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        "resumen" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Antecedentes&#58;</span> La enfermedad cardiovascular &#40;CV&#41; es la principal causa de mortalidad en pacientes en terap&#233;utica de reemplazo renal&#46; El principal objetivo del estudio fue evaluar el perfil de riesgo CV y prevalencia de enfermedad CV en pacientes en di&#225;lisis peritoneal &#40;DP&#41; en Portugal&#46; El segundo fue determinar los par&#225;metros m&#225;s relacionados con enfermedad CV&#46; <span class="elsevierStyleBold">M&#233;todos&#58;</span> Estudio retrospectivo&#44; multic&#233;ntrico&#44; de los adultos en DP&#46; Se incluyeron seiscientos pacientes &#40;56&#44;7&#160;&#37; varones&#44; edad media 53&#44;5&#160;&#177;&#160;15&#44;3 a&#241;os&#41;&#44; en DP por 25&#44;6&#160;&#177;&#160;21&#44;9 meses&#46; Los pacientes se dividieron&#58; grupo 1 &#40;n&#160;&#61;&#160;166&#41; con enfermedad CV y grupo 2 &#40;n&#160;&#61;&#160;434&#41; sin enfermedad CV&#46; Las comparaciones se hicieron con los factores tradicionales de riesgo CV y los asociados a uremia y a propia DP&#59; en el an&#225;lisis multivariante se determinaron las variables asociadas de forma independiente a enfermedad CV&#46; <span class="elsevierStyleBold">Resultados&#58;</span> Al final del estudio&#44; la prevalencia de enfermedad CV fue del 28&#160;&#37;&#46; En el an&#225;lisis univariante&#44; el grupo 1 present&#243; mayor frecuencia de varones &#40;<span class="elsevierStyleItalic">p&#160;</span>&#60;&#160;0&#44;01&#41;&#44; pacientes de m&#225;s edad &#40;<span class="elsevierStyleItalic">p&#160;</span>&#60;&#160;0&#44;01&#41;&#44; diab&#233;ticos &#40;p&#160;&#60;&#160;0&#44;01&#41;&#44; presencia de hipertrofia ventricular izquierda &#40;HVI&#41; &#40;<span class="elsevierStyleItalic">p&#160;</span>&#60;&#160;0&#44;01&#41;&#44; mayor prote&#237;na C-reactiva &#40;PCR&#41; &#40;<span class="elsevierStyleItalic">p&#160;</span>&#61;&#160;0&#44;04&#41;&#44; menor nivel medio de parathormona &#40;<span class="elsevierStyleItalic">p&#160;</span>&#61;&#160;0&#44;014&#41;&#44; menor f&#243;sforo s&#233;rico &#40;p&#160;&#61;&#160;0&#44;02&#41;&#44; menor diuresis diaria &#40;<span class="elsevierStyleItalic">p&#160;</span>&#61;&#160;0&#44;04&#41;&#44; menor Kt&#47;V semanal &#40;p&#160;&#61;&#160;0&#44;008&#41;&#44; un mayor uso de icodextrina y soluciones a base de glucosa hipert&#243;nica &#40;p&#160;&#60;&#160;0&#44;001 y p&#160;&#61;&#160;0&#44;006&#44; respectivamente&#41;&#44; con m&#225;s enfermos sometidos a DP continua ambulatoria &#40;DPCA&#41; &#40;<span class="elsevierStyleItalic">p&#160;</span>&#61;&#160;0&#44;014&#41; y ten&#237;an un transporte peritoneal alto &#40;p&#160;&#61;&#160;0&#44;02&#41;&#46; El an&#225;lisis multivariante demostr&#243; la influencia independiente de edad &#62;&#160;50 a&#241;os&#44; PCR&#160;&#62;&#160;0&#44;6&#160;mg&#47;dl&#44; sexo masculino&#44; diabetes&#44; HVI&#44; DPCA y anuria&#46; <span class="elsevierStyleBold">Conclusiones&#58;</span> Los factores de riesgo m&#225;s relacionados con el desarrollo de enfermedad cardiovascular en la DP en Portugal son edad &#62;&#160;50 a&#241;os&#44; PCR&#160;&#62;&#160;0&#44;6&#160;mg&#47;dl&#44; sexo masculino&#44; diabetes&#44; HVI&#44; DPCA y anuria&#46;</p>"
      ]
      "en" => array:1 [
        "resumen" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Background&#58;</span> Cardiovascular &#40;CV&#41; disease is the major cause of mortality in patients undergoing renal replacement therapy&#46; The primary aim of the study was to evaluate the CV risk profile and prevalence of CV disease in patients on peritoneal dialysis &#40;PD&#41; in Portugal&#46; The secondary goal was to establish parameters most associated with CV disease&#46; <span class="elsevierStyleBold">Methods&#58;</span> Retrospective&#44; multicenter study of the prevalent adult population on PD&#46; Six hundred patients were included &#40;56&#46;7&#37; male&#59; mean age 53&#46;5&#177;15&#46;3 years&#41;&#44; on PD for 25&#46;6&#177;21&#46;9 months&#46; Patients were divided into two groups&#58; group 1 &#40;n&#61;166&#41; with CV disease and group 2 &#40;n&#61;434&#41; without CV disease&#46; Comparisons were made regarding traditional CV risk factors and those associated with uremia and PD itself&#44; and a multivariate analysis was performed to determine variables independently associated with CV disease&#46; <span class="elsevierStyleBold">Results&#58;</span> At the end of the study&#44; the prevalence of CV disease was 28&#37;&#46; At univariate analysis&#44; group 1 presented a higher frequency of males &#40;p&#60;&#46;01&#41;&#44; older patients &#40;p&#60;&#46;01&#41;&#44; diabetics &#40;p&#60;&#46;01&#41;&#44; occurrence of left ventricular hypertrophy &#40;LVH&#41; &#40;p&#60;&#46;01&#41;&#44; mean C&#8211;reactive protein &#40;CRP&#41; &#40;p&#61;&#46;04&#41;&#44; lower mean parathormone level &#40;p&#61;&#46;014&#41;&#44; lower serum phosphorus &#40;p&#61;&#46;02&#41;&#44; lower daily urine output &#40;p&#61;&#46;04&#41;&#44; lower weekly Kt&#47;V &#40;p&#61;&#46;008&#41;&#44; increased use of icodextrin and hypertonic glucose-based PD solutions &#40;p&#60;&#46;001 and p&#61;&#46;006&#44; respectively&#41; and more were under continuous ambulatory PD &#40;CAPD&#41; &#40;p&#61;&#46;014&#41; and had a high peritoneal transport status &#40;p&#61;&#46;02&#41;&#46; Multivariate analysis provided a significant discriminatory influence pertaining to age &#62;50 years&#44; CRP&#62;0&#46;6mg&#47;dl&#44; male gender&#44; diabetes&#44; LVH&#44; CAPD and anuria&#44; when comparing group 1 and group 2&#46; <span class="elsevierStyleBold">Conclusions&#58;</span> Risk factors most related to the development of CV disease in PD in Portugal are age &#62;50 years&#44; CRP&#62;0&#46;6mg&#47;dL&#44; male gender&#44; diabetes&#44; LVH&#44; CAPD and anuria&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
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        0 => array:1 [
          "bibliografiaReferencia" => array:42 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Kwan BC, Szeto CC. Is peritoneal dialysis kinder for the heart? Perit Dial Int 2011;31(2):135-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21427246" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
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            1 => array:3 [
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              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Foley RN, Parfrey PS, Sarnak MJ. Epidemiology of cardiovascular disease in chronic renal disease. J Am Soc Nephrol 1998;9(12 Suppl):S16-23. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11443763" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
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            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "McCullough PA, Steigerwalt S, Tolia K, Chen SC, Li S, Norris KC, et al. Cardiovascular disease in chronic kidney disease: data from the Kidney Early Evaluation Program (KEEP). Curr Diab Rep 2011;11:47-55. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21076895" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
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              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Krediet RT, Balafa O. Cardiovascular risk in the peritoneal dialysis patient. Nat Rev Nephrol 2010;6(8):451-60. <a href="http://www.ncbi.nlm.nih.gov/pubmed/20567248" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
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              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "García-López E, Carrero JJ, Suliman ME, Lindholm B, Stenvinkel P. Risk factors for cardiovascular disease in patients undergoing peritoneal dialysis. Perit Dial Int 2007;27(Suppl 2):S205-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17556305" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
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                    0 => null
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              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Cupples LA, D¿Agostino RB. Section 34: some risk factors related to the annual incidence of cardiovascular disease and death in pooled repeated biennial measurements. In: Kannel WB, Wolf PA, Garrison RJ, eds. Framingham Heart Study: 30 Year Follow-Up. Bethesda, Md: US Department of Health and Human Services; 1987. pp. 1-26."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
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                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Ortega LM, Materson BJ. Hypertension in peritoneal dialysis patients: epidemiology, pathogenesis, and treatment. J Am Soc Hypertens 2011;5(3):128-36. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21459067" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
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                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Günal AI, Ilkay E, Kirciman E, Karaca I, Dogukan A, Celijer H. Blood pressure control and left ventricular hypertrophy in long-term CAPD and hemodialysis patients: a cross-sectional study. Perit Dial Int 2003;23(6):563-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/14703197" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
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                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Konings CJ, Kooman JP, Schonck M, Dammers R, Cheriex E, Palmans Meulemans AP, et al. Fluid status, blood pressure, and cardiovascular abnormalities in patients on peritoneal dialysis. Perit Dial Int 2002;22(4):477-87. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12322819" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Glassock RJ, Pecoits-Filho R, Barberato SH. Left ventricular mass in chronic kidney disease and ESRD. Clin J Am Soc Nephrol 2009;4(Suppl 1):S79-91. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19996010" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Foley RN, Parfrey PS, Kent GM, Harnett JD, Murray DC, Barre PE. Serial changes in echocardiographic parameters and cardiac failure in end-stage renal disease. J Am Soc Nephrol 2000;11:912-6. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10770969" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Jager KJ, Merkus MP, Dekker FW, Boeschoten EW, Tijssen JG, Stevens P, et al. Mortality and technique failure in patients starting chronic peritoneal dialysis: results of The Netherlands Cooperative Study on the Adequacy of Dialysis. NECOSAD Study Group. Kidney Int 1999;55(4):1476-85."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Udayaraj UP, Steenkamp R, Caskey FJ, Rogers C, Nitsch D, Ansell D, et al. Blood pressure and mortality risk on peritoneal dialysis. Am J Kidney Dis 2009;53(1):70-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19027213" target="_blank">[Pubmed]</a>"
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                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Termorshuizen F, Korevaar JC, Dekker FW, van Manen JG, Boeschoten EW, Krediet RT, et al. The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life: an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD)-2. Am J Kidney Dis 2003;41(6):1293-302. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12776283" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Heerspink HJ, Ninomiya T, Zoungas S, de Zeeuw D, Grobbee DE, Jardine MJ, et al. Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis: a systematic review and meta-analysis of randomised controlled trials. Lancet 2009;373(9668):1009-15. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19249092" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Piraino B. Cardiovascular complications in peritoneal dialysis patients. Contrib Nephrol 2009;163:102-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19494602" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Fortes PC, de Moraes TP, Mendes JG, Stinghen AE, Ribeiro SC, Pecoits-Filho R. Insulin resistance and glucose homeostasis in peritoneal dialysis. Perit Dial Int 2009;29(Suppl 2):S145-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19270204" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Szeto CC, Chow KM, Kwan BC, Chung KY, Leung CB, Li PK. New-onset hyperglycemia in nondiabetic Chinese patients started on peritoneal dialysis. Am J Kidney Dis 2007;49(4):524-32. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17386320" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Balafa O, Krediet RT. Peritoneal dialysis and cardiovascular disease. Minerva Urol Nefrol 2012;64(3):153-62. <a href="http://www.ncbi.nlm.nih.gov/pubmed/22971680" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Han SH, Ahn SV, Yun JY, Tranaeus A, Han DS. Effects of icodextrin on patient survival and technique success in patients undergoing peritoneal dialysis. Nephrol Dial Transplant 2012;27(5):2044-50. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21968011" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Sun CY, Lee CC, Lin YY, Wu MS. In younger dialysis patients, automated peritoneal dialysis is associated with better long-term patient and technique survival than is continuous ambulatory peritoneal dialysis. Perit Dial Int 2011;31(3):301-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21282373" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Ortega O, Gallar P, Carreño A, Gutiérrez M, Rodríguez I, Oliet A, et al. Peritoneal sodium mass removal in continuous ambulatory peritoneal dialysis and automated peritoneal dialysis: influence on blood pressure control. Am J Nephrol 2001;21(3):189-93. <a href="http://www.ncbi.nlm.nih.gov/pubmed/11423687" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Rodríguez-Carmona A, Fontán MP. Sodium removal in patients undergoing CAPD and automated peritoneal dialysis. Perit Dial Int 2002;22(6):705-13. <a href="http://www.ncbi.nlm.nih.gov/pubmed/12556073" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Mehrotra R. Long-term outcomes in automated peritoneal dialysis: similar or better than in continuous ambulatory peritoneal dialysis? Perit Dial Int 2009;29 Suppl 2:S111-4."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Michels WM, Verduijn M, Boeschoten EW, Dekker FW, Krediet RT; NECOSAD Study Group. Similar survival on automated peritoneal dialysis and continuous ambulatory peritoneal dialysis in a large prospective cohort. Clin J Am Soc Nephrol 2009;4(5):943-9. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19357244" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Badve SV, Hawley CM, McDonald SP, Mudge DW, Rosman JB, Brown FG, et al. Automated and continuous ambulatory peritoneal dialysis have similar outcomes. Kidney Int 2008;73(4):480-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/18046315" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Guo A, Mujais S. Patient and technique survival on peritoneal dialysis in the United States: evaluation in large incident cohorts. Kidney Int Suppl 2003;(88):S3-12."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Sanchez AR, Madonia C, Rascon-Pacheco RA. Improved patient/technique survival and peritonitis rates in patients treated with automated peritoneal dialysis when compared to continuous ambulatory peritoneal dialysis in a Mexican PD center. Kidney Int Suppl 2008;(108):S76-80."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Rabindranath KS, Adams J, Ali TZ, Daly C, Vale L, Macleod AM. Automated vs continuous ambulatory peritoneal dialysis: a systematic review of randomized controlled trials. Nephrol Dial Transplant 2007;22(10):2991-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/17875571" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
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Vol. 34. Núm. 2.marzo 2014
Páginas 0-272
Vol. 34. Núm. 2.marzo 2014
Páginas 0-272
Acceso a texto completo
Riesgo cardiovascular en diálisis peritoneal - Un estudio multicéntrico portugués
Cardiovascular risk in peritoneal dialysis ¿ A Portuguese multicenter study
Visitas
12059
Grupo Multicéntrico Portugués de Diálisis Peritoneala, Grupo Multicentrico Portugues de Diálisis Peritoneala, Marta Nevesb, Susana Machadob, Luís Rodriguesb, Andreia Borgesb, Pedro Maiac, Mário Camposb
a Portugal,
b Servicio de Nefrología, Hospitais da Universidade de Coimbra, Coimbra, Coimbra, Portugal,
c Servicio de Nefrología, Centro Hospitalar de Coimbra, Coimbra, Coimbra, Portugal,
Este artículo ha recibido
Información del artículo

Antecedentes: La enfermedad cardiovascular (CV) es la principal causa de mortalidad en pacientes en terapéutica de reemplazo renal. El principal objetivo del estudio fue evaluar el perfil de riesgo CV y prevalencia de enfermedad CV en pacientes en diálisis peritoneal (DP) en Portugal. El segundo fue determinar los parámetros más relacionados con enfermedad CV. Métodos: Estudio retrospectivo, multicéntrico, de los adultos en DP. Se incluyeron seiscientos pacientes (56,7 % varones, edad media 53,5 ± 15,3 años), en DP por 25,6 ± 21,9 meses. Los pacientes se dividieron: grupo 1 (n = 166) con enfermedad CV y grupo 2 (n = 434) sin enfermedad CV. Las comparaciones se hicieron con los factores tradicionales de riesgo CV y los asociados a uremia y a propia DP; en el análisis multivariante se determinaron las variables asociadas de forma independiente a enfermedad CV. Resultados: Al final del estudio, la prevalencia de enfermedad CV fue del 28 %. En el análisis univariante, el grupo 1 presentó mayor frecuencia de varones (< 0,01), pacientes de más edad (< 0,01), diabéticos (p < 0,01), presencia de hipertrofia ventricular izquierda (HVI) (< 0,01), mayor proteína C-reactiva (PCR) (= 0,04), menor nivel medio de parathormona (= 0,014), menor fósforo sérico (p = 0,02), menor diuresis diaria (= 0,04), menor Kt/V semanal (p = 0,008), un mayor uso de icodextrina y soluciones a base de glucosa hipertónica (p < 0,001 y p = 0,006, respectivamente), con más enfermos sometidos a DP continua ambulatoria (DPCA) (= 0,014) y tenían un transporte peritoneal alto (p = 0,02). El análisis multivariante demostró la influencia independiente de edad > 50 años, PCR > 0,6 mg/dl, sexo masculino, diabetes, HVI, DPCA y anuria. Conclusiones: Los factores de riesgo más relacionados con el desarrollo de enfermedad cardiovascular en la DP en Portugal son edad > 50 años, PCR > 0,6 mg/dl, sexo masculino, diabetes, HVI, DPCA y anuria.

Palabras clave:
Diálisis peritoneal
Palabras clave:
Multicéntrico
Palabras clave:
Riesgo cardiovascular

Background: Cardiovascular (CV) disease is the major cause of mortality in patients undergoing renal replacement therapy. The primary aim of the study was to evaluate the CV risk profile and prevalence of CV disease in patients on peritoneal dialysis (PD) in Portugal. The secondary goal was to establish parameters most associated with CV disease. Methods: Retrospective, multicenter study of the prevalent adult population on PD. Six hundred patients were included (56.7% male; mean age 53.5±15.3 years), on PD for 25.6±21.9 months. Patients were divided into two groups: group 1 (n=166) with CV disease and group 2 (n=434) without CV disease. Comparisons were made regarding traditional CV risk factors and those associated with uremia and PD itself, and a multivariate analysis was performed to determine variables independently associated with CV disease. Results: At the end of the study, the prevalence of CV disease was 28%. At univariate analysis, group 1 presented a higher frequency of males (p<.01), older patients (p<.01), diabetics (p<.01), occurrence of left ventricular hypertrophy (LVH) (p<.01), mean C–reactive protein (CRP) (p=.04), lower mean parathormone level (p=.014), lower serum phosphorus (p=.02), lower daily urine output (p=.04), lower weekly Kt/V (p=.008), increased use of icodextrin and hypertonic glucose-based PD solutions (p<.001 and p=.006, respectively) and more were under continuous ambulatory PD (CAPD) (p=.014) and had a high peritoneal transport status (p=.02). Multivariate analysis provided a significant discriminatory influence pertaining to age >50 years, CRP>0.6mg/dl, male gender, diabetes, LVH, CAPD and anuria, when comparing group 1 and group 2. Conclusions: Risk factors most related to the development of CV disease in PD in Portugal are age >50 years, CRP>0.6mg/dL, male gender, diabetes, LVH, CAPD and anuria.

Keywords:
Peritoneal dialysis
Keywords:
Multicentre
Keywords:
Cardiovascular risk
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