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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">En los &#250;ltimos a&#241;os el desarrollo de las t&#233;cnicas convectivas ha contribuido a numerosos beneficios en los pacientes con enfermedad renal cr&#243;nica avanzada &#40;ERCA&#41; en hemodi&#225;lisis<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; La hemodiafiltraci&#243;n online &#40;HDF-OL&#41; posdiluci&#243;n se considera la t&#233;cnica m&#225;s eficaz al combinar elevados aclaramientos por difusi&#243;n con altos vol&#250;menes de transporte convectivo<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">3</span></a>&#46; La utilizaci&#243;n de nuevos dializadores&#44; la fabricaci&#243;n online del l&#237;quido de di&#225;lisis o los monitores y biocontroles que optimizan la tasa de sustituci&#243;n han permitido mejorar el rendimiento e incrementar el transporte convectivo en los pacientes en HDF-OL&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La cantidad de transporte convectivo parece tratarse de un factor determinante en conseguir estos beneficios&#58; mientras que la mayor&#237;a de t&#233;cnicas de hemofiltraci&#243;n o hemodiafiltraci&#243;n con vol&#250;menes convectivos m&#225;s bajos no muestran mejor&#237;as en la supervivencia respecto a la hemodi&#225;lisis de alto flujo&#44; la HDF-OL con vol&#250;menes de sustituci&#243;n &#62;<span class="elsevierStyleHsp" style=""></span>23<span class="elsevierStyleHsp" style=""></span>L por sesi&#243;n&#44; &#62;<span class="elsevierStyleHsp" style=""></span>69<span class="elsevierStyleHsp" style=""></span>L por semana o &#62;<span class="elsevierStyleHsp" style=""></span>23<span class="elsevierStyleHsp" style=""></span>L&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> por sesi&#243;n ha demostrado una reducci&#243;n de la mortalidad<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">4-6</span></a>&#44; que fundamentalmente se debe a una reducci&#243;n de la mortalidad cardiovascular<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">7&#44;8</span></a>&#46; Aunque ninguno de los estudios fueron dise&#241;ados para evaluar el efecto &#171;convectivo-dependiente&#187;&#44; estos beneficios parecen ser m&#225;s notables cuanto mayor es la dosis de convecci&#243;n<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Se ha planteado la posibilidad de que el contenido de glucosa del l&#237;quido de sustituci&#243;n pueda suponer un exceso o una carga extra de glucosa que se administra al paciente durante el tratamiento&#44; lo cual ser&#237;a un factor limitante del volumen de sustituci&#243;n en los pacientes con intolerancia a los hidratos de carbono o diabetes mellitus<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">10&#44;11</span></a>&#46; Hasta el momento no existen datos acerca de que la glucosa infundida con las t&#233;cnicas convectivas contribuya a un peor control metab&#243;lico o a empeorar el riesgo cardiovascular en estos pacientes&#46; De hecho&#44; los primeros beneficios que se observaron al incorporar el transporte convectivo con membranas de alto flujo fueron en los pacientes diab&#233;ticos<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">12</span></a>&#44; y los an&#225;lisis de los estudios en HDF-OL muestran que los resultados en la mejor&#237;a de la supervivencia y en la reducci&#243;n de la mortalidad cardiovascular son independientes de subgrupos incluyendo estos pacientes<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">5&#44;13</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El objetivo de este estudio fue analizar la influencia del volumen de sustituci&#243;n en la evoluci&#243;n del perfil metab&#243;lico y la composici&#243;n corporal de los pacientes diab&#233;ticos con ERCA en hemodi&#225;lisis&#44; desde su inicio en HDF-OL&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Material y m&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Dise&#241;o</span>&#46; Es un estudio observacional prospectivo llevado a cabo en los pacientes diab&#233;ticos incidentes en la t&#233;cnica HDF-OL posdiluci&#243;n desde su inicio hasta finalizar el a&#241;o 2016&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Criterios de inclusi&#243;n</span>&#46; Pacientes mayores de 18 a&#241;os&#44; con ERCA en tratamiento renal sustitutivo&#44; diagnosticados de diabetes mellitus antes de iniciar HDF-OL&#44; y con pauta de HDF-OL&#58; 3 sesiones semanales de 4<span class="elsevierStyleHsp" style=""></span>h&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Un total de 29 pacientes fueron incluidos en el estudio&#58; 11 pacientes iniciaron HDF-OL como t&#233;cnica inicial de di&#225;lisis tras un periodo de 4 semanas de adaptaci&#243;n en hemodi&#225;lisis de alto flujo y 18 pacientes cambiaron de t&#233;cnica de di&#225;lisis &#40;17 desde hemodi&#225;lisis de alto flujo y uno desde di&#225;lisis peritoneal&#41;&#46; Todos firmaron un consentimiento informado&#44; y el estudio cumple con los principios de la &#250;ltima Declaraci&#243;n de Helsinki&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Variables</span>&#46; Basalmente se recogieron datos cl&#237;nicos y demogr&#225;ficos&#44; el tratamiento con insulina&#44; antidiab&#233;ticos y&#47;o hipolipemiantes&#44; par&#225;metros de laboratorio metab&#243;licos&#44; nutricionales e inflamatorios &#40;hemoglobina glucosilada &#91;HbA1c&#93;&#44; triglic&#233;ridos&#44; colesterol total&#44; c-LDL&#44; c-HDL&#44; alb&#250;mina&#44; prealb&#250;mina y prote&#237;na C reactiva &#91;PCR&#93;&#41;&#44; medidas antropom&#233;tricas y la composici&#243;n corporal por bioimpedancia espectrosc&#243;pica &#40;BIS&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se recogi&#243; el volumen de sustituci&#243;n y el volumen convectivo &#40;sustituci&#243;n m&#225;s ultrafiltraci&#243;n&#41; de cada sesi&#243;n de HDF-OL y se calcularon los vol&#250;menes medios por sesi&#243;n cada 4 meses&#46; El volumen de sustituci&#243;n se ajust&#243; adem&#225;s a la superficie corporal para estandarizar la dosis de convecci&#243;n&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Cada 4 meses se recogieron los par&#225;metros de laboratorio y medidas antropom&#233;tricas&#46; En 23 pacientes se realiz&#243; otro an&#225;lisis de composici&#243;n corporal por BIS despu&#233;s de al menos un a&#241;o de seguimiento&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Se utilizaron monitores 4008 &#40;FMC<span class="elsevierStyleSup">&#174;</span>&#41;&#44; 5008 &#40;FMC<span class="elsevierStyleSup">&#174;</span>&#41;&#44; AK200U &#40;Baxter<span class="elsevierStyleSup">&#174;</span>&#41;&#44; Artis &#40;Baxter<span class="elsevierStyleSup">&#174;</span>&#41;&#44; DBB-07 y DBB-EXA &#40;Nikkiso<span class="elsevierStyleSup">&#174;</span>&#41; y dializadores de alta permeabilidad FX80 &#40;FMC<span class="elsevierStyleSup">&#174;</span>&#41;&#44; FX1000 &#40;FMC<span class="elsevierStyleSup">&#174;</span>&#41;&#44; Polyflux-210H &#40;Baxter<span class="elsevierStyleSup">&#174;</span>&#41;&#44; Elisio-21H &#40;Nipro<span class="elsevierStyleSup">&#174;</span>&#41; y un caso de triacetato de celulosa Sureflux-21H &#40;Nipro<span class="elsevierStyleSup">&#174;</span>&#41; por hipersensibilidad a membranas de helixona&#46; La prescripci&#243;n del volumen de sustituci&#243;n fue heterog&#233;nea &#40;seg&#250;n la fracci&#243;n de filtraci&#243;n&#44; un volumen objetivo&#44; controles por presi&#243;n u otros controles automatizados de la tasa de sustituci&#243;n&#41; y variable a lo largo del seguimiento&#44; con el objetivo de alcanzar el mayor volumen de sangre procesada y el mayor volumen de sustituci&#243;n posible&#46; El contenido de glucosa en el l&#237;quido de sustituci&#243;n fue de 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Las muestras de laboratorio se extrajeron en todos los casos antes de iniciar la segunda sesi&#243;n de HDF de la semana&#44; despu&#233;s de un periodo interdi&#225;lisis de 44<span class="elsevierStyleHsp" style=""></span>h&#46; Las medidas de BIS se realizaron mediante el monitor BCM &#40;Body Composition Monitor<span class="elsevierStyleSup">&#174;</span>&#44; FMC&#41;&#44; tambi&#233;n antes de iniciar la segunda sesi&#243;n de HDF de la semana&#44; tras de un periodo de 5<span class="elsevierStyleHsp" style=""></span>min en reposo en dec&#250;bito supino<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">14</span></a>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se calcularon las variaciones de par&#225;metros anal&#237;ticos en el primer a&#241;o&#44; a los 2 a&#241;os&#44; 3 a&#241;os y al final del seguimiento&#46; Se calcularon variaciones cuatrimestrales y anuales como periodos independientes&#44; y se calcularon las variaciones de composici&#243;n corporal por BIS en el periodo entre las determinaciones&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">En el an&#225;lisis estad&#237;stico se utiliz&#243; el programa SPSS 20&#46;0 para Mac&#46; Las variables cualitativas se expresan como frecuencias y&#47;o porcentajes&#46; Se comprob&#243; el modelo de distribuci&#243;n de las variables cuantitativas mediante el test de normalidad de Kolmogorov-Smirnoff&#46; Las variables cuantitativas con distribuci&#243;n normal se expresan como media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>desviaci&#243;n est&#225;ndar y las variables cuantitativas con distribuci&#243;n no normal se expresan como mediana &#91;rango intercuart&#237;lico&#93;&#46; Las variaciones de las variables se analizaron como cambios absolutos&#44; relativos &#40;&#37;&#41;&#44; y respecto al tiempo transcurrido&#46; La asociaci&#243;n entre variables se realiz&#243; utilizando test no param&#233;tricos &#40;Spearman&#44; Wilcoxon&#44; Kruskal-Wallis&#44; Fisher test&#41; por el reducido tama&#241;o de la muestra&#46; Se utiliz&#243; el an&#225;lisis de regresi&#243;n lineal multivariante modelo &#171;introducir&#187; para evaluar la asociaci&#243;n independiente con las variaciones en el tiempo&#46; Se consider&#243; significativo un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 con un intervalo de confianza del 95&#37;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Resultados</span><p id="par0065" class="elsevierStylePara elsevierViewall">Los datos cl&#237;nicos&#44; antropom&#233;tricos&#44; de laboratorio y BIS al inicio del estudio se recogen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; El tiempo de seguimiento &#40;tiempo en HDF-OL&#41; fue de 40&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26 meses &#40;m&#237;n&#58; 12&#44; m&#225;x&#58; 101&#59; mediana &#91;RIC&#93;&#58; 35 &#91;19&#44;5-63&#93; meses&#41;&#46; Al final del estudio&#44; 16 pacientes continuaban en HDF-OL&#44; 2 cambiaron a hemodi&#225;lisis de alto flujo&#44; 2 recibieron un trasplante renal&#44; y 9 &#40;31&#37;&#41; hab&#237;an muerto&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">El volumen de sustituci&#243;n medio fue de 26&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n &#40;m&#237;n&#58; 20&#44;5<span class="elsevierStyleHsp" style=""></span>L&#44; m&#225;x&#58; 32&#44;9<span class="elsevierStyleHsp" style=""></span>L&#41; o 26&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;2<span class="elsevierStyleHsp" style=""></span>L&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#47;sesi&#243;n &#40;m&#237;n&#58; 19&#44;5<span class="elsevierStyleHsp" style=""></span>L&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#44; m&#225;x&#58; 40&#44;3<span class="elsevierStyleHsp" style=""></span>L&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&#46; No hubo variaciones significativas del volumen de sustituci&#243;n a lo largo del seguimiento&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Se observ&#243; una correlaci&#243;n significativa entre el volumen de sustituci&#243;n medio y un incremento de los niveles de c-HDL &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;385&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;039&#41; y prealb&#250;mina &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;404&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41; a lo largo del seguimiento&#46; Adem&#225;s&#44; se encontr&#243; una correlaci&#243;n significativa entre el volumen de sustituci&#243;n y la reducci&#243;n de los niveles de PCR al a&#241;o &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;531&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#44; a los 2 a&#241;os &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;463&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;046&#41; y al final del seguimiento &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;498&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#46; Al ajustar el volumen sustituido a la superficie corporal&#44; tambi&#233;n se encontr&#243; una correlaci&#243;n significativa con la reducci&#243;n de los niveles de triglic&#233;ridos &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;423&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;022&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> muestra las diferencias en la evoluci&#243;n de los par&#225;metros de laboratorio y de la composici&#243;n corporal en los pacientes con un volumen de sustituci&#243;n por encima o por debajo de la media del estudio&#46; Los pacientes con volumen de sustituci&#243;n m&#225;s bajo &#40;&#60;<span class="elsevierStyleHsp" style=""></span>26&#44; 9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n&#41; ten&#237;an mayor edad y un seguimiento m&#225;s prolongado&#46; Los pacientes con volumen de sustituci&#243;n &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n tuvieron mayor descenso en los niveles de triglic&#233;ridos y PCR&#44; y un aumento de las cifras de c-HDL &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">La edad se correlacion&#243; con un mayor descenso de alb&#250;mina s&#233;rica cada a&#241;o &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;515&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41; y al final del seguimiento &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;655&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; con un mayor descenso de prealb&#250;mina cada a&#241;o &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;617&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y al final del seguimiento &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;673&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; y con vol&#250;menes convectivos m&#225;s bajos &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;516&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">En el modelo 1 del an&#225;lisis de regresi&#243;n multivariante &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; &#250;nicamente se mantiene la edad como predictor independiente de la reducci&#243;n de prealb&#250;mina a lo largo del seguimiento&#46; En el modelo 2 solo se mantiene la asociaci&#243;n independiente con los niveles de prealb&#250;mina y el peso al inicio del estudio&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Las comparaciones entre el volumen de sustituci&#243;n y los cambios anal&#237;ticos por periodos cuatrimestrales &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>271&#93; mostraron una correlaci&#243;n significativa con un descenso de HbA1c &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;146&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#44; al igual que las comparaciones por periodos anuales &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>72&#93; &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;237&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#46; Un volumen de sustituci&#243;n medio anual &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;6<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n &#40;29&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;7<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n vs&#46; 23&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n&#41; se asoci&#243; a un descenso de HbA1c &#40;&#8722;0&#44;51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;24&#37; vs&#46; 0&#44;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;88&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;043&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">No se observ&#243; correlaci&#243;n entre el volumen de sustituci&#243;n y las variaciones en el peso&#44; IMC o par&#225;metros de la BIS en el periodo entre las determinaciones&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">No se encontr&#243; relaci&#243;n entre el volumen convectivo y los par&#225;metros de laboratorio o composici&#243;n corporal al inicio del estudio&#46; Los pacientes con volumen convectivo m&#225;s elevado &#40;sustituci&#243;n media &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n&#41; finalizaron el estudio con niveles m&#225;s altos de c-HDL &#40;48&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dL vs&#46; 41&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;025&#41; y m&#225;s bajos de PCR &#40;0&#44;21 &#91;0&#44;1-2&#44;22&#93; mg&#47;dL vs&#46; 1&#44;01 &#91;0&#44;15-6&#44;96&#93; mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Los pacientes en tratamiento con estatinas finalizaron el estudio con niveles m&#225;s bajos de c-LDL &#40;60&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>29&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dL vs&#46; 80&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#44;8<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;028&#41;&#44; aunque no se encontraron diferencias significativas en la reducci&#243;n de los niveles en el seguimiento &#40;&#8722;21&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>36&#44;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dL vs&#46; &#8722;4&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#44;1<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;186&#41;&#46; Un paciente recib&#237;a ezetimiba asociada a atorvastatina&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Ning&#250;n paciente inici&#243; insulinoterapia una vez iniciado el estudio&#46; No se recogieron cambios de dosis ni discontinuaci&#243;n de insulinoterapia a lo largo del seguimiento&#46; No hubo diferencias en la evoluci&#243;n del perfil metab&#243;lico-nutricional ni en los cambios de composici&#243;n corporal en los pacientes con y sin insulinoterapia o antidiab&#233;ticos orales &#40;linagliptina&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Discusi&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">El estudio sugiere que los altos vol&#250;menes de sustituci&#243;n no suponen un empeoramiento del perfil metab&#243;lico en los pacientes con diabetes mellitus en hemodi&#225;lisis&#46; Asumiendo la infusi&#243;n de m&#225;s cantidad de glucosa durante el tratamiento&#44; encontramos una mejor&#237;a del perfil metab&#243;lico asociada a los altos vol&#250;menes convectivos&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Balance de glucosa en hemodiafiltraci&#243;n online &#40;HDF-OL&#41; posdiluci&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">El balance de glucosa a lo largo de una sesi&#243;n de HDF-OL no solo depende de la glucosa infundida&#44; sino que est&#225; condicionada por el transporte a trav&#233;s de la membrana y&#44; fundamentalmente&#44; por la glucemia&#46; De esta manera&#44; existe transporte difusivo &#40;al tratarse de un soluto de bajo peso molecular&#41; y existe p&#233;rdida de glucosa por convecci&#243;n con la ultrafiltraci&#243;n &#40;con un coeficiente de cribado cercano a 1 con membranas de alta permeabilidad<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">15</span></a>&#41;&#44; tanto de la ganancia de fluidos del periodo interdi&#225;lisis como del exceso de ultrafiltraci&#243;n que ha de reemplazarse en la l&#237;nea venosa &#40;HDF-OL posdiluci&#243;n&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">La concentraci&#243;n de glucosa m&#225;s utilizada del ba&#241;o de di&#225;lisis y&#44; en el caso de HDF-OL&#44; del l&#237;quido de sustituci&#243;n&#44; es de 100-200<span class="elsevierStyleHsp" style=""></span>mg&#47;dL<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">16&#44;17</span></a>&#46; Excluyendo la p&#233;rdida de glucosa por ultrafiltraci&#243;n que se produce si existe balance negativo&#44; la transferencia de glucosa depender&#225; de la diferencia de concentraci&#243;n entre la sangre y el l&#237;quido de di&#225;lisis &#40;con 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL en nuestro caso&#41;&#58; los pacientes con glucemias en torno a 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL tendr&#225;n un balance neutro de glucosa &#40;tanto por difusi&#243;n como por ultrafiltraci&#243;n y reinfusi&#243;n del l&#237;quido&#41;&#59; los pacientes con glucemias &#62;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL tendr&#225;n un balance negativo de glucosa &#40;tanto por difusi&#243;n como por ultrafiltraci&#243;n y reinfusi&#243;n del l&#237;quido con menor concentraci&#243;n de glucosa que la plasm&#225;tica&#41; y&#44; por tanto&#44; &#250;nicamente los pacientes con glucemias &#60;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL tendr&#225;n un balance positivo tanto por difusi&#243;n como por convecci&#243;n&#46; Del mismo modo&#44; las p&#233;rdidas de glucosa al eliminar la sobrecarga h&#237;drica tambi&#233;n ser&#225;n variables dependiendo de la glucemia &#40;p&#233;rdida de 1<span class="elsevierStyleHsp" style=""></span>g&#47;L de UF por cada 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL de glucemia&#41;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Seg&#250;n este modelo&#44; solo con glucemias &#60;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL el incremento del volumen de sustituci&#243;n supone un peque&#241;o aumento en la cantidad de glucosa infundida &#40;por ejemplo&#44; 10<span class="elsevierStyleHsp" style=""></span>g m&#225;s de glucosa al aumentar de 25 a 35<span class="elsevierStyleHsp" style=""></span>L el volumen de sustituci&#243;n en una sesi&#243;n de HDF-OL&#41;&#44; pero con glucemias &#62;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL el aumento del volumen de sustituci&#243;n supone una mayor eliminaci&#243;n de glucosa por transporte convectivo &#40;al ultrafiltrar un agua plasm&#225;tica con mayor concentraci&#243;n de glucosa que la infundida&#41;&#46; Estos modelos te&#243;ricos no tienen en cuenta la variabilidad de la glucemia a lo largo de la sesi&#243;n&#44; que esta se ve modificada por las concentraciones de glucosa del ba&#241;o y por m&#250;ltiples mecanismos externos al tratamiento &#40;hormonales&#44; corticoides&#44; catecolaminas&#44; la ingesta&#44; etc&#46;&#41;&#44; ni la interferencia entre los transportes difusivo y convectivo en el dializador&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">La hip&#243;tesis de que una mayor infusi&#243;n pueda suponer una mayor carga de glucosa&#44; si bien no apoya la tendencia a reducir el volumen de sustituci&#243;n por las numerosas ventajas asociadas a los altos transportes convectivos&#44; podr&#237;a plantear la realizaci&#243;n de otros estudios utilizando diferentes concentraciones de glucosa en el ba&#241;o&#46; Algunos estudios en pacientes no diab&#233;ticos en hemodi&#225;lisis convencional no encuentran cambios hemodin&#225;micos al eliminar la glucosa del l&#237;quido<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">18</span></a>&#44; y es raro desarrollar hipoglucemias con los ba&#241;os de di&#225;lisis sin glucosa<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">19</span></a>&#46; Aunque el uso potencial de l&#237;quidos de di&#225;lisis con concentraciones m&#225;s bajas pudiera conllevar cambios en el balance de glucosa&#44; deber&#237;an evaluarse tanto los cambios osmolares derivados de la menor concentraci&#243;n en el l&#237;quido como las modificaciones necesarias en la conductividad &#40;para evitar descensos bruscos en la volemia&#41; o en la concentraci&#243;n de potasio en el ba&#241;o &#40;al condicionar una menor secreci&#243;n de insulina y mayor eliminaci&#243;n de potasio&#41;&#44; y las consecuencias de estas modificaciones a largo plazo &#40;como un aumento de la transferencia de sodio&#44; o la depleci&#243;n intracelular de potasio y el incremento en el riesgo de arritmias&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Evoluci&#243;n del perfil metab&#243;lico</span><p id="par0145" class="elsevierStylePara elsevierViewall">La mejor&#237;a del perfil metab&#243;lico en los pacientes con vol&#250;menes de sustituci&#243;n m&#225;s elevados deriva de una reducci&#243;n de los niveles de triglic&#233;ridos y un incremento en las cifras de c-HDL&#44; resultando en un menor &#237;ndice de aterogenicidad&#46; Sin embargo&#44; hay que destacar que la asociaci&#243;n del volumen convectivo con la evoluci&#243;n del perfil metab&#243;lico&#44; aunque cl&#237;nicamente significativa&#44; parece ser moderada-baja&#46; Probablemente estos cambios est&#225;n asociados a una menor inflamaci&#243;n sist&#233;mica que se observa de forma temprana tras el inicio de la t&#233;cnica&#46; Mientras que la edad avanzada se relaciona con unos vol&#250;menes convectivos m&#225;s bajos y explica la mejor evoluci&#243;n de los par&#225;metros nutricionales en los pacientes j&#243;venes &#40;con un transporte convectivo m&#225;s elevado&#41;&#44; los beneficios en el perfil lip&#237;dico e inflamatorio no tuvieron relaci&#243;n con la edad&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">A pesar de una mayor infusi&#243;n de glucosa&#44; los pacientes con altos vol&#250;menes no tuvieron peor control gluc&#233;mico de la diabetes &#40;HbA1c&#41; ni m&#225;s hipertrigliceridemia&#46; La asociaci&#243;n entre los altos vol&#250;menes y un descenso de HbA1c al aumentar la muestra &#40;por periodos de tiempo&#41; apunta a un mejor control metab&#243;lico en estos pacientes&#44; a pesar de tener una mejor evoluci&#243;n de par&#225;metros nutricionales y de&#44; probablemente&#44; una mayor ingesta diet&#233;tica&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Estos resultados sugieren que los altos vol&#250;menes no inducen negativos o delet&#233;reos en el control metab&#243;lico o la composici&#243;n corporal de los pacientes diab&#233;ticos en HDF-OL&#44; y permiten asumir la infusi&#243;n de una peque&#241;a cantidad m&#225;s de glucosa al incrementar el volumen de sustituci&#243;n&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Mientras que la mayor&#237;a de estudios encuentran que el tratamiento farmacol&#243;gico para el control de los factores de riesgo cardiovascular no es claramente efectivo en la reducci&#243;n de los eventos o de la mortalidad de los pacientes en di&#225;lisis<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">20</span></a>&#44; varios ensayos cl&#237;nicos s&#237; encuentran esta mejor&#237;a con la HDF-OL&#46; En este sentido&#44; ning&#250;n ensayo ha demostrado un claro efecto beneficioso en el manejo de la dislipidemia en la enfermedad renal cr&#243;nica en di&#225;lisis<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">21-23</span></a>&#44; pero en este caso la propia t&#233;cnica podr&#237;a contribuir a la mejor&#237;a de estos pacientes&#44; independientemente de la intervenci&#243;n farmacol&#243;gica planificada anteriormente&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Al igual que los beneficios de la HDF-OL y de los altos vol&#250;menes han sido atribuidos a m&#250;ltiples mecanismos<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">24</span></a> &#40;mejor depuraci&#243;n de toxinas ur&#233;micas&#44; menor inflamaci&#243;n&#44; m&#225;s estabilidad hemodin&#225;mica&#44; menor temperatura&#44; etc&#46;&#41;&#44; probablemente la mejor&#237;a del control metab&#243;lico tambi&#233;n tenga un origen multifactorial&#44; y no se puede descartar que esta mejor&#237;a sea en parte responsable de la reducci&#243;n del riesgo cardiovascular y la mortalidad&#46; De forma global&#44; no hay suficiente evidencia para elegir una t&#233;cnica de baja eficacia convectiva en ninguna poblaci&#243;n de pacientes en di&#225;lisis&#44; y tampoco para restringir el transporte convectivo en los pacientes diab&#233;ticos en HDF-OL por el contenido de glucosa del l&#237;quido de sustituci&#243;n&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Limitaciones</span><p id="par0170" class="elsevierStylePara elsevierViewall">La principal limitaci&#243;n del estudio es su reducido tama&#241;o muestral para el dise&#241;o observacional&#44; que no permite asumir beneficios del transporte convectivo en el perfil metab&#243;lico&#46; Por otro lado&#44; varios factores han podido influir en la cantidad de volumen convectivo alcanzado&#44; tanto dependientes del paciente &#40;edad&#44; composici&#243;n corporal&#44; anemia y hemoconcentraci&#243;n&#44; etc&#46;&#41; como de la utilizaci&#243;n de diferentes monitores y dializadores de alta permeabilidad&#46; Otras limitaciones incluyen la variabilidad del periodo de seguimiento&#44; no disponer de los cambios de dosis o la retirada de insulina e hipolipemiantes&#44; y el valor dudoso de los niveles plasm&#225;ticos de l&#237;pidos o de HbA1c en los pacientes en di&#225;lisis&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusi&#243;n</span><p id="par0175" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; no existe evidencia para limitar el transporte convectivo en los pacientes diab&#233;ticos en HDF-OL por el contenido de glucosa del l&#237;quido de sustituci&#243;n&#46; La HDF-OL con altos vol&#250;menes de sustituci&#243;n puede aportar una mejor&#237;a del control metab&#243;lico en los pacientes diab&#233;ticos en HDF-OL&#44; que podr&#237;a estar contribuyendo al beneficio en el control del riesgo cardiovascular&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0180" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes y objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La hemodiafiltraci&#243;n online &#40;HDF-OL&#41; con altos vol&#250;menes de transporte convectivo mejora la supervivencia en los pacientes en hemodi&#225;lisis&#46; Se ha propuesto limitar el volumen convectivo en los pacientes diab&#233;ticos por la carga de glucosa administrada con el l&#237;quido de sustituci&#243;n&#46; El objetivo del estudio fue analizar la influencia del volumen de sustituci&#243;n en la evoluci&#243;n del perfil metab&#243;lico y la composici&#243;n corporal de los pacientes diab&#233;ticos incidentes en HDF-OL&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional prospectivo en 29 pacientes diab&#233;ticos incidentes en HDF-OL posdiluci&#243;n&#46; Basalmente se recogieron datos cl&#237;nicos y demogr&#225;ficos&#44; par&#225;metros anal&#237;ticos metab&#243;licos&#44; nutricionales e inflamatorios&#44; y la composici&#243;n corporal por bioimpedancia espectrosc&#243;pica &#40;BIS&#41;&#46; Cada 4 meses se recogieron par&#225;metros anal&#237;ticos y el volumen de sustituci&#243;n medio por sesi&#243;n&#44; y en 23 pacientes se realiz&#243; otra BIS al menos un a&#241;o despu&#233;s&#46; Se calcularon variaciones de hemoglobina glucosilada &#40;HbA1c&#41;&#44; triglic&#233;ridos&#44; colesterol total&#44; c-LDL&#44; c-HDL&#44; alb&#250;mina&#44; prealb&#250;mina y prote&#237;na C reactiva &#40;PCR&#41; al a&#241;o&#44; 2 a&#241;os&#44; 3 a&#241;os y al final del seguimiento&#46; Se calcularon las variaciones cuatrimestrales y anuales como periodos independientes&#44; y se analizaron los cambios de composici&#243;n corporal&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La edad al inicio fue a los 69&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;6 a&#241;os&#59; el 62&#44;1&#37; eran varones&#44; de 72&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#44; 1&#44;78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;16<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#44; y con 48 &#40;35&#44;5-76&#41; meses en di&#225;lisis&#46; El 81&#44;5&#37; recib&#237;a insulinoterapia&#44; el 7&#44;4&#37; antidiab&#233;ticos y el 51&#44;9&#37; estatinas&#46; El volumen de sustituci&#243;n medio fue de 26&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n y el periodo de seguimiento &#40;tiempo en HDF-OL&#41; fue de 40&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26 meses&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se observ&#243; una correlaci&#243;n significativa entre el volumen de sustituci&#243;n medio y un incremento de los niveles de c-HDL &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;385&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;039&#41; y prealb&#250;mina &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;404&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41; a lo largo del seguimiento&#46; El volumen convectivo se asoci&#243; a la reducci&#243;n de los niveles de PCR al a&#241;o &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;531&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#44; a los 2 a&#241;os &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;463&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;046&#41; y al final del seguimiento &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;498&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#46; Los pacientes con volumen de sustituci&#243;n &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n tuvieron mayor descenso en los niveles de triglic&#233;ridos y PCR&#44; y un aumento de las cifras de c-HDL&#46; Estos pacientes con &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n finalizaron el estudio con niveles m&#225;s altos de c-HDL &#40;48&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dL vs&#46; 41&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;025&#41; y m&#225;s bajos de PCR &#40;0&#44;21 &#91;0&#44;1-2&#44;22&#93; mg&#47;dL vs&#46; 1&#44;01 &#91;0&#44;15-6&#44;96&#93; mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; sin diferencias al inicio&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Las comparaciones entre el volumen de sustituci&#243;n y los cambios anal&#237;ticos por periodos cuatrimestrales &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>271&#93; mostraron una correlaci&#243;n significativa con un descenso de HbA1c &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;146&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#44; al igual que las comparaciones por periodos anuales &#91;n&#61;72&#93; &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;237&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#46; Un volumen de sustituci&#243;n medio anual &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;6<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n &#40;29&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;7<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n vs&#46; 23&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n&#41; se asoci&#243; a un descenso de HbA1c &#40;&#8722;0&#44;51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;24&#37; vs&#46; 0&#44;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;88&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;043&#41;&#46; No se observ&#243; correlaci&#243;n entre el volumen de sustituci&#243;n y las variaciones en el peso&#44; IMC o par&#225;metros de la BIS&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Conclusi&#243;n No existe suficiente evidencia para limitar el transporte convectivo en los pacientes diab&#233;ticos en HDF-OL por el contenido de glucosa del l&#237;quido de sustituci&#243;n&#46;</p></span>"
        "secciones" => array:3 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Antecedentes y objetivo"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material y m&#233;todos"
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            "titulo" => "Resultados"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Background and objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Online haemodiafiltration &#40;OL-HDF&#41; with high convective transport volumes improves patient survival in haemodialysis&#46; Limiting the amount of convective volume has been proposed in patients with diabetes mellitus due to glucose load that is administered with replacement fluid&#46; The objective of the study was to analyse the influence of substitution volume on the evolution of the metabolic profile and body composition of incident diabetic patients on OL-HDF&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Prospective observational study in 29 incident diabetic patients on postdilution OL-HDF&#46; Baseline data included clinical and demographic data&#44; laboratory parameters &#40;metabolic&#44; nutritional and inflammatory profile&#41; and body composition with bioimpedance spectroscopy &#40;BIS&#41;&#46; Laboratory parameters and mean substitution volume per session were collected every 4 months&#44; and in 23 patients a further BIS was performed after a minimum of one year&#46; Variations in glycosylated haemoglobin &#40;HbA1c&#41;&#44; triglycerides&#44; total cholesterol&#44; LDL-c&#44; HDL-c&#44; albumin&#44; prealbumin and C reactive protein &#40;CRP&#41; were calculated at one year&#44; 2 years&#44; 3 years&#44; and at the end of follow-up&#46; Quarterly and annual variations were calculated as independent periods&#44; and changes in body composition were analysed&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Age at baseline was 69&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;6 years&#44; 62&#46;1&#37; were male&#44; 72&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;9<span class="elsevierStyleHsp" style=""></span>kg&#44; 1&#46;78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;16<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#44; with 48 &#40;35&#46;5-76&#41; months on dialysis&#46; Approximately 81&#46;5&#37; received insulin&#44; 7&#46;4&#37; antidiabetic drugs and 51&#46;9&#37; statins&#46; Mean substitution volume was 26&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;9<span class="elsevierStyleHsp" style=""></span>L&#47;session and follow-up period &#40;time on OL-HDF&#41; was 40&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26 months&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A significant correlation was observed between mean substitution volume and the increase in HDL-c &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;385&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;039&#41; and prealbumin levels &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;404&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41; throughout follow-up&#46; Moreover&#44; substitution volume was correlated with a reduction in CRP levels at one year &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#46;531&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#44; 2 years &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#46;463&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;046&#41;&#44; and at the end of follow-up &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#46;498&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#46; Patients with mean substitution volume &#62;<span class="elsevierStyleHsp" style=""></span>26&#46;9<span class="elsevierStyleHsp" style=""></span>L&#47;session had a higher reduction in triglycerides and CRP&#44; and an increase in HDL-c levels&#46; These patients with &#62;<span class="elsevierStyleHsp" style=""></span>26&#46;9<span class="elsevierStyleHsp" style=""></span>L&#47;session finished the study with higher HDL-c &#40;48&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dL vs&#46; 41&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;025&#41; and lower CRP levels &#40;0&#46;21 &#91;0&#46;1-2&#46;22&#93; mg&#47;dL vs&#46; 1&#46;01 &#91;0&#46;15-6&#46;96&#93; mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; with no differences at baseline&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Quarterly comparisons between substitution volume and laboratory changes &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>271&#93; showed a significant correlation with a reduction in HbA1c &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#46;146&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;021&#41;&#46; Similar findings were obtained with annual comparisons &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>72&#93; &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#46;237&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;045&#41;&#46; An annual mean substitution volume over 26&#46;6<span class="elsevierStyleHsp" style=""></span>L&#47;session &#40;29&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;7<span class="elsevierStyleHsp" style=""></span>L&#47;session vs&#46; 23&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9<span class="elsevierStyleHsp" style=""></span>L&#47;session&#41; was associated with a reduction in HbA1c &#40;&#8211;0&#46;51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;24&#37; vs&#46; 0&#46;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;88&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;043&#41;&#46; No correlation was observed between substitution volume and changes in weight&#44; body mass index or BIS parameters&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusion</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">There is not enough evidence to restrict convective transport in diabetic patients on OL-HDF due to the glucose content of the replacement fluid&#46;</p></span>"
        "secciones" => array:4 [
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            "titulo" => "Background and objective"
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          1 => array:2 [
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            "titulo" => "Material and methods"
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            "titulo" => "Results"
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          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Diferencias en la evoluci&#243;n de los niveles plasm&#225;ticos seg&#250;n la media de volumen de sustituci&#243;n &#40;columna izquierda&#41; y de volumen de sustituci&#243;n ajustado a la superficie corporal &#40;columna derecha&#41;&#46;</p>"
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">c-HDL&#58; colesterol ligado a lipoprote&#237;nas de alta densidad&#59; c-LDL&#58; colesterol ligado a lipoprote&#237;nas de baja densidad&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; DM&#58; diabetes mellitus&#59; ERC&#58; enfermedad renal cr&#243;nica&#59; FAV&#58; f&#237;stula arteriovenosa&#59; HbA1c&#58; hemoglobina glucosilada&#59; IFCC&#58; <span class="elsevierStyleItalic">International Federation of Clinical Chemistry and Laboratory Medicine</span>&#59; IMC&#58; &#237;ndice de masa corporal&#59; PCR&#58; prote&#237;na C reactiva&#59; TRS&#58; tratamiento renal sustitutivo&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo&#58; var&#243;n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otras&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Acceso vascular&#58; FAV &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">IMC &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">27&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Superficie corporal &#40;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">DM tipo 1 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#44;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">DM tipo 2 &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">96&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Insulinoterapia &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Antidiab&#233;ticos orales &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Dieta y ejercicio &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Estatinas &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#44;96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;3 &#47; 52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Triglic&#233;ridos &#40;mg&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">133&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>58&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">153&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>37&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">c-HDL &#40;mg&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">c-LDL &#40;mg&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Agua corporal total &#40;L&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Masa magra &#40;kg&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">&#205;ndice tejido magro &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">&#205;ndice tejido graso &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">No se encontraron diferencias significativas en los par&#225;metros de laboratorio basales ni en la composici&#243;n corporal al inicio del estudio entre ambos grupos&#46; Test de Mann-Whitney y Chi cuadrado&#47;test exacto de Fisher&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">BIS&#58; bioimpedancia espectrosc&#243;pica&#59; c-HDL&#58; colesterol ligado a lipoprote&#237;nas de alta densidad&#59; c-LDL&#58; colesterol ligado a lipoprote&#237;nas de baja densidad&#59; HbA1c&#58; hemoglobina glucosilada&#59; HDF-OL&#58; hemodiafiltraci&#243;n online&#59; IMC&#58; &#237;ndice de masa corporal&#59; n&#46;s&#46;&#58; no significativo&#59; PCR&#58; prote&#237;na C reactiva&#59; TG&#58; triglic&#233;ridos&#59; TRS&#58; tratamiento renal sustitutivo&#46;</p>"
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alb&#250;mina &#40;g&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Prealb&#250;mina &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PCR &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cambios anuales en los par&#225;metros de laboratorio</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HbA1c &#40;&#37;&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TG &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Colesterol &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>c-LDL &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;041&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alb&#250;mina &#40;g&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Prealb&#250;mina &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PCR &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo entre BIS &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peso &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;0&#44;066<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;08&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Agua extracelular &#40;L&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#8722;0&#44;06<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;20&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Agua intracelular &#40;L&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;37<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;79&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masa magra &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;Constante&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;497&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;682&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;528&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;602&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;418&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;528&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#44;964&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vol&#46; sustituci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;432&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;647&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;667&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;510&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R<span class="elsevierStyleSup">2</span> corregida&#58; 0&#44;300</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Modelo 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Coeficientes no estandarizados</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coeficientes tipificados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Error t&#237;p&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Beta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">t&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Sig&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;Constante&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#44;911&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;502&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;624&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;221&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;166&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;248&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;335&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;205&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;3&#44;600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;535&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;157&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;794&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;442&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tiempo de seguimiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;087&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;086&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;208&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;023&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;325&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vol&#46; sustituci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;212&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;826&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;046&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;256&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;802&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prealb&#250;mina basal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;570&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;245&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;396&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#44;326&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;037</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Prealb&#250;mina 1&#46;<span class="elsevierStyleSup">er</span> a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;362&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;320&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;130&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;279&nbsp;\t\t\t\t\t\t\n
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Original
Los altos volúmenes convectivos se asocian a la mejoría del perfil metabólico en los pacientes diabéticos en hemodiafiltración online
High convective volumes are associated with improvement in metabolic profile in diabetic patients on online haemodiafiltration
Nicolás Macías
Autor para correspondencia
nicomc13@gmail.com

Autor para correspondencia.
, Soraya Abad, Almudena Vega, Santiago Cedeño, Alba Santos, Úrsula Verdalles, Tania Linares, Inés Aragoncillo, Isabel Galán, Ana García-Prieto, José Luño, Juan Manuel López Gómez
Servicio de Nefrología, Hospital Gregorio Marañón, Madrid, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">En los &#250;ltimos a&#241;os el desarrollo de las t&#233;cnicas convectivas ha contribuido a numerosos beneficios en los pacientes con enfermedad renal cr&#243;nica avanzada &#40;ERCA&#41; en hemodi&#225;lisis<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; La hemodiafiltraci&#243;n online &#40;HDF-OL&#41; posdiluci&#243;n se considera la t&#233;cnica m&#225;s eficaz al combinar elevados aclaramientos por difusi&#243;n con altos vol&#250;menes de transporte convectivo<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">3</span></a>&#46; La utilizaci&#243;n de nuevos dializadores&#44; la fabricaci&#243;n online del l&#237;quido de di&#225;lisis o los monitores y biocontroles que optimizan la tasa de sustituci&#243;n han permitido mejorar el rendimiento e incrementar el transporte convectivo en los pacientes en HDF-OL&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La cantidad de transporte convectivo parece tratarse de un factor determinante en conseguir estos beneficios&#58; mientras que la mayor&#237;a de t&#233;cnicas de hemofiltraci&#243;n o hemodiafiltraci&#243;n con vol&#250;menes convectivos m&#225;s bajos no muestran mejor&#237;as en la supervivencia respecto a la hemodi&#225;lisis de alto flujo&#44; la HDF-OL con vol&#250;menes de sustituci&#243;n &#62;<span class="elsevierStyleHsp" style=""></span>23<span class="elsevierStyleHsp" style=""></span>L por sesi&#243;n&#44; &#62;<span class="elsevierStyleHsp" style=""></span>69<span class="elsevierStyleHsp" style=""></span>L por semana o &#62;<span class="elsevierStyleHsp" style=""></span>23<span class="elsevierStyleHsp" style=""></span>L&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> por sesi&#243;n ha demostrado una reducci&#243;n de la mortalidad<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">4-6</span></a>&#44; que fundamentalmente se debe a una reducci&#243;n de la mortalidad cardiovascular<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">7&#44;8</span></a>&#46; Aunque ninguno de los estudios fueron dise&#241;ados para evaluar el efecto &#171;convectivo-dependiente&#187;&#44; estos beneficios parecen ser m&#225;s notables cuanto mayor es la dosis de convecci&#243;n<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Se ha planteado la posibilidad de que el contenido de glucosa del l&#237;quido de sustituci&#243;n pueda suponer un exceso o una carga extra de glucosa que se administra al paciente durante el tratamiento&#44; lo cual ser&#237;a un factor limitante del volumen de sustituci&#243;n en los pacientes con intolerancia a los hidratos de carbono o diabetes mellitus<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">10&#44;11</span></a>&#46; Hasta el momento no existen datos acerca de que la glucosa infundida con las t&#233;cnicas convectivas contribuya a un peor control metab&#243;lico o a empeorar el riesgo cardiovascular en estos pacientes&#46; De hecho&#44; los primeros beneficios que se observaron al incorporar el transporte convectivo con membranas de alto flujo fueron en los pacientes diab&#233;ticos<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">12</span></a>&#44; y los an&#225;lisis de los estudios en HDF-OL muestran que los resultados en la mejor&#237;a de la supervivencia y en la reducci&#243;n de la mortalidad cardiovascular son independientes de subgrupos incluyendo estos pacientes<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">5&#44;13</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El objetivo de este estudio fue analizar la influencia del volumen de sustituci&#243;n en la evoluci&#243;n del perfil metab&#243;lico y la composici&#243;n corporal de los pacientes diab&#233;ticos con ERCA en hemodi&#225;lisis&#44; desde su inicio en HDF-OL&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Material y m&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Dise&#241;o</span>&#46; Es un estudio observacional prospectivo llevado a cabo en los pacientes diab&#233;ticos incidentes en la t&#233;cnica HDF-OL posdiluci&#243;n desde su inicio hasta finalizar el a&#241;o 2016&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Criterios de inclusi&#243;n</span>&#46; Pacientes mayores de 18 a&#241;os&#44; con ERCA en tratamiento renal sustitutivo&#44; diagnosticados de diabetes mellitus antes de iniciar HDF-OL&#44; y con pauta de HDF-OL&#58; 3 sesiones semanales de 4<span class="elsevierStyleHsp" style=""></span>h&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Un total de 29 pacientes fueron incluidos en el estudio&#58; 11 pacientes iniciaron HDF-OL como t&#233;cnica inicial de di&#225;lisis tras un periodo de 4 semanas de adaptaci&#243;n en hemodi&#225;lisis de alto flujo y 18 pacientes cambiaron de t&#233;cnica de di&#225;lisis &#40;17 desde hemodi&#225;lisis de alto flujo y uno desde di&#225;lisis peritoneal&#41;&#46; Todos firmaron un consentimiento informado&#44; y el estudio cumple con los principios de la &#250;ltima Declaraci&#243;n de Helsinki&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Variables</span>&#46; Basalmente se recogieron datos cl&#237;nicos y demogr&#225;ficos&#44; el tratamiento con insulina&#44; antidiab&#233;ticos y&#47;o hipolipemiantes&#44; par&#225;metros de laboratorio metab&#243;licos&#44; nutricionales e inflamatorios &#40;hemoglobina glucosilada &#91;HbA1c&#93;&#44; triglic&#233;ridos&#44; colesterol total&#44; c-LDL&#44; c-HDL&#44; alb&#250;mina&#44; prealb&#250;mina y prote&#237;na C reactiva &#91;PCR&#93;&#41;&#44; medidas antropom&#233;tricas y la composici&#243;n corporal por bioimpedancia espectrosc&#243;pica &#40;BIS&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se recogi&#243; el volumen de sustituci&#243;n y el volumen convectivo &#40;sustituci&#243;n m&#225;s ultrafiltraci&#243;n&#41; de cada sesi&#243;n de HDF-OL y se calcularon los vol&#250;menes medios por sesi&#243;n cada 4 meses&#46; El volumen de sustituci&#243;n se ajust&#243; adem&#225;s a la superficie corporal para estandarizar la dosis de convecci&#243;n&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Cada 4 meses se recogieron los par&#225;metros de laboratorio y medidas antropom&#233;tricas&#46; En 23 pacientes se realiz&#243; otro an&#225;lisis de composici&#243;n corporal por BIS despu&#233;s de al menos un a&#241;o de seguimiento&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Se utilizaron monitores 4008 &#40;FMC<span class="elsevierStyleSup">&#174;</span>&#41;&#44; 5008 &#40;FMC<span class="elsevierStyleSup">&#174;</span>&#41;&#44; AK200U &#40;Baxter<span class="elsevierStyleSup">&#174;</span>&#41;&#44; Artis &#40;Baxter<span class="elsevierStyleSup">&#174;</span>&#41;&#44; DBB-07 y DBB-EXA &#40;Nikkiso<span class="elsevierStyleSup">&#174;</span>&#41; y dializadores de alta permeabilidad FX80 &#40;FMC<span class="elsevierStyleSup">&#174;</span>&#41;&#44; 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para evaluar la asociaci&#243;n independiente con las variaciones en el tiempo&#46; Se consider&#243; significativo un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 con un intervalo de confianza del 95&#37;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Resultados</span><p id="par0065" class="elsevierStylePara elsevierViewall">Los datos cl&#237;nicos&#44; antropom&#233;tricos&#44; de laboratorio y BIS al inicio del estudio se recogen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; El tiempo de seguimiento &#40;tiempo en HDF-OL&#41; fue de 40&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26 meses &#40;m&#237;n&#58; 12&#44; m&#225;x&#58; 101&#59; mediana &#91;RIC&#93;&#58; 35 &#91;19&#44;5-63&#93; meses&#41;&#46; Al final del estudio&#44; 16 pacientes continuaban en HDF-OL&#44; 2 cambiaron a hemodi&#225;lisis de alto flujo&#44; 2 recibieron un trasplante renal&#44; y 9 &#40;31&#37;&#41; hab&#237;an muerto&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">El volumen de sustituci&#243;n medio fue de 26&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n &#40;m&#237;n&#58; 20&#44;5<span class="elsevierStyleHsp" style=""></span>L&#44; m&#225;x&#58; 32&#44;9<span class="elsevierStyleHsp" style=""></span>L&#41; o 26&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;2<span class="elsevierStyleHsp" style=""></span>L&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#47;sesi&#243;n &#40;m&#237;n&#58; 19&#44;5<span class="elsevierStyleHsp" style=""></span>L&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#44; m&#225;x&#58; 40&#44;3<span class="elsevierStyleHsp" style=""></span>L&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&#46; No hubo variaciones significativas del volumen de sustituci&#243;n a lo largo del seguimiento&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Se observ&#243; una correlaci&#243;n significativa entre el volumen de sustituci&#243;n medio y un incremento de los niveles de c-HDL &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;385&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;039&#41; y prealb&#250;mina &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;404&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41; a lo largo del seguimiento&#46; Adem&#225;s&#44; se encontr&#243; una correlaci&#243;n significativa entre el volumen de sustituci&#243;n y la reducci&#243;n de los niveles de PCR al a&#241;o &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;531&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#44; a los 2 a&#241;os &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;463&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;046&#41; y al final del seguimiento &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;498&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#46; Al ajustar el volumen sustituido a la superficie corporal&#44; tambi&#233;n se encontr&#243; una correlaci&#243;n significativa con la reducci&#243;n de los niveles de triglic&#233;ridos &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;423&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;022&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> muestra las diferencias en la evoluci&#243;n de los par&#225;metros de laboratorio y de la composici&#243;n corporal en los pacientes con un volumen de sustituci&#243;n por encima o por debajo de la media del estudio&#46; Los pacientes con volumen de sustituci&#243;n m&#225;s bajo &#40;&#60;<span class="elsevierStyleHsp" style=""></span>26&#44; 9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n&#41; ten&#237;an mayor edad y un seguimiento m&#225;s prolongado&#46; Los pacientes con volumen de sustituci&#243;n &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n tuvieron mayor descenso en los niveles de triglic&#233;ridos y PCR&#44; y un aumento de las cifras de c-HDL &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">La edad se correlacion&#243; con un mayor descenso de alb&#250;mina s&#233;rica cada a&#241;o &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;515&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41; y al final del seguimiento &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;655&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; con un mayor descenso de prealb&#250;mina cada a&#241;o &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;617&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y al final del seguimiento &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;673&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; y con vol&#250;menes convectivos m&#225;s bajos &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;516&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">En el modelo 1 del an&#225;lisis de regresi&#243;n multivariante &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; &#250;nicamente se mantiene la edad como predictor independiente de la reducci&#243;n de prealb&#250;mina a lo largo del seguimiento&#46; En el modelo 2 solo se mantiene la asociaci&#243;n independiente con los niveles de prealb&#250;mina y el peso al inicio del estudio&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Las comparaciones entre el volumen de sustituci&#243;n y los cambios anal&#237;ticos por periodos cuatrimestrales &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>271&#93; mostraron una correlaci&#243;n significativa con un descenso de HbA1c &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;146&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#44; al igual que las comparaciones por periodos anuales &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>72&#93; &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;237&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#46; Un volumen de sustituci&#243;n medio anual &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;6<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n &#40;29&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;7<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n vs&#46; 23&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n&#41; se asoci&#243; a un descenso de HbA1c &#40;&#8722;0&#44;51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;24&#37; vs&#46; 0&#44;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;88&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;043&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">No se observ&#243; correlaci&#243;n entre el volumen de sustituci&#243;n y las variaciones en el peso&#44; IMC o par&#225;metros de la BIS en el periodo entre las determinaciones&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">No se encontr&#243; relaci&#243;n entre el volumen convectivo y los par&#225;metros de laboratorio o composici&#243;n corporal al inicio del estudio&#46; Los pacientes con volumen convectivo m&#225;s elevado &#40;sustituci&#243;n media &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n&#41; finalizaron el estudio con niveles m&#225;s altos de c-HDL &#40;48&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dL vs&#46; 41&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;025&#41; y m&#225;s bajos de PCR &#40;0&#44;21 &#91;0&#44;1-2&#44;22&#93; mg&#47;dL vs&#46; 1&#44;01 &#91;0&#44;15-6&#44;96&#93; mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Los pacientes en tratamiento con estatinas finalizaron el estudio con niveles m&#225;s bajos de c-LDL &#40;60&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>29&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dL vs&#46; 80&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#44;8<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;028&#41;&#44; aunque no se encontraron diferencias significativas en la reducci&#243;n de los niveles en el seguimiento &#40;&#8722;21&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>36&#44;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dL vs&#46; &#8722;4&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#44;1<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;186&#41;&#46; Un paciente recib&#237;a ezetimiba asociada a atorvastatina&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Ning&#250;n paciente inici&#243; insulinoterapia una vez iniciado el estudio&#46; No se recogieron cambios de dosis ni discontinuaci&#243;n de insulinoterapia a lo largo del seguimiento&#46; No hubo diferencias en la evoluci&#243;n del perfil metab&#243;lico-nutricional ni en los cambios de composici&#243;n corporal en los pacientes con y sin insulinoterapia o antidiab&#233;ticos orales &#40;linagliptina&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Discusi&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">El estudio sugiere que los altos vol&#250;menes de sustituci&#243;n no suponen un empeoramiento del perfil metab&#243;lico en los pacientes con diabetes mellitus en hemodi&#225;lisis&#46; Asumiendo la infusi&#243;n de m&#225;s cantidad de glucosa durante el tratamiento&#44; encontramos una mejor&#237;a del perfil metab&#243;lico asociada a los altos vol&#250;menes convectivos&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Balance de glucosa en hemodiafiltraci&#243;n online &#40;HDF-OL&#41; posdiluci&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">El balance de glucosa a lo largo de una sesi&#243;n de HDF-OL no solo depende de la glucosa infundida&#44; sino que est&#225; condicionada por el transporte a trav&#233;s de la membrana y&#44; fundamentalmente&#44; por la glucemia&#46; De esta manera&#44; existe transporte difusivo &#40;al tratarse de un soluto de bajo peso molecular&#41; y existe p&#233;rdida de glucosa por convecci&#243;n con la ultrafiltraci&#243;n &#40;con un coeficiente de cribado cercano a 1 con membranas de alta permeabilidad<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">15</span></a>&#41;&#44; tanto de la ganancia de fluidos del periodo interdi&#225;lisis como del exceso de ultrafiltraci&#243;n que ha de reemplazarse en la l&#237;nea venosa &#40;HDF-OL posdiluci&#243;n&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">La concentraci&#243;n de glucosa m&#225;s utilizada del ba&#241;o de di&#225;lisis y&#44; en el caso de HDF-OL&#44; del l&#237;quido de sustituci&#243;n&#44; es de 100-200<span class="elsevierStyleHsp" style=""></span>mg&#47;dL<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">16&#44;17</span></a>&#46; Excluyendo la p&#233;rdida de glucosa por ultrafiltraci&#243;n que se produce si existe balance negativo&#44; la transferencia de glucosa depender&#225; de la diferencia de concentraci&#243;n entre la sangre y el l&#237;quido de di&#225;lisis &#40;con 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL en nuestro caso&#41;&#58; los pacientes con glucemias en torno a 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL tendr&#225;n un balance neutro de glucosa &#40;tanto por difusi&#243;n como por ultrafiltraci&#243;n y reinfusi&#243;n del l&#237;quido&#41;&#59; los pacientes con glucemias &#62;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL tendr&#225;n un balance negativo de glucosa &#40;tanto por difusi&#243;n como por ultrafiltraci&#243;n y reinfusi&#243;n del l&#237;quido con menor concentraci&#243;n de glucosa que la plasm&#225;tica&#41; y&#44; por tanto&#44; &#250;nicamente los pacientes con glucemias &#60;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL tendr&#225;n un balance positivo tanto por difusi&#243;n como por convecci&#243;n&#46; Del mismo modo&#44; las p&#233;rdidas de glucosa al eliminar la sobrecarga h&#237;drica tambi&#233;n ser&#225;n variables dependiendo de la glucemia &#40;p&#233;rdida de 1<span class="elsevierStyleHsp" style=""></span>g&#47;L de UF por cada 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL de glucemia&#41;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Seg&#250;n este modelo&#44; solo con glucemias &#60;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL el incremento del volumen de sustituci&#243;n supone un peque&#241;o aumento en la cantidad de glucosa infundida &#40;por ejemplo&#44; 10<span class="elsevierStyleHsp" style=""></span>g m&#225;s de glucosa al aumentar de 25 a 35<span class="elsevierStyleHsp" style=""></span>L el volumen de sustituci&#243;n en una sesi&#243;n de HDF-OL&#41;&#44; pero con glucemias &#62;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL el aumento del volumen de sustituci&#243;n supone una mayor eliminaci&#243;n de glucosa por transporte convectivo &#40;al ultrafiltrar un agua plasm&#225;tica con mayor concentraci&#243;n de glucosa que la infundida&#41;&#46; Estos modelos te&#243;ricos no tienen en cuenta la variabilidad de la glucemia a lo largo de la sesi&#243;n&#44; que esta se ve modificada por las concentraciones de glucosa del ba&#241;o y por m&#250;ltiples mecanismos externos al tratamiento &#40;hormonales&#44; corticoides&#44; catecolaminas&#44; la ingesta&#44; etc&#46;&#41;&#44; ni la interferencia entre los transportes difusivo y convectivo en el dializador&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">La hip&#243;tesis de que una mayor infusi&#243;n pueda suponer una mayor carga de glucosa&#44; si bien no apoya la tendencia a reducir el volumen de sustituci&#243;n por las numerosas ventajas asociadas a los altos transportes convectivos&#44; podr&#237;a plantear la realizaci&#243;n de otros estudios utilizando diferentes concentraciones de glucosa en el ba&#241;o&#46; Algunos estudios en pacientes no diab&#233;ticos en hemodi&#225;lisis convencional no encuentran cambios hemodin&#225;micos al eliminar la glucosa del l&#237;quido<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">18</span></a>&#44; y es raro desarrollar hipoglucemias con los ba&#241;os de di&#225;lisis sin glucosa<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">19</span></a>&#46; Aunque el uso potencial de l&#237;quidos de di&#225;lisis con concentraciones m&#225;s bajas pudiera conllevar cambios en el balance de glucosa&#44; deber&#237;an evaluarse tanto los cambios osmolares derivados de la menor concentraci&#243;n en el l&#237;quido como las modificaciones necesarias en la conductividad &#40;para evitar descensos bruscos en la volemia&#41; o en la concentraci&#243;n de potasio en el ba&#241;o &#40;al condicionar una menor secreci&#243;n de insulina y mayor eliminaci&#243;n de potasio&#41;&#44; y las consecuencias de estas modificaciones a largo plazo &#40;como un aumento de la transferencia de sodio&#44; o la depleci&#243;n intracelular de potasio y el incremento en el riesgo de arritmias&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Evoluci&#243;n del perfil metab&#243;lico</span><p id="par0145" class="elsevierStylePara elsevierViewall">La mejor&#237;a del perfil metab&#243;lico en los pacientes con vol&#250;menes de sustituci&#243;n m&#225;s elevados deriva de una reducci&#243;n de los niveles de triglic&#233;ridos y un incremento en las cifras de c-HDL&#44; resultando en un menor &#237;ndice de aterogenicidad&#46; Sin embargo&#44; hay que destacar que la asociaci&#243;n del volumen convectivo con la evoluci&#243;n del perfil metab&#243;lico&#44; aunque cl&#237;nicamente significativa&#44; parece ser moderada-baja&#46; Probablemente estos cambios est&#225;n asociados a una menor inflamaci&#243;n sist&#233;mica que se observa de forma temprana tras el inicio de la t&#233;cnica&#46; Mientras que la edad avanzada se relaciona con unos vol&#250;menes convectivos m&#225;s bajos y explica la mejor evoluci&#243;n de los par&#225;metros nutricionales en los pacientes j&#243;venes &#40;con un transporte convectivo m&#225;s elevado&#41;&#44; los beneficios en el perfil lip&#237;dico e inflamatorio no tuvieron relaci&#243;n con la edad&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">A pesar de una mayor infusi&#243;n de glucosa&#44; los pacientes con altos vol&#250;menes no tuvieron peor control gluc&#233;mico de la diabetes &#40;HbA1c&#41; ni m&#225;s hipertrigliceridemia&#46; La asociaci&#243;n entre los altos vol&#250;menes y un descenso de HbA1c al aumentar la muestra &#40;por periodos de tiempo&#41; apunta a un mejor control metab&#243;lico en estos pacientes&#44; a pesar de tener una mejor evoluci&#243;n de par&#225;metros nutricionales y de&#44; probablemente&#44; una mayor ingesta diet&#233;tica&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Estos resultados sugieren que los altos vol&#250;menes no inducen negativos o delet&#233;reos en el control metab&#243;lico o la composici&#243;n corporal de los pacientes diab&#233;ticos en HDF-OL&#44; y permiten asumir la infusi&#243;n de una peque&#241;a cantidad m&#225;s de glucosa al incrementar el volumen de sustituci&#243;n&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Mientras que la mayor&#237;a de estudios encuentran que el tratamiento farmacol&#243;gico para el control de los factores de riesgo cardiovascular no es claramente efectivo en la reducci&#243;n de los eventos o de la mortalidad de los pacientes en di&#225;lisis<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">20</span></a>&#44; varios ensayos cl&#237;nicos s&#237; encuentran esta mejor&#237;a con la HDF-OL&#46; En este sentido&#44; ning&#250;n ensayo ha demostrado un claro efecto beneficioso en el manejo de la dislipidemia en la enfermedad renal cr&#243;nica en di&#225;lisis<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">21-23</span></a>&#44; pero en este caso la propia t&#233;cnica podr&#237;a contribuir a la mejor&#237;a de estos pacientes&#44; independientemente de la intervenci&#243;n farmacol&#243;gica planificada anteriormente&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Al igual que los beneficios de la HDF-OL y de los altos vol&#250;menes han sido atribuidos a m&#250;ltiples mecanismos<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">24</span></a> &#40;mejor depuraci&#243;n de toxinas ur&#233;micas&#44; menor inflamaci&#243;n&#44; m&#225;s estabilidad hemodin&#225;mica&#44; menor temperatura&#44; etc&#46;&#41;&#44; probablemente la mejor&#237;a del control metab&#243;lico tambi&#233;n tenga un origen multifactorial&#44; y no se puede descartar que esta mejor&#237;a sea en parte responsable de la reducci&#243;n del riesgo cardiovascular y la mortalidad&#46; De forma global&#44; no hay suficiente evidencia para elegir una t&#233;cnica de baja eficacia convectiva en ninguna poblaci&#243;n de pacientes en di&#225;lisis&#44; y tampoco para restringir el transporte convectivo en los pacientes diab&#233;ticos en HDF-OL por el contenido de glucosa del l&#237;quido de sustituci&#243;n&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Limitaciones</span><p id="par0170" class="elsevierStylePara elsevierViewall">La principal limitaci&#243;n del estudio es su reducido tama&#241;o muestral para el dise&#241;o observacional&#44; que no permite asumir beneficios del transporte convectivo en el perfil metab&#243;lico&#46; Por otro lado&#44; varios factores han podido influir en la cantidad de volumen convectivo alcanzado&#44; tanto dependientes del paciente &#40;edad&#44; composici&#243;n corporal&#44; anemia y hemoconcentraci&#243;n&#44; etc&#46;&#41; como de la utilizaci&#243;n de diferentes monitores y dializadores de alta permeabilidad&#46; Otras limitaciones incluyen la variabilidad del periodo de seguimiento&#44; no disponer de los cambios de dosis o la retirada de insulina e hipolipemiantes&#44; y el valor dudoso de los niveles plasm&#225;ticos de l&#237;pidos o de HbA1c en los pacientes en di&#225;lisis&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusi&#243;n</span><p id="par0175" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; no existe evidencia para limitar el transporte convectivo en los pacientes diab&#233;ticos en HDF-OL por el contenido de glucosa del l&#237;quido de sustituci&#243;n&#46; La HDF-OL con altos vol&#250;menes de sustituci&#243;n puede aportar una mejor&#237;a del control metab&#243;lico en los pacientes diab&#233;ticos en HDF-OL&#44; que podr&#237;a estar contribuyendo al beneficio en el control del riesgo cardiovascular&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0180" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes y objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La hemodiafiltraci&#243;n online &#40;HDF-OL&#41; con altos vol&#250;menes de transporte convectivo mejora la supervivencia en los pacientes en hemodi&#225;lisis&#46; Se ha propuesto limitar el volumen convectivo en los pacientes diab&#233;ticos por la carga de glucosa administrada con el l&#237;quido de sustituci&#243;n&#46; El objetivo del estudio fue analizar la influencia del volumen de sustituci&#243;n en la evoluci&#243;n del perfil metab&#243;lico y la composici&#243;n corporal de los pacientes diab&#233;ticos incidentes en HDF-OL&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional prospectivo en 29 pacientes diab&#233;ticos incidentes en HDF-OL posdiluci&#243;n&#46; Basalmente se recogieron datos cl&#237;nicos y demogr&#225;ficos&#44; par&#225;metros anal&#237;ticos metab&#243;licos&#44; nutricionales e inflamatorios&#44; y la composici&#243;n corporal por bioimpedancia espectrosc&#243;pica &#40;BIS&#41;&#46; Cada 4 meses se recogieron par&#225;metros anal&#237;ticos y el volumen de sustituci&#243;n medio por sesi&#243;n&#44; y en 23 pacientes se realiz&#243; otra BIS al menos un a&#241;o despu&#233;s&#46; Se calcularon variaciones de hemoglobina glucosilada &#40;HbA1c&#41;&#44; triglic&#233;ridos&#44; colesterol total&#44; c-LDL&#44; c-HDL&#44; alb&#250;mina&#44; prealb&#250;mina y prote&#237;na C reactiva &#40;PCR&#41; al a&#241;o&#44; 2 a&#241;os&#44; 3 a&#241;os y al final del seguimiento&#46; Se calcularon las variaciones cuatrimestrales y anuales como periodos independientes&#44; y se analizaron los cambios de composici&#243;n corporal&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La edad al inicio fue a los 69&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;6 a&#241;os&#59; el 62&#44;1&#37; eran varones&#44; de 72&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#44; 1&#44;78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;16<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#44; y con 48 &#40;35&#44;5-76&#41; meses en di&#225;lisis&#46; El 81&#44;5&#37; recib&#237;a insulinoterapia&#44; el 7&#44;4&#37; antidiab&#233;ticos y el 51&#44;9&#37; estatinas&#46; El volumen de sustituci&#243;n medio fue de 26&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n y el periodo de seguimiento &#40;tiempo en HDF-OL&#41; fue de 40&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26 meses&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se observ&#243; una correlaci&#243;n significativa entre el volumen de sustituci&#243;n medio y un incremento de los niveles de c-HDL &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;385&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;039&#41; y prealb&#250;mina &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;404&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41; a lo largo del seguimiento&#46; El volumen convectivo se asoci&#243; a la reducci&#243;n de los niveles de PCR al a&#241;o &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;531&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#44; a los 2 a&#241;os &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;463&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;046&#41; y al final del seguimiento &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;498&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#46; Los pacientes con volumen de sustituci&#243;n &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n tuvieron mayor descenso en los niveles de triglic&#233;ridos y PCR&#44; y un aumento de las cifras de c-HDL&#46; Estos pacientes con &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n finalizaron el estudio con niveles m&#225;s altos de c-HDL &#40;48&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dL vs&#46; 41&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;025&#41; y m&#225;s bajos de PCR &#40;0&#44;21 &#91;0&#44;1-2&#44;22&#93; mg&#47;dL vs&#46; 1&#44;01 &#91;0&#44;15-6&#44;96&#93; mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; sin diferencias al inicio&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Las comparaciones entre el volumen de sustituci&#243;n y los cambios anal&#237;ticos por periodos cuatrimestrales &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>271&#93; mostraron una correlaci&#243;n significativa con un descenso de HbA1c &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;146&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#44; al igual que las comparaciones por periodos anuales &#91;n&#61;72&#93; &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;237&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#46; Un volumen de sustituci&#243;n medio anual &#62;<span class="elsevierStyleHsp" style=""></span>26&#44;6<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n &#40;29&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;7<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n vs&#46; 23&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;9<span class="elsevierStyleHsp" style=""></span>L&#47;sesi&#243;n&#41; se asoci&#243; a un descenso de HbA1c &#40;&#8722;0&#44;51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;24&#37; vs&#46; 0&#44;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;88&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;043&#41;&#46; No se observ&#243; correlaci&#243;n entre el volumen de sustituci&#243;n y las variaciones en el peso&#44; IMC o par&#225;metros de la BIS&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Conclusi&#243;n No existe suficiente evidencia para limitar el transporte convectivo en los pacientes diab&#233;ticos en HDF-OL por el contenido de glucosa del l&#237;quido de sustituci&#243;n&#46;</p></span>"
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        "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Background and objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Online haemodiafiltration &#40;OL-HDF&#41; with high convective transport volumes improves patient survival in haemodialysis&#46; Limiting the amount of convective volume has been proposed in patients with diabetes mellitus due to glucose load that is administered with replacement fluid&#46; The objective of the study was to analyse the influence of substitution volume on the evolution of the metabolic profile and body composition of incident diabetic patients on OL-HDF&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Prospective observational study in 29 incident diabetic patients on postdilution OL-HDF&#46; Baseline data included clinical and demographic data&#44; laboratory parameters &#40;metabolic&#44; nutritional and inflammatory profile&#41; and body composition with bioimpedance spectroscopy &#40;BIS&#41;&#46; Laboratory parameters and mean substitution volume per session were collected every 4 months&#44; and in 23 patients a further BIS was performed after a minimum of one year&#46; Variations in glycosylated haemoglobin &#40;HbA1c&#41;&#44; triglycerides&#44; total cholesterol&#44; LDL-c&#44; HDL-c&#44; albumin&#44; prealbumin and C reactive protein &#40;CRP&#41; were calculated at one year&#44; 2 years&#44; 3 years&#44; and at the end of follow-up&#46; Quarterly and annual variations were calculated as independent periods&#44; and changes in body composition were analysed&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Age at baseline was 69&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;6 years&#44; 62&#46;1&#37; were male&#44; 72&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;9<span class="elsevierStyleHsp" style=""></span>kg&#44; 1&#46;78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;16<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#44; with 48 &#40;35&#46;5-76&#41; months on dialysis&#46; Approximately 81&#46;5&#37; received insulin&#44; 7&#46;4&#37; antidiabetic drugs and 51&#46;9&#37; statins&#46; Mean substitution volume was 26&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;9<span class="elsevierStyleHsp" style=""></span>L&#47;session and follow-up period &#40;time on OL-HDF&#41; was 40&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>26 months&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A significant correlation was observed between mean substitution volume and the increase in HDL-c &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;385&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;039&#41; and prealbumin levels &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;404&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41; throughout follow-up&#46; Moreover&#44; substitution volume was correlated with a reduction in CRP levels at one year &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#46;531&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41;&#44; 2 years &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#46;463&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;046&#41;&#44; and at the end of follow-up &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#46;498&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#46; Patients with mean substitution volume &#62;<span class="elsevierStyleHsp" style=""></span>26&#46;9<span class="elsevierStyleHsp" style=""></span>L&#47;session had a higher reduction in triglycerides and CRP&#44; and an increase in HDL-c levels&#46; These patients with &#62;<span class="elsevierStyleHsp" style=""></span>26&#46;9<span class="elsevierStyleHsp" style=""></span>L&#47;session finished the study with higher HDL-c &#40;48&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dL vs&#46; 41&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;6<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;025&#41; and lower CRP levels &#40;0&#46;21 &#91;0&#46;1-2&#46;22&#93; mg&#47;dL vs&#46; 1&#46;01 &#91;0&#46;15-6&#46;96&#93; mg&#47;dL&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; with no differences at baseline&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Quarterly comparisons between substitution volume and laboratory changes &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>271&#93; showed a significant correlation with a reduction in HbA1c &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#46;146&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;021&#41;&#46; Similar findings were obtained with annual comparisons &#91;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>72&#93; &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8211;0&#46;237&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;045&#41;&#46; An annual mean substitution volume over 26&#46;6<span class="elsevierStyleHsp" style=""></span>L&#47;session &#40;29&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;7<span class="elsevierStyleHsp" style=""></span>L&#47;session vs&#46; 23&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9<span class="elsevierStyleHsp" style=""></span>L&#47;session&#41; was associated with a reduction in HbA1c &#40;&#8211;0&#46;51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;24&#37; vs&#46; 0&#46;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;88&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;043&#41;&#46; No correlation was observed between substitution volume and changes in weight&#44; body mass index or BIS parameters&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusion</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">There is not enough evidence to restrict convective transport in diabetic patients on OL-HDF due to the glucose content of the replacement fluid&#46;</p></span>"
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otras&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">27&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;78<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;16&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">81&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14&#44;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">51&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">HbA1c &#40;&#37; &#47; IFCC&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6&#44;96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;3 &#47; 52<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Triglic&#233;ridos &#40;mg&#47;dL&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TRS previa &#47; HDF-OL inicial &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#47; 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#47; 6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo TRS<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>23&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>79&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo de seguimiento &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>30&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;029&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cambios en los par&#225;metros de laboratorio al final del seguimiento</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HbA1c &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TG &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;17&#44;73<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>47&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Colesterol &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>c-LDL &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>c-HDL &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alb&#250;mina &#40;g&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Prealb&#250;mina &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PCR &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;67<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cambios anuales en los par&#225;metros de laboratorio</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HbA1c &#40;&#37;&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TG &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;62<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44;83&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;23&#44;58<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>28&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Colesterol &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#44;29<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44;74&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;3&#44;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;01&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>c-LDL &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>c-HDL &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;041&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alb&#250;mina &#40;g&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Prealb&#250;mina &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PCR &#40;mg&#47;dL&#47;a&#241;o&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Cambios de composici&#243;n corporal</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tiempo entre BIS &#40;meses&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peso &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Agua corporal total &#40;L&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Agua extracelular &#40;L&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Agua intracelular &#40;L&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sobrehidrataci&#243;n &#40;L&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masa magra &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#205;ndice tejido magro &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masa grasa &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;18<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;42&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#205;ndice tejido graso &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masa adiposa &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;1&#44;21<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44;21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masa celular &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">1&#44;26<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;35&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;1&#44;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;01&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;s&#46;&nbsp;\t\t\t\t\t\t\n
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                  """
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          "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Variables independientes del modelo 1&#58; edad&#44; volumen de sustituci&#243;n&#46; Variables independientes del modelo 2&#58; edad&#44; sexo&#44; tiempo en HDF-OL&#44; volumen de sustituci&#243;n&#44; prealb&#250;mina basal&#44; variaci&#243;n de prealb&#250;mina en el primer a&#241;o&#44; peso basal&#46;</p><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Los resultados de p resaltados en negrita son los resultados significativos del an&#225;lisis estad&#237;stico&#46;</p>"
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                  <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-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t" scope="col">Modelo 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Coeficientes no estandarizados</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Coeficientes tipificados&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Error t&#237;p&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Beta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">t&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sig&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;Constante&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;497&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;682&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;528&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;602&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;418&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;528&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#44;964&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vol&#46; sustituci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;432&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;647&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;667&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;510&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">R<span class="elsevierStyleSup">2</span> corregida&#58; 0&#44;300</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Modelo 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Coeficientes no estandarizados</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Coeficientes tipificados&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Error t&#237;p&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Beta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">t&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Sig&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;Constante&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#44;911&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;502&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;624&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Prealb&#250;mina 1&#46;<span class="elsevierStyleSup">er</span> a&#241;o&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis de regresi&#243;n lineal multivariante para la variaci&#243;n de prealb&#250;mina a lo largo del seguimiento</p>"
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Información del artículo
ISSN: 02116995
Idioma original: Español
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