Letter to the Editor
Amyloid angiopathy in the context of hemodialysis: An unknown field
Angiopatía amiloide en el contexto de hemodiálisis: un terreno desconocido
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CAA irrupts as a intracranial hemorrhage, which can be a cerebral hematoma or multifocal microhemorrhages. It is difficult to estimate its real incidence because diagnosis confirmation requires an anatomopathological study, but it is rated that almost 57% of non-traumatic intracranial hemorrhages in patients between 71 and 80 years old might be caused by CAA.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The spectrum of disease due to Aβ includes several disorders. In 1985, β2 microglobulin was identified as the responsible of hemodialysis-associated amyloidosis.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> In the 1980 decade, CAA was considered an Alzheimer's disease subtype,<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4</span></a> and they have been proposed as different conditions since the 1990 early decade.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Therefore, CAA is a disease with its own entity, but it lacks diagnosis, prevention and treatment protocols.</p><p id="par0010" class="elsevierStylePara elsevierViewall">There is evidence that uremic environment and glomerular filtration rate decline in patients with chronic kidney disease, aggravate cognitive functions and are related to microhemorrhages occurrence.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Both, it is necessary to clarify to what extent anticoagulant or antiplatelet treatments worsen CAA evolution. In this regard, it is interesting the case of an 82 years old patient with chronic kidney disease and hemodialysis for four years, who was evaluated due to a 48<span class="elsevierStyleHsp" style=""></span>hours disorientation state. His antecedents included memory impairment for nine years and an episode of multiple microangiopathic infarcts eight years ago. Non-contrast head CT showed a right frontal hematoma with perilesional edema, and hypodense lesions located in periventricular and subcortical white matter and left cerebellar hemisphere. That supported former infarcts or hemorrhages. According to the Boston criteria,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> the patient diagnosis was probable CAA.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The deficiency of standardized strategies to detect CAA and the bleeding risk that the disease entails, complicate the management of concomitant pathologies with antithrombotic therapy requirement. This is particularly important in patients under hemodialysis, who need anticoagulation treatment during sessions. In regard to antiplatelet treatment, retrospective researches show different outcomes respecting bleeding risk,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> although acetylsalicylic acid is generally avoided and replaced by clopidogrel. Anticoagulation with heparin is also controversial. On the one hand, a case report of CAA-related inflammation treated with enoxaparin 4000<span class="elsevierStyleHsp" style=""></span>IU/12<span class="elsevierStyleHsp" style=""></span>h due to venous thrombosis, described a subsequent big cerebral hematoma which caused death.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> On the other hand, low-molecular-weight heparin (LMWH) is recommended despite cerebral hemorrhage if immobilization extends beyond 3–4 days.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> In the exposed case of the patient, LMWH treatment was kept during hemodialysis sessions, and he continued his previous therapy with clopidogrel. Six days later, a control non-contrast head TC showed the resolution of acute hemorrhage, and due to the remarkable clinical improvement, the patient was discharged from the hospital showing a normal orientation state (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Because of its significance for hemodialysis patients, CAA is an important disease in Nephrology sphere. It is already known the importance of controlling parameters like arterial pressure, anemia, or hydroelectrolytic equilibrium in those patients in order to prevent microhemorrhages onset. However, prospective researches should focus on the bleeding risk stratification in CAA patients undergoing hemodialysis, the impact of different antithrombotic treatments in those patients, and emphasize diagnostic methods for CAA, like gradient echo sequences MRI.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 815 "Ancho" => 900 "Tamanyo" => 83855 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Non-contrast head CT along hospitalization (September 2015).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 900 "Ancho" => 900 "Tamanyo" => 73187 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">FLAIR MRI (December 2011) which showed hyperintense lesions compatible with microhemorrhages.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <span class="elsevierStyleInterRef" id="intr0005" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+amyloid+angiopathy-associated+intracerebral+hemorrhage%3A+pathology+and+management">http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+amyloid+angiopathy-associated+intracerebral+hemorrhage%3A+pathology+and+management</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cerebral amyloid angiopathy-associated intracerebral hemorrhage: pathology and management [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Mehndiratta" 1 => "S. Manjila" 2 => "T. Ostergard" 3 => "S. Eisele" 4 => "M.L. Cohen" 5 => "C. Sila" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/2012.1.FOCUS11370" "Revista" => array:6 [ "tituloSerie" => "Neurosurg Focus" "fecha" => "2012" "volumen" => "32" "numero" => "4" "paginaInicial" => "E7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22655696" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <span class="elsevierStyleInterRef" id="intr0010" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=A+new+form+of+amyloid+protein+associated+with+chronic+hemodialysis+was+identified+as+beta+2-microglobulin">http://www.ncbi.nlm.nih.gov/pubmed/?term=A+new+form+of+amyloid+protein+associated+with+chronic+hemodialysis+was+identified+as+beta+2-microglobulin</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new form of amyloid protein associated with chronic hemodialysis was identified as beta 2-microglobulin [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Gejyo" 1 => "T. Yamada" 2 => "S. Odani" 3 => "Y. Nakagawa" 4 => "M. Arakawa" 5 => "T. Kunitomo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Biochem Biophys Res Commun" "fecha" => "1985" "volumen" => "129" "numero" => "3" "paginaInicial" => "701" "paginaFinal" => "706" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3893430" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <span class="elsevierStyleInterRef" id="intr0015" href="http://www.ncbi.nlm.nih.gov/pubmed/6169353">http://www.ncbi.nlm.nih.gov/pubmed/6169353</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congophilic angiopathy in the pathogenesis of Alzheimer's degeneration [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.G. Glenner" 1 => "J.H. Henry" 2 => "S. Fujihara" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Ann Pathol" "fecha" => "1981" "volumen" => "1" "numero" => "2" "paginaInicial" => "120" "paginaFinal" => "129" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6169353" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <span class="elsevierStyleInterRef" id="intr0020" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=The+significance+of+clinically+defined+subgroups+of+Alzheimer%25C2%25B4s+disease">http://www.ncbi.nlm.nih.gov/pubmed/?term=The+significance+of+clinically+defined+subgroups+of+Alzheimer%C2%B4s+disease</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The significance of clinically defined subgroups of Alzheimer's disease [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H.C. Chui" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neural Transm Suppl" "fecha" => "1987" "volumen" => "24" "paginaInicial" => "57" "paginaFinal" => "68" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3316501" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <span class="elsevierStyleInterRef" id="intr0025" href="http://www.ncbi.nlm.nih.gov/pubmed/1469419">http://www.ncbi.nlm.nih.gov/pubmed/1469419</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cerebral amyloid angiopathy and Alzheimer's disease: two entities or one? [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H.V. Vinters" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Neurol Sci" "fecha" => "1992" "volumen" => "112" "numero" => "1" "paginaInicial" => "1" "paginaFinal" => "3" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1469419" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <span class="elsevierStyleInterRef" id="intr0030" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+microbleeds+and+cognitive+decline+in+a+hemodialysis+patient%3A+case+report+and+review+of+literature">http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+microbleeds+and+cognitive+decline+in+a+hemodialysis+patient%3A+case+report+and+review+of+literature</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cerebral microbleeds and cognitive decline in a hemodialysis patient: case report and review of literature [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Li" 1 => "M. Fisher" 2 => "W. Lau" 3 => "H. Moradi" 4 => "A. Cheung" 5 => "G. Thai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/hdi.12275" "Revista" => array:7 [ "tituloSerie" => "Hemodial Int" "fecha" => "2015" "volumen" => "19" "numero" => "3" "paginaInicial" => "E1" "paginaFinal" => "E7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25649895" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <span class="elsevierStyleInterRef" id="intr0035" href="http://www.ncbi.nlm.nih.gov/pubmed/11222803">http://www.ncbi.nlm.nih.gov/pubmed/11222803</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.A. Knudsen" 1 => "J. Rosand" 2 => "D. Karluk" 3 => "S.M. Greenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Neurology" "fecha" => "2001" "volumen" => "56" "numero" => "4" "paginaInicial" => "537" "paginaFinal" => "539" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11222803" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <span class="elsevierStyleInterRef" id="intr0040" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Elderly+and+forgetful%3A+is+aspirin+safe+for+you?">http://www.ncbi.nlm.nih.gov/pubmed/?term=Elderly+and+forgetful%3A+is+aspirin+safe+for+you%3F</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Elderly and forgetful: is aspirin safe for you? [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.H. Selim" 1 => "C.A. Molina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/STROKEAHA.114.006620" "Revista" => array:7 [ "tituloSerie" => "Stroke" "fecha" => "2014" "volumen" => "45" "numero" => "10" "paginaInicial" => "3153" "paginaFinal" => "3154" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25205308" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <span class="elsevierStyleInterRef" id="intr0045" href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+amyloid+angiopathy-related+inflammation%3A+report+of+a+case+with+very+difficult+therapeutic+management">http://www.ncbi.nlm.nih.gov/pubmed/?term=Cerebral+amyloid+angiopathy-related+inflammation%3A+report+of+a+case+with+very+difficult+therapeutic+management</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cerebral amyloid angiopathy-related inflammation: report of a case with very difficult therapeutic management [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Crosta" 1 => "B. Orlandi" 2 => "F. De Santis" 3 => "G. Passalacqua" 4 => "J.C. DiFrancesco" 5 => "F. Piazza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2015/483020" "Revista" => array:2 [ "tituloSerie" => "Case Rep Neurol Med" "fecha" => "2015" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "[cited 2015 Sept 29]. Available from: <span class="elsevierStyleInterRef" id="intr0050" href="http://www.ncbi.nlm.nih.gov/pubmed/18601836">http://www.ncbi.nlm.nih.gov/pubmed/18601836</span>" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Actualización en hemorragia cerebral espontánea [Internet]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Escudero Augusto" 1 => "L. Marqués Álvarez" 2 => "F. Taboada Costa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Med Intensiva" "fecha" => "2008" "volumen" => "32" "numero" => "6" "paginaInicial" => "282" "paginaFinal" => "295" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18601836" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/02116995/0000003600000005/v3_201705130058/S0211699516300108/v3_201705130058/en/main.assets" "Apartado" => array:4 [ "identificador" => "46115" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Carta al Director" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/02116995/0000003600000005/v3_201705130058/S0211699516300108/v3_201705130058/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699516300108?idApp=UINPBA000064" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 2 | 3 | 5 |
| 2024 Octubre | 49 | 51 | 100 |
| 2024 Septiembre | 45 | 34 | 79 |
| 2024 Agosto | 56 | 79 | 135 |
| 2024 Julio | 52 | 33 | 85 |
| 2024 Junio | 62 | 42 | 104 |
| 2024 Mayo | 73 | 35 | 108 |
| 2024 Abril | 56 | 49 | 105 |
| 2024 Marzo | 44 | 23 | 67 |
| 2024 Febrero | 33 | 33 | 66 |
| 2024 Enero | 28 | 25 | 53 |
| 2023 Diciembre | 36 | 21 | 57 |
| 2023 Noviembre | 62 | 31 | 93 |
| 2023 Octubre | 47 | 27 | 74 |
| 2023 Septiembre | 39 | 26 | 65 |
| 2023 Agosto | 42 | 25 | 67 |
| 2023 Julio | 57 | 43 | 100 |
| 2023 Junio | 51 | 24 | 75 |
| 2023 Mayo | 66 | 35 | 101 |
| 2023 Abril | 45 | 19 | 64 |
| 2023 Marzo | 63 | 21 | 84 |
| 2023 Febrero | 58 | 28 | 86 |
| 2023 Enero | 48 | 24 | 72 |
| 2022 Diciembre | 79 | 42 | 121 |
| 2022 Noviembre | 53 | 35 | 88 |
| 2022 Octubre | 83 | 47 | 130 |
| 2022 Septiembre | 55 | 37 | 92 |
| 2022 Agosto | 51 | 52 | 103 |
| 2022 Julio | 47 | 42 | 89 |
| 2022 Junio | 47 | 41 | 88 |
| 2022 Mayo | 51 | 45 | 96 |
| 2022 Abril | 46 | 50 | 96 |
| 2022 Marzo | 55 | 44 | 99 |
| 2022 Febrero | 50 | 58 | 108 |
| 2022 Enero | 46 | 30 | 76 |
| 2021 Diciembre | 46 | 46 | 92 |
| 2021 Noviembre | 61 | 37 | 98 |
| 2021 Octubre | 48 | 39 | 87 |
| 2021 Septiembre | 61 | 36 | 97 |
| 2021 Agosto | 64 | 46 | 110 |
| 2021 Julio | 59 | 45 | 104 |
| 2021 Junio | 48 | 33 | 81 |
| 2021 Mayo | 83 | 38 | 121 |
| 2021 Abril | 104 | 107 | 211 |
| 2021 Marzo | 39 | 29 | 68 |
| 2021 Febrero | 62 | 33 | 95 |
| 2021 Enero | 41 | 26 | 67 |
| 2020 Diciembre | 24 | 16 | 40 |
| 2020 Noviembre | 36 | 21 | 57 |
| 2020 Octubre | 30 | 24 | 54 |
| 2020 Septiembre | 36 | 15 | 51 |
| 2020 Agosto | 48 | 17 | 65 |
| 2020 Julio | 29 | 19 | 48 |
| 2020 Junio | 34 | 28 | 62 |
| 2020 Mayo | 54 | 32 | 86 |
| 2020 Abril | 34 | 44 | 78 |
| 2020 Marzo | 29 | 24 | 53 |
| 2020 Febrero | 39 | 13 | 52 |
| 2020 Enero | 47 | 22 | 69 |
| 2019 Diciembre | 42 | 30 | 72 |
| 2019 Noviembre | 47 | 21 | 68 |
| 2019 Octubre | 32 | 15 | 47 |
| 2019 Septiembre | 39 | 22 | 61 |
| 2019 Agosto | 25 | 12 | 37 |
| 2019 Julio | 28 | 22 | 50 |
| 2019 Junio | 25 | 24 | 49 |
| 2019 Mayo | 21 | 22 | 43 |
| 2019 Abril | 73 | 31 | 104 |
| 2019 Marzo | 39 | 24 | 63 |
| 2019 Febrero | 34 | 22 | 56 |
| 2019 Enero | 29 | 24 | 53 |
| 2018 Diciembre | 178 | 48 | 226 |
| 2018 Noviembre | 381 | 27 | 408 |
| 2018 Octubre | 403 | 20 | 423 |
| 2018 Septiembre | 166 | 20 | 186 |
| 2018 Agosto | 85 | 18 | 103 |
| 2018 Julio | 79 | 22 | 101 |
| 2018 Junio | 91 | 16 | 107 |
| 2018 Mayo | 107 | 19 | 126 |
| 2018 Abril | 209 | 10 | 219 |
| 2018 Marzo | 193 | 13 | 206 |
| 2018 Febrero | 207 | 15 | 222 |
| 2018 Enero | 189 | 10 | 199 |
| 2017 Diciembre | 168 | 15 | 183 |
| 2017 Noviembre | 73 | 14 | 87 |
| 2017 Octubre | 57 | 12 | 69 |
| 2017 Septiembre | 64 | 15 | 79 |
| 2017 Agosto | 93 | 20 | 113 |
| 2017 Julio | 109 | 24 | 133 |
| 2017 Junio | 95 | 18 | 113 |
| 2017 Mayo | 104 | 26 | 130 |
| 2017 Abril | 84 | 12 | 96 |
| 2017 Marzo | 71 | 35 | 106 |
| 2017 Febrero | 53 | 21 | 74 |
| 2017 Enero | 38 | 17 | 55 |
| 2016 Diciembre | 54 | 9 | 63 |
| 2016 Noviembre | 98 | 27 | 125 |
| 2016 Octubre | 132 | 19 | 151 |
| 2016 Septiembre | 71 | 3 | 74 |
| 2016 Agosto | 53 | 5 | 58 |
| 2016 Julio | 42 | 5 | 47 |
| 2016 Junio | 55 | 0 | 55 |
| 2016 Mayo | 58 | 0 | 58 |
| 2016 Abril | 2 | 0 | 2 |
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