September	41	8	49
2020 August	32	9	41
2020 July	44	8	52
2020 June	48	10	58
2020 May	41	12	53
2020 April	48	10	58
2020 March	35	14	49
2020 February	33	23	56
2020 January	42	23	65
2019 December	49	22	71
2019 November	41	19	60
2019 October	27	16	43
2019 September	44	14	58
2019 August	27	14	41
2019 July	36	28	64
2019 June	41	18	59
2019 May	27	22	49
2019 April	48	32	80
2019 March	36	15	51
2019 February	25	14	39
2019 January	30	19	49
2018 December	114	35	149
2018 November	80	11	91
2018 October	74	15	89
2018 September	63	13	76
2018 August	37	14	51
2018 July	51	16	67
2018 June	45	13	58
2018 May	45	13	58
2018 April	47	6	53
2018 March	21	9	30
2018 February	28	4	32
2018 January	25	8	33
2017 December	25	8	33
2017 November	43	8	51
2017 October	37	4	41
2017 September	39	9	48
2017 August	49	4	53
2017 July	50	13	63
2017 June	61	6	67
2017 May	65	8	73
2017 April	63	6	69
2017 March	41	3	44
2017 February	43	8	51
2017 January	37	7	44
2016 December	72	7	79
2016 November	91	13	104
2016 October	121	19	140
2016 September	157	8	165
2016 August	213	0	213
2016 July	214	0	214
2016 June	140	0	140
2016 May	187	0	187
2016 April	102	0	102
2016 March	86	0	86
2016 February	155	0	155
2016 January	144	0	144
2015 December	160	1	161
2015 November	100	1	101
2015 October	114	5	119
2015 September	107	6	113
2015 August	132	28	160
2015 July	136	0	136
2015 June	77	0	77
2015 May	132	34	166
2015 April	28	0	28

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