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array:24 [ "pii" => "S0211699516301746" "issn" => "02116995" "doi" => "10.1016/j.nefro.2016.10.005" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "280" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2017;37:548-50" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 6206 "formatos" => array:3 [ "EPUB" => 570 "HTML" => 4624 "PDF" => 1012 ] ] "itemSiguiente" => array:19 [ "pii" => "S0211699516301734" "issn" => "02116995" "doi" => "10.1016/j.nefro.2016.11.001" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "279" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2017;37:550-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4543 "formatos" => array:3 [ "EPUB" => 509 "HTML" => 3184 "PDF" => 850 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Switch to belatacept in kidney graft recipients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "550" "paginaFinal" => "552" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cambio a belatacept en trasplante renal" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María O. López-Oliva, Laura Álvarez, Mª Luisa Testillano, Tamara Pérez, María Fernández Nieto, Mª José Santana, Elena González, Alicia Herrero, Rafael Selgas, Carlos Jiménez" "autores" => array:10 [ 0 => array:2 [ "nombre" => "María O." "apellidos" => "López-Oliva" ] 1 => array:2 [ "nombre" => "Laura" "apellidos" => "Álvarez" ] 2 => array:2 [ "nombre" => "Mª Luisa" "apellidos" => "Testillano" ] 3 => array:2 [ "nombre" => "Tamara" "apellidos" => "Pérez" ] 4 => array:2 [ "nombre" => "María Fernández" "apellidos" => "Nieto" ] 5 => array:2 [ "nombre" => "Mª José" "apellidos" => "Santana" ] 6 => array:2 [ "nombre" => "Elena" "apellidos" => "González" ] 7 => array:2 [ "nombre" => "Alicia" "apellidos" => "Herrero" ] 8 => array:2 [ "nombre" => "Rafael" "apellidos" => "Selgas" ] 9 => array:2 [ "nombre" => "Carlos" "apellidos" => "Jiménez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699516301734?idApp=UINPBA000064" "url" => "/02116995/0000003700000005/v2_201709270247/S0211699516301734/v2_201709270247/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S0211699516301771" "issn" => "02116995" "doi" => "10.1016/j.nefro.2016.10.008" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "283" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Nefrologia. 2017;37:547-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4889 "formatos" => array:3 [ "EPUB" => 396 "HTML" => 3679 "PDF" => 814 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Enfermedad renal «oculta» en ancianos: ¿deja de ocultarse a los 10 años de seguimiento?" 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"" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251417301463?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699516301771?idApp=UINPBA000064" "url" => "/02116995/0000003700000005/v2_201709270247/S0211699516301771/v2_201709270247/es/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Acute kidney injury secondary to diarrhea caused by “sprue-like” enteropathy associated with olmesartan" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "548" "paginaFinal" => "550" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Lourdes Roca-Argente, Francia-Carolina Diaz-Jaime, Luis-Carlos López-Romero, Yeri Manzur-Aguilar, Jose-Luis Moll-Guillem, Adolfo del Val-Antoñana, Julio Hernandez-Jaras" "autores" => array:7 [ 0 => array:3 [ "nombre" => "Lourdes" "apellidos" => "Roca-Argente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Francia-Carolina" "apellidos" => "Diaz-Jaime" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Luis-Carlos" "apellidos" => "López-Romero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Yeri" "apellidos" => "Manzur-Aguilar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Jose-Luis" "apellidos" => "Moll-Guillem" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Adolfo" "apellidos" => "del Val-Antoñana" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:4 [ "nombre" => "Julio" "apellidos" => "Hernandez-Jaras" "email" => array:1 [ 0 => "Hernandez_jul@gva.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Nefrología, Hospital Universitario y Politécnico La Fe, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Gastroenterología, Servicio de Medicina Digestiva, Hospital Universitario y Politécnico La Fe, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Daño renal agudo secundario a diarrea debido a enteropatía “sprue-like” asociada al olmesartan" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1104 "Ancho" => 2627 "Tamanyo" => 117291 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Serum creatinine levels prior to the diarrhea episode, at admission and at discharge in 19 olmesartan-related enteropathy patients classified by the Acute Kidney Injury Network (AKIN) stages. Bar height denotes median values while error bars denote range.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Olmesartan is an angiotensin II receptor antagonist used for managing hypertension. Despite being an effective and secure drug, several reports have shown that olmesartan treatment can induce “sprue-like” enteropathy.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Histological studies of kidney tissue from patients have often shown duodenal villous atrophy, increased intraepithelial lymphocytes and collagen depositions.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> The pathophysiological mechanisms causing the olmesartan-induced sprue-like enteropathy (OSLE) are not fully elucidated, but recent observations suggest a cell-mediated hypersensitivity reaction<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> possibly related to the haplotype DQ2/DQ8.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> Persistent diarrhea often accompanies enteropathy due to olmesartan use, which could have an impact on renal function. Indeed, three previous reports have shown renal involvement secondary to diarrhea due to olmesartan-related enteropathy.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5–7</span></a> Here we present a series of 19 cases of enteropathy related to olmesartan. Fourteen of these patients showed acute renal failure at admission, which was reverted after rehydration and discontinuing olmesartan.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Nineteen cases (9 females; median age 70, ranging from 56 to 88 years old) of OSLE were admitted to our hospital between September 2012 and June 2016. Patients went to the hospital due to persistent diarrhea that was non-responsive to conventional treatment. Prior to admission, patients had been treated with olmesartan for an average of 30 months (9–84 months). Most patients were taking 40<span class="elsevierStyleHsp" style=""></span>mg/day olmesartan (10–40<span class="elsevierStyleHsp" style=""></span>mg/day). OSLE was diagnosed after ruling out other possible causes for enteropathy (seronegative for tissular transglutaminase antibodies) and determining that the patient fulfilled the criteria set by Rubio et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Sixteen patients needed hospitalization for a time period ranging from 1 to 35 days and one was treated in the intensive care unit. Treatment consisted of rehydration therapy and olmesartan discontinuation, which reverted the enteropathy and associated diarrhea. At the time of this publication histological analyses in 12 patients showed full tissue recovery.</p><p id="par0015" class="elsevierStylePara elsevierViewall">None of the patients had previous history of chronic renal disease, and estimated glomerular filtrate was normal prior to injury (86.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>17.4<span class="elsevierStyleHsp" style=""></span>mL/min/1.73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>). At admission, electrolyte imbalance was observed (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) while serum creatinine was considerably higher in comparison to previous values (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). Acute Kidney Injury Network (AKIN) classification<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> showed 5 patients with no renal involvement, 3 patients at stage 1, 2 at stage 2 and 9 at stage 3. In addition, hypokalemia and metabolic acidosis was present in these patients (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">We have presented a series of cases (14 out of a total of 19) in which acute renal injury was secondary to dehydration due to OSLE. Renal involvement was severe in 11 patients (2 cases of AKIN stage 2 and 9 cases AKIN stage 3) accompanied by hypokalemia and metabolic acidosis.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The data obtained in this case series is similar to 2 cases in Spain with high creatinine and low potassium levels associated with enteropathy in patients treated with olmesartan, which reverted after drug discontinuation.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Along the same lines, another case of enteropathy related to olmesartan with high serum creatinine and hypokalemia has been reported.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Chronic enteropathy could be associated with severe dehydration and weight loss by diarrhea, which would explain the renal involvement observed in these patients.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Olmesartan is commonly used for hypertension treatment. Although it is a safe and reliable drug, the Food and Drug Administration has recommended suspending treatment if intestinal problems occur.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Our data highlight the severe effects on renal tissue due to chronic diarrhea secondary to OSLE. More than half of the patients had stage 2 or 3 AKIN, in which kidney tissue was affected. It is likely that the duration and severity of the diarrhea episodes and the patient's hydration pattern contribute to the extent of kidney injury. Rehydration therapy and suspension of olmesartan treatment reverted symptoms and renal function was normal at discharge. However, in some cases, the extent of kidney tissue damage was high, which in turn could jeopardize patients’ renal function.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Besides weight loss, dehydration and other complications secondary to diarrhea, the renal involvement shown in this case series highlights the necessity of including olmesartan treatment in the differential diagnosis of chronic diarrhea in order to minimize the effects on kidney tissue and preserve patients’ renal function.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1104 "Ancho" => 2627 "Tamanyo" => 117291 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Serum creatinine levels prior to the diarrhea episode, at admission and at discharge in 19 olmesartan-related enteropathy patients classified by the Acute Kidney Injury Network (AKIN) stages. Bar height denotes median values while error bars denote range.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Hypokalemia (K<span class="elsevierStyleSup">+</span> <3.5<span class="elsevierStyleHsp" style=""></span>mEq/L) data has been reported as count (percentage). The rest of the data is reported as median (max–min). Hb, hemoglobin.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">AKIN<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0<br>(<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>5) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">AKIN<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1<br>(<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">AKIN<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2<br>(<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">AKIN<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3<br>(<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>9) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hypokalemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (40%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (33%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (89%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Urea (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.0 (57.0–30.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">70.0 (87.0–44.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.5 (78.0–43.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">129.0 (242.0–38.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cl<span class="elsevierStyleSup">−</span> (mEq/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">105.0 (107.0–102.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">102.0 (108.0–98.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">103.5 (104.0–103.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">103.0 (116.0–95.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Na<span class="elsevierStyleSup">+</span> (mEq/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">139 (141–136) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">139 (139–136) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">137 (138–136) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">136 (139–130) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">K<span class="elsevierStyleSup">+</span> (mEq/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.0 (4.3–2.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.6 (4.0–3.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.3 (4.6–3.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.3 (4.4–2.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">pH \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.38 (7.46–7.37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.32 (7.32–7.32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.24 (7.29–7.18) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7.14 (7.29–6.98) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">CO<span class="elsevierStyleInf">2</span> (mEq/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39.4 (47.3–19.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49.0 (49.0–49.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.1 (47.2–43.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.7 (48.0–4.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">HCO<span class="elsevierStyleInf">3</span><span class="elsevierStyleSup">−</span> (mEq/L) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22.2 (27.5–16.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22.9 (24.7–21.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18.6 (20.1–17.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.0 (16.0–4.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hb (g/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.3 (14.5–12.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.9 (14.6–10.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.9 (16.6–15.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.8 (18.1–12.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1524918.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Incidence of hypokalemia and serum biochemical values at hospital admission in olmesartan-related enteropathy patients classified by the Acute Kidney Injury Network (AKIN) stages.</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:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Severe sprue like enteropathy associated with olmesartan" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. 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año/Mes | Html | Total | |
---|---|---|---|
2024 Noviembre | 7 | 12 | 19 |
2024 Octubre | 83 | 51 | 134 |
2024 Septiembre | 108 | 33 | 141 |
2024 Agosto | 104 | 92 | 196 |
2024 Julio | 61 | 35 | 96 |
2024 Junio | 91 | 37 | 128 |
2024 Mayo | 65 | 36 | 101 |
2024 Abril | 86 | 45 | 131 |
2024 Marzo | 61 | 26 | 87 |
2024 Febrero | 43 | 38 | 81 |
2024 Enero | 53 | 21 | 74 |
2023 Diciembre | 39 | 27 | 66 |
2023 Noviembre | 73 | 41 | 114 |
2023 Octubre | 72 | 22 | 94 |
2023 Septiembre | 96 | 28 | 124 |
2023 Agosto | 77 | 25 | 102 |
2023 Julio | 64 | 38 | 102 |
2023 Junio | 101 | 24 | 125 |
2023 Mayo | 129 | 32 | 161 |
2023 Abril | 63 | 14 | 77 |
2023 Marzo | 79 | 25 | 104 |
2023 Febrero | 52 | 29 | 81 |
2023 Enero | 59 | 23 | 82 |
2022 Diciembre | 80 | 41 | 121 |
2022 Noviembre | 67 | 33 | 100 |
2022 Octubre | 68 | 36 | 104 |
2022 Septiembre | 75 | 42 | 117 |
2022 Agosto | 99 | 51 | 150 |
2022 Julio | 75 | 51 | 126 |
2022 Junio | 62 | 41 | 103 |
2022 Mayo | 56 | 41 | 97 |
2022 Abril | 85 | 50 | 135 |
2022 Marzo | 57 | 56 | 113 |
2022 Febrero | 56 | 40 | 96 |
2022 Enero | 44 | 46 | 90 |
2021 Diciembre | 107 | 44 | 151 |
2021 Noviembre | 79 | 39 | 118 |
2021 Octubre | 113 | 42 | 155 |
2021 Septiembre | 54 | 37 | 91 |
2021 Agosto | 41 | 33 | 74 |
2021 Julio | 39 | 41 | 80 |
2021 Junio | 35 | 23 | 58 |
2021 Mayo | 72 | 54 | 126 |
2021 Abril | 82 | 54 | 136 |
2021 Marzo | 54 | 48 | 102 |
2021 Febrero | 84 | 26 | 110 |
2021 Enero | 38 | 25 | 63 |
2020 Diciembre | 44 | 13 | 57 |
2020 Noviembre | 34 | 25 | 59 |
2020 Octubre | 39 | 22 | 61 |
2020 Septiembre | 31 | 16 | 47 |
2020 Agosto | 48 | 18 | 66 |
2020 Julio | 32 | 18 | 50 |
2020 Junio | 36 | 30 | 66 |
2020 Mayo | 39 | 33 | 72 |
2020 Abril | 48 | 23 | 71 |
2020 Marzo | 30 | 22 | 52 |
2020 Febrero | 49 | 35 | 84 |
2020 Enero | 52 | 25 | 77 |
2019 Diciembre | 46 | 37 | 83 |
2019 Noviembre | 65 | 23 | 88 |
2019 Octubre | 59 | 24 | 83 |
2019 Septiembre | 53 | 17 | 70 |
2019 Agosto | 48 | 30 | 78 |
2019 Julio | 70 | 16 | 86 |
2019 Junio | 57 | 29 | 86 |
2019 Mayo | 60 | 20 | 80 |
2019 Abril | 125 | 45 | 170 |
2019 Marzo | 79 | 41 | 120 |
2019 Febrero | 64 | 22 | 86 |
2019 Enero | 44 | 28 | 72 |
2018 Diciembre | 157 | 56 | 213 |
2018 Noviembre | 379 | 60 | 439 |
2018 Octubre | 343 | 41 | 384 |
2018 Septiembre | 153 | 35 | 188 |
2018 Agosto | 155 | 49 | 204 |
2018 Julio | 111 | 40 | 151 |
2018 Junio | 131 | 26 | 157 |
2018 Mayo | 149 | 35 | 184 |
2018 Abril | 201 | 14 | 215 |
2018 Marzo | 210 | 15 | 225 |
2018 Febrero | 230 | 19 | 249 |
2018 Enero | 121 | 16 | 137 |
2017 Diciembre | 209 | 18 | 227 |
2017 Noviembre | 151 | 29 | 180 |
2017 Octubre | 135 | 16 | 151 |
2017 Septiembre | 147 | 24 | 171 |
2017 Agosto | 114 | 17 | 131 |
2017 Julio | 97 | 15 | 112 |
2017 Junio | 87 | 18 | 105 |
2017 Mayo | 97 | 13 | 110 |
2017 Abril | 97 | 26 | 123 |
2017 Marzo | 99 | 17 | 116 |
2017 Febrero | 76 | 15 | 91 |
2017 Enero | 108 | 22 | 130 |
2016 Diciembre | 11 | 1 | 12 |