Letter to the Editor
Karyomegalic nephropathy – Letter to the Editor
Nefritis kariomegálica – Carta al Editor
Rocio Gimena Muñoza,
, Jessy Korina Peña Esparragozab, Carolina Castillo Torresc, Fuensanta Moreno Barriod
Autor para correspondencia
a Nephrology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
b Nephrology Department, Hospital Universitario La Paz, Madrid, Spain
c Pathology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
d Associate Professor, Universidad Alcalá de Henares, Nephrology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
Leído
1728
Vecesse ha leído el artículo
653
Total PDF
1075
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S0211699523000632" "issn" => "02116995" "doi" => "10.1016/j.nefro.2023.04.002" "estado" => "S300" "fechaPublicacion" => "2024-07-01" "aid" => "1161" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2023" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Nefrologia. 2024;44:604-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S2013251424001536" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2023.04.008" "estado" => "S300" "fechaPublicacion" => "2024-07-01" "aid" => "1161" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Nefrologia (English Version). 2024;44:604-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Karyomegalic nephropathy- Letter to the Editor" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "604" "paginaFinal" => "605" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nefritis kariomegálica – Carta al Editor" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 567 "Ancho" => 755 "Tamanyo" => 121320 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tubular cells with large, irregular and hyperchromatic nuclei, associated with acute tubular damage, lymphoplasmacytic inflammatory infiltrate, glomerular sclerosis and arteriosclerosis.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rocio Gimena Muñoz, Jessy Korina Peña Esparragoza, Carolina Castillo Torres, Fuensanta Moreno Barrio" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Rocio Gimena" "apellidos" => "Muñoz" ] 1 => array:2 [ "nombre" => "Jessy Korina Peña" "apellidos" => "Esparragoza" ] 2 => array:2 [ "nombre" => "Carolina Castillo" "apellidos" => "Torres" ] 3 => array:2 [ "nombre" => "Fuensanta Moreno" "apellidos" => "Barrio" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0211699523000632" "doi" => "10.1016/j.nefro.2023.04.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699523000632?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251424001536?idApp=UINPBA000064" "url" => "/20132514/0000004400000004/v1_202408300447/S2013251424001536/v1_202408300447/en/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S021169952300070X" "issn" => "02116995" "doi" => "10.1016/j.nefro.2023.05.001" "estado" => "S300" "fechaPublicacion" => "2024-07-01" "aid" => "1168" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Nefrologia. 2024;44:605-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Hipofosfatemia ligada al cromosoma X: resultado a largo plazo con diferentes modalidades de tratamiento" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "605" "paginaFinal" => "608" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "X-linked hypophosphatemia: Long-term outcomes of different treatment strategies" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Laura Alconcher, Lucas Lucarelli, Sabrina Bronfen" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Laura" "apellidos" => "Alconcher" ] 1 => array:2 [ "nombre" => "Lucas" "apellidos" => "Lucarelli" ] 2 => array:2 [ "nombre" => "Sabrina" "apellidos" => "Bronfen" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2013251424001548" "doi" => "10.1016/j.nefroe.2023.05.021" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251424001548?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021169952300070X?idApp=UINPBA000064" "url" => "/02116995/0000004400000004/v1_202407151348/S021169952300070X/v1_202407151348/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0211699523000450" "issn" => "02116995" "doi" => "10.1016/j.nefro.2023.03.006" "estado" => "S300" "fechaPublicacion" => "2024-07-01" "aid" => "1157" "copyright" => "Sociedad Española de Nefrología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Nefrologia. 2024;44:601-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Hodgkin lymphoma in a patient with kidney transplantation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "601" "paginaFinal" => "603" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Linfoma de Hodgkin en un paciente con trasplante renal" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2092 "Ancho" => 3500 "Tamanyo" => 597375 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical course of the patient.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Kubra Kaynar, Tuba Ertekin, Gizem Erdoğan Üreyener, Sevdegül Mungan, Harbi Abuhadwan" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Kubra" "apellidos" => "Kaynar" ] 1 => array:2 [ "nombre" => "Tuba" "apellidos" => "Ertekin" ] 2 => array:2 [ "nombre" => "Gizem Erdoğan" "apellidos" => "Üreyener" ] 3 => array:2 [ "nombre" => "Sevdegül" "apellidos" => "Mungan" ] 4 => array:2 [ "nombre" => "Harbi" "apellidos" => "Abuhadwan" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699523000450?idApp=UINPBA000064" "url" => "/02116995/0000004400000004/v1_202407151348/S0211699523000450/v1_202407151348/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Karyomegalic nephropathy – Letter to the Editor" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "604" "paginaFinal" => "605" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Rocio Gimena Muñoz, Jessy Korina Peña Esparragoza, Carolina Castillo Torres, Fuensanta Moreno Barrio" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Rocio" "apellidos" => "Gimena Muñoz" "email" => array:1 [ 0 => "rociogimu3@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Jessy Korina" "apellidos" => "Peña Esparragoza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Carolina" "apellidos" => "Castillo Torres" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Fuensanta" "apellidos" => "Moreno Barrio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Nephrology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Nephrology Department, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Pathology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Associate Professor, Universidad Alcalá de Henares, Nephrology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nefritis kariomegálica – Carta al Editor" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 567 "Ancho" => 755 "Tamanyo" => 121320 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tubular cells with large, irregular and hyperchromatic nuclei, associated with acute tubular damage, lymphoplasmacytic inflammatory infiltrate, glomerular sclerosis and arteriosclerosis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Karyomegalic tubulointerstitial nephritis is a rare disease of uncertain etiology which has been linked to a genetic condition related to FAN1 gene. It is characterized by chronic tubulointerstitial nephritis with karyomegalic tubular epithelial cells (characteristic of the disease) lining the proximal and distal tubules and with enlarged hyperchromatic nuclei. It is a systemic entity that inevitably leads to end-stage renal disease.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> Involvement of other extrarenal organs may be present and is usually mild. It may consist of recurrent upper respiratory tract infections and liver impairment, as evidenced by elevated liver enzymes.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> The disease was first described by Burry in 1974,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> and the term karyomegalic nephritis was coined by Mihatsch in 1979.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> The exact pathogenesis of this disorder is unknown; however, it is thought to be associated with mitotic blockage linked to certain genotypes.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A 51-year-old male patient with no cardiovascular risk factors, was admitted to the Nephrology Department of our Hospital due to acute renal failure (maximum creatinine 2.49<span class="elsevierStyleHsp" style=""></span>mg/dl, CKD-EPI 28<span class="elsevierStyleHsp" style=""></span>ml/min/1.73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>), fever and elevated liver enzymes. Urinalysis showed microhaematuria 5–10 red blood cells/field, proteinuria 350<span class="elsevierStyleHsp" style=""></span>mg/24<span class="elsevierStyleHsp" style=""></span>h and absence of eosinophils. A glomerular immunological study was performed, with normal immunoglobulins, negative antinuclear antibodies, normal complement (C3 and C4), normal electrophoresis in blood and urine. Given the persistent altered renal function without a clear cause, we decided to perform a renal biopsy.</p><p id="par0015" class="elsevierStylePara elsevierViewall">This biopsy, which included renal parenchyma consisting of cortex and medulla, with 32 glomeruli; 16 of them were sclerosed and the remaining showed slight segmental proliferation. The characteristic lesion is observed in the interstitium, at the level of the tubule cells, which show large, hyperchromatic and pleomorphic nuclei (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). In the rest of the interstitium, histological lesions of acute tubular damage are observed (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), associated with a patchy lymphoplasmacytic inflammatory infiltrate of moderate intensity, foci of fibrosis and tubular atrophy. The immunohistochemistry study showed negativity for LMP-1 (EBV), CMV, Herpes virus. Ki67 (cell proliferation index) is negative in atypical cells and less than 5% in tubular cells. The direct immunofluorescence study shows no significant deposits with the antisera studied. Electron microscopy showed a glomerulus with no significant lesions. Based on these data, the following diagnoses were made: Histological lesion pattern: (1) Global sclerosis in 50% of the glomeruli, with no defined lesion pattern in the non-sclerosed glomeruli. (2) Acute tubular damage at different stages with marked nuclear atypia in tubular epithelial cells. Note: The negativity of Ki67 in most of the atypical cells rules out the possibility of regenerative changes and suggests investigating the following entities as aetiological causes: heavy metal nephrotoxins, infection by viruses other than those already studied and karyomegalic interstitial nephritis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Given these results, we proceeded to investigate possible infectious causes. Microbiological and serological tests for hepatitis B,C, HIV, toxoplasma, syphilis, rickettsia, leishmania, Herpes Simplex, CMV and EBV were all negative. Given that the patient worked in damp environments (in basements), we thought of Ochratoxin A, derived from fungus, this test was also negative. The patient was then referred to the Clinical Genetics Unit of our hospital to investigate a possible genetic etiology. With findings of homozygous mutation in the FAN1 gene (associated with karyomegalic interstitial nephritis with an autosomal recessive inheritance pattern). Carrier of the probably pathogenic variant c.1578-1G>T in homozygosis in the FAN1 gene.</p><p id="par0025" class="elsevierStylePara elsevierViewall">This is one of the rare cases of karyomegalic interstitial nephritis with confirmed genetic study published in the literature. The prevalence of this entity is very low (<1/1,000,000) and there are very few cases described. FAN 1 is considered an effector of the Fanconi pathway, a DNA damage response signaling pathway dedicated to repair DNA inter-strand crosslink damage. However, no FAN1 mutations were detected in Fanconi anemia<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> because Fanconi anemia involves other nucleases in its pathogenesis.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> These differences in cellular phenotypes lines may explain the lack of apparent phenotypic similarities between FAN1-negative individuals, compared to those who present karyomegalic interstitial nephritis, and Fanconi individuals who have clinical disease.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">We would like to highlight the fact that there is a high percentage of individuals treated with renal replacement therapy, diagnosed of fibrotic nephropathy, of unknown cause, in which a further study should be done as well as genetic causes should be considered. Also, to emphasize the importance of renal biopsy as a diagnostic tool, and the importance of giving a name and surname to the renal diseases we treat.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 567 "Ancho" => 755 "Tamanyo" => 121320 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tubular cells with large, irregular and hyperchromatic nuclei, associated with acute tubular damage, lymphoplasmacytic inflammatory infiltrate, glomerular sclerosis and arteriosclerosis.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 567 "Ancho" => 755 "Tamanyo" => 118355 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Tubular cells with large, irregular and hyperchromatic nuclei, associated with acute tubular damage.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Karyomegalic tubulointerstitial nephritis – a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Baba" 1 => "L. Nanovic" 2 => "J.B. Jaffery" 3 => "A. Friedl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.prp.2006.02.004" "Revista" => array:6 [ "tituloSerie" => "Pathol Res Pract" "fecha" => "2006" "volumen" => "202" "paginaInicial" => "555" "paginaFinal" => "559" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16678356" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0050" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Karyomegalic nephropathy: an uncommon cause of progressive renal failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Bhandari" 1 => "S. Kalowski" 2 => "P. Collett" 3 => "B.E. Cooke" 4 => "P. Kerr" 5 => "R. Newland" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndt/17.11.1914" "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant" "fecha" => "2002" "volumen" => "17" "paginaInicial" => "1914" "paginaFinal" => "1920" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12401846" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0055" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extreme dysplasia in renal epithelium of a young woman dying from hepatocarcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.F. Burry" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/path.1711130303" "Revista" => array:6 [ "tituloSerie" => "J Pathol" "fecha" => "1974" "volumen" => "113" "paginaInicial" => "147" "paginaFinal" => "150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4372331" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0060" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systemic karyomegaly associated with chronic interstitial nephritis. A new disease entity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.J. Mihatsch" 1 => "F. Gudat" 2 => "H.U. Zollinger" 3 => "C. Heierli" 4 => "H. Thölen" 5 => "F.W. Reutter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Nephrol" "fecha" => "1979" "volumen" => "12" "paginaInicial" => "54" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/527271" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0065" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Karyomegalic interstitial nephritis: report of 3 new cases and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Monga" 1 => "G. Banfi" 2 => "M. Salvadore" 3 => "O. Amatruda" 4 => "C. Bozzola" 5 => "G. Mazzucco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5414/cnp65349" "Revista" => array:6 [ "tituloSerie" => "Clin Nephrol" "fecha" => "2006" "volumen" => "65" "paginaInicial" => "349" "paginaFinal" => "355" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16724656" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0070" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Fanconi anemia pathway promotes replication-dependent DNA interstrand cross-link repair" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Knipscheer" 1 => "M. Räschle" 2 => "A. Smogorzewska" 3 => "M. Enoiu" 4 => "T.V. Ho" 5 => "O.D. Schärer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1126/science.1182372" "Revista" => array:6 [ "tituloSerie" => "Science" "fecha" => "2009" "volumen" => "326" "paginaInicial" => "1698" "paginaFinal" => "1701" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19965384" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0075" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "FAN1 mutations cause karyomegalic interstitial nephritis, linking chronic kidney failure to defective DNA damage repair" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Zhou" 1 => "E.A. Otto" 2 => "A. Cluckey" 3 => "R. Airik" 4 => "T.W. Hurd" 5 => "M. Chaki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/ng.2347" "Revista" => array:6 [ "tituloSerie" => "Nat Genet" "fecha" => "2012" "volumen" => "44" "paginaInicial" => "910" "paginaFinal" => "915" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22772369" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0080" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Karyomegalic interstitial nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Godin" 1 => "A. Francois" 2 => "F. Le Roy" 3 => "J.P. Morin" 4 => "E. Creppy" 5 => "J. Hemet" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0272-6386(96)90047-5" "Revista" => array:5 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "1996" "volumen" => "27" "paginaInicial" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8546134" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/02116995/0000004400000004/v1_202407151348/S0211699523000632/v1_202407151348/en/main.assets" "Apartado" => array:4 [ "identificador" => "48186" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Cartas al Director" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/02116995/0000004400000004/v1_202407151348/S0211699523000632/v1_202407151348/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211699523000632?idApp=UINPBA000064" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 22 | 15 | 37 |
| 2024 Septiembre | 59 | 29 | 88 |
| 2024 Agosto | 58 | 66 | 124 |
| 2024 Julio | 61 | 35 | 96 |
| 2024 Junio | 73 | 47 | 120 |
| 2024 Mayo | 94 | 44 | 138 |
| 2024 Abril | 73 | 25 | 98 |
| 2024 Marzo | 50 | 21 | 71 |
| 2024 Febrero | 59 | 40 | 99 |
| 2024 Enero | 38 | 21 | 59 |
| 2023 Diciembre | 48 | 22 | 70 |
| 2023 Noviembre | 70 | 39 | 109 |
| 2023 Octubre | 66 | 27 | 93 |
| 2023 Septiembre | 80 | 24 | 104 |
| 2023 Agosto | 62 | 29 | 91 |
| 2023 Julio | 48 | 29 | 77 |
| 2023 Junio | 34 | 23 | 57 |
| 2023 Mayo | 60 | 65 | 125 |
| 2023 Abril | 20 | 52 | 72 |
Mostrar todo
