CLINICAL SCIENCE
The reduction of serum aminotransferase levels is proportional to the decline of the glomerular filtration rate in patients with chronic kidney disease
Luís Henrique Bezerra Cavalcanti Sette
, Edmundo Pessoa de Almeida Lopes
Corresponding author
Department of Internal Medicine, Universidade Federal de Pernambuco (UFPE), Recife/PE, Brazil
Read
1021
Timeswas read the article
317
Total PDF
704
Total HTML
Share statistics
array:24 [ "pii" => "S1807593222013837" "issn" => "18075932" "doi" => "10.6061/clinics/2015(05)07" "estado" => "S300" "fechaPublicacion" => "2015-05-01" "aid" => "1383" "copyright" => "CLINICS" "copyrightAnyo" => "2015" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "fla" "cita" => "Clinics. 2015;70:346-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S1807593222013849" "issn" => "18075932" "doi" => "10.6061/clinics/2015(05)08" "estado" => "S300" "fechaPublicacion" => "2015-05-01" "aid" => "1384" "copyright" => "CLINICS" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "fla" "cita" => "Clinics. 2015;70:350-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">CLINICAL SCIENCE</span>" "titulo" => "Effectiveness of Limberg and Karydakis flap in recurrent pilonidal sinus disease" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "350" "paginaFinal" => "355" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig2" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 284 "Ancho" => 678 "Tamanyo" => 29580 ] ] "descripcion" => array:1 [ "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Limberg flap technique.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "İlhan Bali, Mehmet Aziret, Selim Sözen, Seyfi Emir, Hasan Erdem, Süleyman Çetinkünar, Oktay İrkörücü" "autores" => array:7 [ 0 => array:2 [ "nombre" => "İlhan" "apellidos" => "Bali" ] 1 => array:2 [ "nombre" => "Mehmet" "apellidos" => "Aziret" ] 2 => array:2 [ "nombre" => "Selim" "apellidos" => "Sözen" ] 3 => array:2 [ "nombre" => "Seyfi" "apellidos" => "Emir" ] 4 => array:2 [ "nombre" => "Hasan" "apellidos" => "Erdem" ] 5 => array:2 [ "nombre" => "Süleyman" "apellidos" => "Çetinkünar" ] 6 => array:2 [ "nombre" => "Oktay" "apellidos" => "İrkörücü" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222013849?idApp=UINPBA00004N" "url" => "/18075932/0000007000000005/v1_202212011403/S1807593222013849/v1_202212011403/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1807593222013825" "issn" => "18075932" "doi" => "10.6061/clinics/2015(05)06" "estado" => "S300" "fechaPublicacion" => "2015-05-01" "aid" => "1382" "copyright" => "CLINICS" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "fla" "cita" => "Clinics. 2015;70:339-45" "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">CLINICAL SCIENCE</span>" "titulo" => "Evaluation of oral-motor movements and facial mimic in patients with head and neck burns by a public service in Brazil" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "339" "paginaFinal" => "345" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Dicarla Motta Magnani, Fernanda Chiarion Sassi, Luiz Philipe Molina Vana, Nivaldo Alonso, Claudia Regina Furquim de Andrade" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Dicarla Motta" "apellidos" => "Magnani" ] 1 => array:2 [ "nombre" => "Fernanda Chiarion" "apellidos" => "Sassi" ] 2 => array:2 [ "nombre" => "Luiz Philipe Molina" "apellidos" => "Vana" ] 3 => array:2 [ "nombre" => "Nivaldo" "apellidos" => "Alonso" ] 4 => array:2 [ "nombre" => "Claudia Regina Furquim" "apellidos" => "de Andrade" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222013825?idApp=UINPBA00004N" "url" => "/18075932/0000007000000005/v1_202212011403/S1807593222013825/v1_202212011403/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">CLINICAL SCIENCE</span>" "titulo" => "The reduction of serum aminotransferase levels is proportional to the decline of the glomerular filtration rate in patients with chronic kidney disease" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "346" "paginaFinal" => "349" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Luís Henrique Bezerra Cavalcanti Sette, Edmundo Pessoa de Almeida Lopes" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Luís Henrique Bezerra Cavalcanti" "apellidos" => "Sette" "email" => array:1 [ 0 => "setteluis@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "Edmundo Pessoa" "apellidos" => "de Almeida Lopes" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Internal Medicine, Universidade Federal de Pernambuco (UFPE), Recife/PE, Brazil" "identificador" => "aff1" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Corresponding author: Luís Henrique Bezerra Cavalcanti Sette" ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 719 "Ancho" => 666 "Tamanyo" => 43493 ] ] "descripcion" => array:1 [ "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">A flow chart of the patients who met the inclusion/exclusion criteria for the study. ULN, AST and ALT.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle60">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall">Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are markers of aggression to hepatocytes and aid in the diagnosis, monitoring and treatment of liver diseases because they reflect the inflammatory activity of the liver <a class="elsevierStyleCrossRefs" href="#bib1">1-3</a>. However, patients with chronic kidney disease (CKD) on hemodialysis (HD) have lower aminotransferase serum levels than those with preserved renal function, which might adversely affect the assessment of liver injury among these patients <a class="elsevierStyleCrossRefs" href="#bib4">4,5</a>.</p><p id="para20" class="elsevierStylePara elsevierViewall">Some factors are implicated in the reduction of AST and ALT serum levels among patients with CKD on HD such as lower pyridoxine serum levels, higher homocysteine levels and hemodilution due to fluid retention <a class="elsevierStyleCrossRefs" href="#bib6">6-8</a>. In patients on HD infected with the hepatitis B (HBV) or hepatitis C viruses (HCV), other factors also contribute to the decrease in aminotransferases, such as the lower viremia caused by the dialysis procedure through the sequestration of the virus by the dialyzer; the higher production of hepatocyte growth factor (HGF), which is induced via dialysis and accelerates liver regeneration; and the increased endogenous α-interferon serum levels and lymphocyte activation that fight the viral agent together <a class="elsevierStyleCrossRefs" href="#bib9">9-11</a>.</p><p id="para30" class="elsevierStylePara elsevierViewall">However, most studies evaluating serum aminotransferase levels have involved patients with CKD on HD, and only one article has described a reduction in serum aminotransferase levels among patients with predialysis CKD <a class="elsevierStyleCrossRef" href="#bib12">12</a>. In that study, only the AST serum levels were correlated with the creatinine concentration, whereas the relationship between the aminotransferases and the glomerular filtration rate (GFR) was not assessed; furthermore, this analysis was not conducted according to CKD stage <a class="elsevierStyleCrossRefs" href="#bib12">12,13</a>. In fact, the behavior of AST and ALT serum levels during CKD progression is still not fully known.</p><p id="para40" class="elsevierStylePara elsevierViewall">Therefore, this study aimed to determine the AST and ALT serum levels of patients with predialysis CKD and correlate them with their creatinine serum levels and GFRs.</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">PATIENTS AND METHODS</span><p id="para50" class="elsevierStylePara elsevierViewall">A cross-sectional study was conducted from September 2011 to May 2012 that included all of the patients older than 18 years who attended the CKD outpatient clinic of the Nephrology Service, Hospital das Clínicas (UFPE) and who were diagnosed with CKD at least 3 months previously.</p><p id="para60" class="elsevierStylePara elsevierViewall">The patients were consecutively selected using the following criteria during their arrival at the clinic. Those with positive serological markers for HBV, HCV, HIV or a chronic liver disease were excluded, as were those who consumed more than 210 g of alcohol/week, those with a manifest infectious disease, and pregnant or postpartum women.</p><p id="para70" class="elsevierStylePara elsevierViewall">The patients who agreed to participate signed an informed term of consent and completed a questionnaire regarding their demographic, socioeconomic, anthropometric and clinical data. Thereafter, approximately 5 mL of blood was collected to perform biochemical testing using an automated kinetic method (COBAS C501 ROCHE, Roche Diagnostics, Indianapolis, Indiana, U.S.A.), which included evaluations of their ALT, AST and creatinine levels.</p><p id="para80" class="elsevierStylePara elsevierViewall">When indicated, the test results were standardized for gender by calculating the ratio of the value found by the method and the upper limit of normal (ULN). Patients presenting ALT and AST values greater than 5 times the ULN were excluded from the analyses. Renal function was assessed using the creatinine serum levels and by estimating the GFR with the Cockcroft-Gault (CG) formula <a class="elsevierStyleCrossRef" href="#bib13">13</a> corrected for body surface area <a class="elsevierStyleCrossRef" href="#bib14">14</a> and the abbreviated Modification of Diet in Renal Disease (MDRD) equation <a class="elsevierStyleCrossRef" href="#bib15">15</a>.</p><p id="para90" class="elsevierStylePara elsevierViewall">The patients were classified into different CKD stages based on the GFR (mL/min/1.73 m<span class="elsevierStyleSup">2</span>) defined by the guidelines of the Kidney Disease Outcomes Quality Initiative, such that GFR >90=Stage 1; between 60-89=Stage 2; between 30-59=Stage 3; between 15-29=Stage 4; and <15 or under dialysis=Stage 5 <a class="elsevierStyleCrossRef" href="#bib16">16</a>. The early CKD stages were defined as Stages 2 or 3, and the advanced stages were categorized as Stages 4 and 5.</p><p id="para100" class="elsevierStylePara elsevierViewall">Initially, the population was described using a frequency distribution when the variable was categorical; means and standard deviations were calculated when the variable was quantitative.</p><p id="para110" class="elsevierStylePara elsevierViewall">The Kolmogorov-Smirnov normality test was applied; when the distribution was not normal, a logarithmic transformation was applied to normalize the data. Student's t test (up to 2 levels) and ANOVA followed by a Bonferroni post hoc test (>2 levels) were applied to compare means. Pearson's chi-square test was applied to evaluate the association between the CKD stages and the categorical variables. A linear regression model was applied to analyze the association with the GFR, and significant associations were adjusted for BMI. All of the tests were conducted using a significance threshold of 5% (p < 0.05). STATA version 12.0 was used for all data analyses.</p><p id="para120" class="elsevierStylePara elsevierViewall">The Research Ethics Committee of the Universidade Federal de Pernambuco Health Sciences Center approved this study under registration number 335/11, CAAE 0314.0.172.000-11. This study follows the precepts set forth in Resolution No. 196/96 of the (Brazilian) National Health Council.</p></span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">RESULTS</span><p id="para130" class="elsevierStylePara elsevierViewall">During the study period, 191 patients were assessed, but only 142 were included. The non-enrollment reasons for these screened patients are shown in <a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>.</p><elsevierMultimedia ident="fig1"></elsevierMultimedia><p id="para140" class="elsevierStylePara elsevierViewall">The mean age of participants was 64±16 years, and 72 patients (51%) were male. The mean serum creatinine level was 3.3±1.2 mg/dL, and the mean GFRs, as estimated using the CG and MDRD equations, were 28.9±13 mL/min/1.73 m<span class="elsevierStyleSup">2</span> and 25.5±12.9 mL/min/1.73 m<span class="elsevierStyleSup">2</span>, respectively. The major drug groups that the patients used are listed in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>. The patients were distributed across the CKD stages according to the CG equation thusly: 3 (2.1%) patients were classified as Stage 2; 54 (38%) were Stage 3; 70 (49.3%) were Stage 4; and 15 (10.5%) were Stage 5. In addition, when the MDRD equation was used, the following distribution was noted: 3 (2.1%) patients were classified as Stage 2; 48 (33.8%) were Stage 3; 73 (51.4%) were Stage 4; and 18 (12.6%) were Stage 5. Because the number of Stage 2 patients was small and their GFRs approximated those of the Stage 3 patients, these patients were reclassified as Stage 3 for the purpose of statistical analysis. The clinical and epidemiological characteristic distributions are shown in <a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>.</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><elsevierMultimedia ident="tbl2"></elsevierMultimedia><p id="para150" class="elsevierStylePara elsevierViewall">The means of patients with regard to stage distribution as evaluated using the CG and MDRD formulas were not significantly different; therefore, we used the CG formula to evaluate the variables.</p><p id="para160" class="elsevierStylePara elsevierViewall">The mean serum level divided by the AST or ALT ULNs were 0.55 and 0.29, respectively. AST and ALT serum levels above the ULN (>1) were found in 6 (4.2%) and 2 (1.4%) patients, respectively.</p><p id="para170" class="elsevierStylePara elsevierViewall">The AST and ALT serum level means reduced in proportion to the increase in creatinine levels (<span class="elsevierStyleItalic">p</span>=0.001, r=−0.27; and <span class="elsevierStyleItalic">p</span>=0.05, r=−0.17, respectively). In addition, the mean ALT and AST serum levels were also reduced in proportion to the descent in GFR (<span class="elsevierStyleItalic">p</span>=0.007 and <span class="elsevierStyleItalic">p</span>=0.028, respectively; see <a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>).</p><elsevierMultimedia ident="tbl3"></elsevierMultimedia><p id="para180" class="elsevierStylePara elsevierViewall">Female patients had higher GFR levels, and significant associations were observed with regard to the BMI and aminotransferase measurements. The associations among AST, ALT, and GFR remained significant after adjusting for BMI (<span class="elsevierStyleItalic">p=</span>0.008 and <span class="elsevierStyleItalic">p=</span>0.039, respectively; see <a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>).</p><p id="para190" class="elsevierStylePara elsevierViewall">A significant difference was not detected when the association of the AST and ALT serum levels were evaluated for each CKD stage (<span class="elsevierStyleItalic">p=</span>0.16 and <span class="elsevierStyleItalic">p=</span>0.18, respectively). When the earlier CKD stages (2 and 3) were combined and compared with the more advanced stages (4 and 5), significant trends in the ALT (<span class="elsevierStyleItalic">p=</span>0.08) and AST (<span class="elsevierStyleItalic">p=</span>0.06) serum levels were observed, as described in <a class="elsevierStyleCrossRef" href="#tbl4">Table 4</a>. Reductions of approximately 12% and 10% were observed in the ALT and AST serum levels, respectively, when Stages 2 and 3 were compared with Stages 4 and 5.</p><elsevierMultimedia ident="tbl4"></elsevierMultimedia></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">DISCUSSION</span><p id="para200" class="elsevierStylePara elsevierViewall">Serum aminotransferase levels decrease in patients with CKD who undergo HD <a class="elsevierStyleCrossRef" href="#bib17">17</a>; however, little is known with regard to how the levels of these enzymes behave during the earliest stages of CKD under predialysis treatment. This study is the first to find a direct correlation between a reduction in GFR and a decrease in aminotransferases.</p><p id="para210" class="elsevierStylePara elsevierViewall">In fact, we observed that AST and ALT serum levels tended to be higher during the initial stages (2 and 3) of CKD compared with the later stages (4 and 5). The possible increases in the number of patients within each CKD stage might reveal a more gradual and significant decrease in serum aminotransferases levels; this finding is in line with the reduction in the GFR. Importantly, the sample size must be regarded as one of the limitations of this study.</p><p id="para220" class="elsevierStylePara elsevierViewall">Some hypotheses have been offered to explain the reduction of serum aminotransferase levels among patients with CKD on HD: a deficiency of pyridoxine, hemodilution and hyperhomocysteinemia <a class="elsevierStyleCrossRefs" href="#bib6">6-8</a>. In fact, Ono et al. reported that patients with CKD on HD with pyridoxine deficiencies have lower serum aminotransferase levels than those without vitamin deficiencies <a class="elsevierStyleCrossRef" href="#bib7">7</a>. Lopes et al. observed hemodilution and found that weight loss during HD was associated with a rise in ALT serum levels (r=0.3, <span class="elsevierStyleItalic">p</span><0.001) <a class="elsevierStyleCrossRef" href="#bib6">6</a>. Huang et al. evaluated the serum homocysteine levels of 145 patients undergoing HD and found that they were negatively related to AST (r=0.4, <span class="elsevierStyleItalic">p</span><0.001). Thus, AST serum levels might reflect the high metabolic activity of homocysteine and influence its serum levels <a class="elsevierStyleCrossRef" href="#bib8">8</a>. Importantly, these hypotheses concern patients with CKD under HD; however, they cannot be rejected with regard to patients during predialysis. Therefore, another limitation of this study is that it did not measure homocysteine or pyridoxine.</p><p id="para230" class="elsevierStylePara elsevierViewall">Interestingly, this study found that almost all of the patients had aminotransferase levels below the ULN, even when they were using several potentially hepatotoxic drugs (4 per patient on average) such as statins, which were used by approximately 60% of the patients <a class="elsevierStyleCrossRef" href="#bib18">18</a>. Moreover, a considerable number of patients had diabetes mellitus, which might lead to liver inflammation (steatohepatitis) and a consequent rise in liver enzymes <a class="elsevierStyleCrossRef" href="#bib19">19</a>.</p><p id="para240" class="elsevierStylePara elsevierViewall">Another interesting finding of this study concerns the significant reduction in BMI based on CKD progression. This behavior is explained not only by the fact that patient weight is included in the calculation of the GFR but also given the malnutrition associated with CKD <a class="elsevierStyleCrossRefs" href="#bib13">13,20,21</a>. In fact, the progressive decrease of BMI might reduce dyslipidemia or glucose levels, thereby promoting a regression of underlying fatty liver disease that contributes to decreased aminotransferase levels <a class="elsevierStyleCrossRef" href="#bib22">22</a>. To reduce this possible confound, the association between GFR and aminotransferases was adjusted for BMI; however, it remained significant. Moreover, malnutrition might reduce the stocks of B-complex vitamins, especially pyridoxine, which act as a co-factor in the synthesis of aminotransferases by reducing their production <a class="elsevierStyleCrossRef" href="#bib23">23</a>.</p><p id="para250" class="elsevierStylePara elsevierViewall">Male patients presented lower GFRs than their female counterparts. This finding might be related to the CKD progression rate, which occurs more rapidly in males, thereby increasing the chances that these patients are at more advanced stages of the disease <a class="elsevierStyleCrossRef" href="#bib24">24</a>.</p><p id="para260" class="elsevierStylePara elsevierViewall">This preliminary study revealed that the decrease in AST and ALT serum levels among patients with CKD occurs before the start of dialysis, and these enzymes are independently decreasing factors associated with HD. Future studies, should collect larger samples of patients with CKD to evaluate the evidence of aminotransferase reduction in these patients, such as pyridoxine and homocysteine serum levels.</p><p id="para270" class="elsevierStylePara elsevierViewall">In conclusion, the AST and ALT serum levels of patients with pre-dialysis CKD tended to decrease in proportion to their CKD progression, and these levels were negatively correlated with their creatinine serum levels and directly correlated with the GFR.</p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle100">AUTHOR CONTRIBUTIONS</span><p id="para280" class="elsevierStylePara elsevierViewall">Lopes EP was responsible for the conception and design of this paper as well as the data analysis and interpretation. Sette LH was responsible for the data collection, patient interviews, laboratory analyses, text preparation and data analysis. Both authors contributed to, read and approved the final manuscript.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "xpalclavsec1582299" "titulo" => "KEYWORDS" ] 1 => array:2 [ "identificador" => "cesec10" "titulo" => "INTRODUCTION" ] 2 => array:2 [ "identificador" => "cesec20" "titulo" => "PATIENTS AND METHODS" ] 3 => array:2 [ "identificador" => "cesec30" "titulo" => "RESULTS" ] 4 => array:2 [ "identificador" => "cesec40" "titulo" => "DISCUSSION" ] 5 => array:2 [ "identificador" => "cesec50" "titulo" => "AUTHOR CONTRIBUTIONS" ] 6 => array:2 [ "identificador" => "xack639266" "titulo" => "Acknowledgments" ] 7 => array:1 [ "titulo" => "REFERENCES" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-02-04" "fechaAceptado" => "2015-02-13" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "KEYWORDS" "identificador" => "xpalclavsec1582299" "palabras" => array:5 [ 0 => "Aspartate aminotransferase" 1 => "Alanine aminotransferase" 2 => "Creatinine" 3 => "Chronic kidney disease" 4 => "Glomerular filtration rate" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">OBJECTIVE:</span><p id="spara60" class="elsevierStyleSimplePara elsevierViewall">This study sought to determine the serum aminotransferase levels of patients with predialysis chronic kidney disease and establish their relationships with serum creatinine levels and glomerular filtration rate.</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">METHODS:</span><p id="spara70" class="elsevierStyleSimplePara elsevierViewall">Patients with chronic kidney disease were evaluated between September 2011 and May 2012. Aminotransferase and creatinine serum levels were measured using an automated kinetic method, and glomerular filtration rates were estimated using the Cockroft-Gault and Modification of Diet in Renal Disease formulas to classify patients into chronic kidney disease stages.</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">RESULTS:</span><p id="spara80" class="elsevierStyleSimplePara elsevierViewall">Exactly 142 patients were evaluated (mean age: 64±16 years). The mean creatinine serum level and glomerular filtration rate were 3.3±1.2 mg/dL and 29.1±13 mL/min/1.73 m<span class="elsevierStyleSup">2</span>, respectively. Patients were distributed according to their chronic kidney disease stages as follows: 3 (2.1%) patients were Stage 2; 54 (38%) were Stage 3; 70 (49.3%) were Stage 4; and 15 (10.5%) were Stage 5. The mean aspartate aminotransferase and alanine aminotransferase serum levels showed a reduction in proportion to the increase in creatinine levels (<span class="elsevierStyleItalic">p</span>=0.001 and <span class="elsevierStyleItalic">p</span>=0.05, respectively) and the decrease in glomerular filtration rate (<span class="elsevierStyleItalic">p</span>=0.007 and <span class="elsevierStyleItalic">p</span>=0.028, respectively). Alanine aminotransferase and aspartate aminotransferase serum levels tended to be higher among patients classified as stage 2 or 3 compared with those classified as stage 4 or 5 (<span class="elsevierStyleItalic">p</span>=0.08 and <span class="elsevierStyleItalic">p</span>=0.06, respectively).</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">CONCLUSIONS:</span><p id="spara90" class="elsevierStyleSimplePara elsevierViewall">The aspartate aminotransferase and alanine aminotransferase serum levels of patients with predialysis chronic kidney disease decreased in proportion to the progression of the disease; they were negatively correlated with creatinine levels and directly correlated with glomerular filtration rate.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "OBJECTIVE:" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "METHODS:" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "RESULTS:" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "CONCLUSIONS:" ] ] ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">No potential conflict of interest was reported.</p>" ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 719 "Ancho" => 666 "Tamanyo" => 43493 ] ] "descripcion" => array:1 [ "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">A flow chart of the patients who met the inclusion/exclusion criteria for the study. ULN, AST and ALT.</p>" ] ] 1 => array:7 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\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"><span class="elsevierStyleBold">Major Medications in Use</span> \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"><span class="elsevierStyleBold">N</span> \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"><span class="elsevierStyleBold">%</span> \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" 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">ACE (angiotensin converting enzyme) inhibitors and ARBS (angiotensin II receptor blockers) \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">77 \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">54.2 \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">Aspirin \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">61 \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">43 \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">Calcium channel blockers \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">63 \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">44.3 \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">Β-Blockers \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">52 \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">36.6 \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">Diuretics \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">90 \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">63.3 \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">Erythropoietin-stimulation agents \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">13 \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">9.1 \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">Insulin \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">42 \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">29.5 \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">Alpha blockers \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">19 \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">13.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">The major medications used among the 142 patients with predialysis CKD.</p>" ] ] 2 => array:7 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="tfn1" class="elsevierStyleSimplePara elsevierViewall">*ANOVA, post hoc Bonferroni test</p><p id="tfn2" class="elsevierStyleSimplePara elsevierViewall">**Pearson's chi-squared test</p><p id="tfn3" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">a</span> Difference between the patients with Stage 2 and 3 versus those with Stage 4</p>" "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " rowspan="2" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"><span class="elsevierStyleBold">Characteristic</span></th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"><span class="elsevierStyleBold">Stages of CKD</span></th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " rowspan="2" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleBold">-value</span></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"><span class="elsevierStyleBold">Stages 2 & 3</span> \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"><span class="elsevierStyleBold">Stage 4</span> \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"><span class="elsevierStyleBold">Stage 5</span> \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" 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"><span class="elsevierStyleBold">N</span> \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">57 \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">70 \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">15 \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"> \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"><span class="elsevierStyleBold">Age</span><a class="elsevierStyleCrossRef" href="#tfn1">*</a> \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">65.3±12.9 \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">63.2±17.4 \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">60.2±22.1 \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">0.506 \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"><span class="elsevierStyleBold">BMI</span><a class="elsevierStyleCrossRef" href="#tfn1">*</a> \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">27.6±4.4 \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">25.7±4.8 \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">23.6±2.4 \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">0.007<a class="elsevierStyleCrossRef" href="#tfn3">a</a> \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"><span class="elsevierStyleBold">Diabetic</span> \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"> \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"> \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"> \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"> \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">Yes (%) \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">27 (47.3) \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">24 (34.2) \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">7 (46.7) \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">0.400 \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">No (%) \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">30 (52.7) \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">46 (65.8) \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">8 (53.3) \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"> \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"><span class="elsevierStyleBold">Use of statin</span> \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"> \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"> \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"> \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"> \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">Yes (%) \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">37 (64.9) \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">38 (54.2) \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">8 (53.3) \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">0.601 \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">No (%) \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">20 (35.1) \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">32 (45.8) \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">7 (46.7) \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"> \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"><span class="elsevierStyleBold">N<span class="elsevierStyleSup">o</span> of medications</span> \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">4.4±2.1 \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">4.4±2.2 \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">4.6±2.2 \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">0.926 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">The distribution of clinical and epidemiological characteristics according to the CKD stages of the 142 patients with predialysis CKD.</p>" ] ] 3 => array:7 [ "identificador" => "tbl3" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="tfn4" class="elsevierStyleSimplePara elsevierViewall">ULN: upper limit of normal</p><p id="tfn5" class="elsevierStyleSimplePara elsevierViewall">*Logarithmic transformation</p>" "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\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"><span class="elsevierStyleBold">Characteristic</span> \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="4" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"><span class="elsevierStyleBold">GFR</span></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"> \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="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"><span class="elsevierStyleBold">Univariate analysis</span></th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"><span class="elsevierStyleBold">Adjusted by BMI</span></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"> \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">β coefficient \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"><span class="elsevierStyleItalic">p</span>-value \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">β coefficient \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"><span class="elsevierStyleItalic">p</span>-value \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" 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"><span class="elsevierStyleBold">Clinics</span> \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"> \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"> \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"> \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"> \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">Age (years old) \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">0.03 \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">0.625 \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"> \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"> \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">Gender (F > M) \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">6.9 \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">0.001 \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">6.1 \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">0.005 \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">BMI<a class="elsevierStyleCrossRef" href="#tfn5">*</a> \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">24.1 \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">0.000 \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"> \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"> \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">Diabetes (Yes > No) \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">1.4 \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">0.546 \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"> \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"> \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">Use of a statin (Yes > No) \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">3.0 \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">0.171 \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">2.9 \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">0.183 \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">Number of medication \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">0.43 \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">0.408 \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"> \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"> \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"><span class="elsevierStyleBold">Laboratory</span> \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"> \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"> \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"> \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"> \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">AST/ULN<a class="elsevierStyleCrossRef" href="#tfn5">*</a> \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">8.87 \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">0.007 \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">8.40 \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">0.008 \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">ALT/ULN<a class="elsevierStyleCrossRef" href="#tfn5">*</a> \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">5.06 \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">0.028 \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">4.58 \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">0.039 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spara40" class="elsevierStyleSimplePara elsevierViewall">A linear regression of the clinical and laboratory characteristics according to the GFRs of the 142 patients with predialysis CKD.</p>" ] ] 4 => array:7 [ "identificador" => "tbl4" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="tfn6" class="elsevierStyleSimplePara elsevierViewall">ULN: upper limit of normal</p><p id="tfn7" class="elsevierStyleSimplePara elsevierViewall">*Student's t-test; measures with logarithmic transformation</p>" "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " rowspan="2" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"><span class="elsevierStyleBold">Aminotransferase</span></th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"><span class="elsevierStyleBold">Stages of CKD</span></th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " rowspan="2" align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleBold">-value</span><a class="elsevierStyleCrossRef" href="#tfn7">*</a></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"><span class="elsevierStyleBold">Early (2 & 3)</span> \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"><span class="elsevierStyleBold">Advanced (4 & 5)</span> \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" 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"><span class="elsevierStyleBold">N</span> \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">57 \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">85 \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"> \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">AST/ULN \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">0.586±0.211 \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">0.530±0.201 \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">0.061 \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">ALT/ULN \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">0.311±0.156 \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">0.274±0.162 \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">0.084 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spara50" class="elsevierStyleSimplePara elsevierViewall">The mean serum aminotransferase levels, divided by the ULN for the early (2 and 3) and advanced (4 and 5) stages of CKD among the 142 patients undergoing conservative treatment.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec10" "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ YJ Kim \n \t\t\t\t\t\t\t\t """ 1 => """ BK Jang \n \t\t\t\t\t\t\t\t """ 2 => """ ES Kim \n \t\t\t\t\t\t\t\t """ 3 => """ KS Park \n \t\t\t\t\t\t\t\t """ 4 => """ KB Cho \n \t\t\t\t\t\t\t\t """ 5 => """ WJ Chung \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.3350/kjhep.2012.18.1.41" "Revista" => array:7 [ "tituloSerie" => "Korean J Hepatol" "fecha" => "2012" "volumen" => "18" "numero" => "1" "paginaInicial" => "41" "paginaFinal" => "47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22511902" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.3350/kjhep.2012.18.1.41" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.3350/kjhep.2012.18.1.41" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gamma glutamyl transferase" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ JB Whitfield \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1080/20014091084227" "Revista" => array:7 [ "tituloSerie" => "Crit Rev Clin Lab Sci" "fecha" => "2001" "volumen" => "38" "numero" => "4" "paginaInicial" => "263" "paginaFinal" => "355" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11563810" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1080/20014091084227" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1080/20014091084227" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gamma-glutamyl transferase (GGT) as an independent predictive factor of sustained virologic response in patients with hepatitis C treated with interferon-alpha and ribavirin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ CA Villela-Nogueira \n \t\t\t\t\t\t\t\t """ 1 => """ RM Perez \n \t\t\t\t\t\t\t\t """ 2 => """ JA de Segadas Soares \n \t\t\t\t\t\t\t\t """ 3 => """ HSM Coelho \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1097/01.mcg.0000174025.19214.32" "Revista" => array:7 [ "tituloSerie" => "J Clin Gastroenterol" "fecha" => "2005" "volumen" => "39" "numero" => "8" "paginaInicial" => "728" "paginaFinal" => "730" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16082285" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1097/01.mcg.0000174025.19214.32" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1097/01.mcg.0000174025.19214.32" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low aspartate transaminase activity in serum of patients undergoing chronic hemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ PL Wolf \n \t\t\t\t\t\t\t\t """ 1 => """ D Williams \n \t\t\t\t\t\t\t\t """ 2 => """ N Coplon \n \t\t\t\t\t\t\t\t """ 3 => """ AS Coulson \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Clin Chem" "fecha" => "1972" "volumen" => "18" "numero" => "6" "paginaInicial" => "567" "paginaFinal" => "568" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5026769" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low serum aminotransferase activity in patients undergoing regular hemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ M Chimata \n \t\t\t\t\t\t\t\t """ 1 => """ H Masaoka \n \t\t\t\t\t\t\t\t """ 2 => """ M Fujimaki \n \t\t\t\t\t\t\t\t """ 3 => """ N Hamada \n \t\t\t\t\t\t\t\t """ 4 => """ K Oda \n \t\t\t\t\t\t\t\t """ 5 => """ M Sudo \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Nihon Jinzo Gakkai Shi" "fecha" => "1994" "volumen" => "36" "numero" => "4" "paginaInicial" => "389" "paginaFinal" => "395" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8022112" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serum alanine aminotransferase levels, hematocrit rate and body weight correlations before and after hemodialysis session" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ EP Lopes \n \t\t\t\t\t\t\t\t """ 1 => """ LHBC Sette \n \t\t\t\t\t\t\t\t """ 2 => """ JBC Sette \n \t\t\t\t\t\t\t\t """ 3 => """ CF Luna \n \t\t\t\t\t\t\t\t """ 4 => """ AM Andrade \n \t\t\t\t\t\t\t\t """ 5 => """ M Moraes \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/S1807-59322009001000002" "Revista" => array:7 [ "tituloSerie" => "Clinics" "fecha" => "2009" "volumen" => "64" "numero" => "10" "paginaInicial" => "941" "paginaFinal" => "945" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19841699" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The pathogenesis of decreased aspartate aminotransferase and alanine aminotransferase activity in the plasma of hemodialysis patients: the role of vitamin B6 deficiency" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ K Ono \n \t\t\t\t\t\t\t\t """ 1 => """ T Ono \n \t\t\t\t\t\t\t\t """ 2 => """ T Matsumata \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Clin Nephrol" "fecha" => "1995" "volumen" => "43" "numero" => "6" "paginaInicial" => "405" "paginaFinal" => "408" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7554526" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between serum aspartate transaminase and homocysteine levels in hemodialysis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ J Huang \n \t\t\t\t\t\t\t\t """ 1 => """ C Yen \n \t\t\t\t\t\t\t\t """ 2 => """ M Pai \n \t\t\t\t\t\t\t\t """ 3 => """ K Wu \n \t\t\t\t\t\t\t\t """ 4 => """ T Tsai \n \t\t\t\t\t\t\t\t """ 5 => """ B Hsieh \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1053/ajkd.2002.36948b" "Revista" => array:7 [ "tituloSerie" => "Am J kidney Dis" "fecha" => "2002" "volumen" => "40" "numero" => "6" "paginaInicial" => "1195" "paginaFinal" => "1201" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12460038" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1053/ajkd.2002.36948b" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1053/ajkd.2002.36948b" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changes in viremia and circulating interferon-α during hemodialysis in hepatitis C virus-positive patients: only coincidental phenomena?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ S Badalamenti \n \t\t\t\t\t\t\t\t """ 1 => """ A Catania \n \t\t\t\t\t\t\t\t """ 2 => """ G Lunghi \n \t\t\t\t\t\t\t\t """ 3 => """ G Covini \n \t\t\t\t\t\t\t\t """ 4 => """ E Bredi \n \t\t\t\t\t\t\t\t """ 5 => """ D Brancaccio \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/s0272-6386(03)00417-7" "Revista" => array:7 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2003" "volumen" => "42" "numero" => "1" "paginaInicial" => "143" "paginaFinal" => "150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12830466" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/s0272-6386(03)00417-7" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1016/S0272-6386(03)00417-7" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hemodialysis prevents liver disease caused by hepatitis C virus: role of hepatocyte growth factor" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ T Rampino \n \t\t\t\t\t\t\t\t """ 1 => """ E Arbustini \n \t\t\t\t\t\t\t\t """ 2 => """ M Gregorini \n \t\t\t\t\t\t\t\t """ 3 => """ P Guallini \n \t\t\t\t\t\t\t\t """ 4 => """ C Libetta \n \t\t\t\t\t\t\t\t """ 5 => """ M Maggio \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1046/j.1523-1755.1999.00791.x" "Revista" => array:7 [ "tituloSerie" => "Kidney Int" "fecha" => "1999" "volumen" => "56" "numero" => "6" "paginaInicial" => "2286" "paginaFinal" => "2291" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10594807" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1046/j.1523-1755.1999.00791.x" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1046/j.1523-1755.1999.00791.x" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hepatitis C virus screening and clinical monitoring of biomarkers in patients undergoing hemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ LPV Maia \n \t\t\t\t\t\t\t\t """ 1 => """ OA Martins-Filho \n \t\t\t\t\t\t\t\t """ 2 => """ A Teixeira-Carvalho \n \t\t\t\t\t\t\t\t """ 3 => """ E Speziali \n \t\t\t\t\t\t\t\t """ 4 => """ R Vermhren \n \t\t\t\t\t\t\t\t """ 5 => """ EF Lira \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1002/jmv.21521" "Revista" => array:7 [ "tituloSerie" => "J Med Virol" "fecha" => "2009" "volumen" => "81" "numero" => "7" "paginaInicial" => "1220" "paginaFinal" => "1231" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19475604" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1002/jmv.21521" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1002/jmv.v81:7" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Decreased serum aminotransferase activity in patients with chronic renal failure: impact on the detection of viral hepatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ F Fabrizi \n \t\t\t\t\t\t\t\t """ 1 => """ G Lunghi \n \t\t\t\t\t\t\t\t """ 2 => """ S Finazzi \n \t\t\t\t\t\t\t\t """ 3 => """ P Colucci \n \t\t\t\t\t\t\t\t """ 4 => """ A Pagano \n \t\t\t\t\t\t\t\t """ 5 => """ C Ponticelli \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1053/ajkd.2001.28590" "Revista" => array:7 [ "tituloSerie" => "Am J kidney Dis" "fecha" => "2001" "volumen" => "38" "numero" => "5" "paginaInicial" => "1009" "paginaFinal" => "1015" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11684554" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1053/ajkd.2001.28590" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1053/ajkd.2001.28590" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction of creatinine clearance from serum creatinine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ DW Cockcroft \n \t\t\t\t\t\t\t\t """ 1 => """ MH Gault \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1159/000180580" "Revista" => array:7 [ "tituloSerie" => "Nephron" "fecha" => "1976" "volumen" => "16" "numero" => "1" "paginaInicial" => "31" "paginaFinal" => "41" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1244564" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1159/000180580" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1159/000180580" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A Formula to estimate the approximate surface area if height and weight be known" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ D Du BOIS \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Intern Med" "fecha" => "1916" "volumen" => "XVII" "numero" => "62" "paginaInicial" => "863" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1001/archinte.1916.00080130010002" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ AS Levey \n \t\t\t\t\t\t\t\t """ 1 => """ JP Bosch \n \t\t\t\t\t\t\t\t """ 2 => """ JB Lewis \n \t\t\t\t\t\t\t\t """ 3 => """ T Greene \n \t\t\t\t\t\t\t\t """ 4 => """ N Rogers \n \t\t\t\t\t\t\t\t """ 5 => """ D Roth \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.7326/0003-4819-130-6-199903160-00002" "Revista" => array:7 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1999" "volumen" => "130" "numero" => "6" "paginaInicial" => "461" "paginaFinal" => "470" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10075613" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.7326/0003-4819-130-6-199903160-00002" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.7326/0003-4819-130-6-199903160-00002" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ AS Levey \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Am J kidney Dis" "fecha" => "2002" "volumen" => "39" "numero" => "2 Suppl 1" "paginaInicial" => "S1" "paginaFinal" => "266" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11904577" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hypoaminotransferasemia in patients undergoing long-term hemodialysis: clinical and biochemical appraisal" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ K Yasuda \n \t\t\t\t\t\t\t\t """ 1 => """ K Okuda \n \t\t\t\t\t\t\t\t """ 2 => """ N Endo \n \t\t\t\t\t\t\t\t """ 3 => """ Y Ishiwatari \n \t\t\t\t\t\t\t\t """ 4 => """ R Ikeda \n \t\t\t\t\t\t\t\t """ 5 => """ H Hayashi \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/0016-5085(95)90591-x" "Revista" => array:7 [ "tituloSerie" => "Gastroenterology" "fecha" => "1995" "volumen" => "109" "numero" => "4" "paginaInicial" => "1295" "paginaFinal" => "1300" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7557098" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/0016-5085(95)90591-x" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1016/0016-5085(95)90591-X" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lipid-lowering agents that cause drug-induced hepatotoxicity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ SS Bhardwaj \n \t\t\t\t\t\t\t\t """ 1 => """ N Chalasani \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/j.cld.2007.06.010" "Revista" => array:7 [ "tituloSerie" => "Clin Liver Dis" "fecha" => "2007" "volumen" => "11" "numero" => "3" "paginaInicial" => "597" "paginaFinal" => "613" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17723922" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/j.cld.2007.06.010" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1016/j.cld.2007.06.010" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between diabetes and elevated serum alanine aminotransferase activity among Mexican Americans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ AA Meltzer \n \t\t\t\t\t\t\t\t """ 1 => """ JE Everhart \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1093/oxfordjournals.aje.a009315" "Revista" => array:7 [ "tituloSerie" => "Am J Epidemiol" "fecha" => "1997" "volumen" => "146" "numero" => "7" "paginaInicial" => "565" "paginaFinal" => "571" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9326434" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1093/oxfordjournals.aje.a009315" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1093/oxfordjournals.aje.a009315" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Malnutrition in patients with chronic kidney disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ S Chung \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Open J Intern Med" "fecha" => "2012" "volumen" => "02" "numero" => "02" "paginaInicial" => "89" "paginaFinal" => "99" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "http://dx.doi.org/10.4236/ojim.2012.22018" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ P Stenvinkel \n \t\t\t\t\t\t\t\t """ 1 => """ O Heimbürger \n \t\t\t\t\t\t\t\t """ 2 => """ F Paultre \n \t\t\t\t\t\t\t\t """ 3 => """ U Diczfalusy \n \t\t\t\t\t\t\t\t """ 4 => """ T Wang \n \t\t\t\t\t\t\t\t """ 5 => """ L Berglund \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1046/j.1523-1755.1999.00422.x" "Revista" => array:7 [ "tituloSerie" => "Kidney Int" "fecha" => "1999" "volumen" => "55" "numero" => "5" "paginaInicial" => "1899" "paginaFinal" => "1911" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10231453" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1046/j.1523-1755.1999.00422.x" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1046/j.1523-1755.1999.00422.x" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Modest weight loss and physical activity in overweight patients with chronic liver disease results in sustained improvements in alanine aminotransferase, fasting insulin, and quality of life" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ IJ Hickman \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1136/gut.2003.027581" "Revista" => array:7 [ "tituloSerie" => "Gut" "fecha" => "2004" "volumen" => "53" "numero" => "3" "paginaInicial" => "413" "paginaFinal" => "419" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14960526" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1136/gut.2003.027581" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1136/gut.2003.027581" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Daily requirement for pyridoxine supplements in chronic renal failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ JD Kopple \n \t\t\t\t\t\t\t\t """ 1 => """ K Mercurio \n \t\t\t\t\t\t\t\t """ 2 => """ MJ Blumenkrantz \n \t\t\t\t\t\t\t\t """ 3 => """ MR Jones \n \t\t\t\t\t\t\t\t """ 4 => """ J Tallos \n \t\t\t\t\t\t\t\t """ 5 => """ C Roberts \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1038/ki.1981.69" "Revista" => array:7 [ "tituloSerie" => "Kidney Int" "fecha" => "1981" "volumen" => "19" "numero" => "5" "paginaInicial" => "694" "paginaFinal" => "704" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7289398" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1038/ki.1981.69" "WWW" => array:1 [ "link" => "http://dx.doi.org/10.1038/ki.1981.69" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of gender on the progression of nondiabetic renal disease: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ J Neugarten \n \t\t\t\t\t\t\t\t """ 1 => """ A Acharya \n \t\t\t\t\t\t\t\t """ 2 => """ SR Silbiger \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1681/ASN.V112319" "Revista" => array:7 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "2000" "volumen" => "11" "numero" => "2" "paginaInicial" => "319" "paginaFinal" => "329" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10665939" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack639266" "titulo" => "Acknowledgments" "texto" => "<p id="para290" class="elsevierStylePara elsevierViewall">We thank Ulisses Montarroyos for his collaboration on the statistical analysis.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/18075932/0000007000000005/v1_202212011403/S1807593222013837/v1_202212011403/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/18075932/0000007000000005/v1_202212011403/S1807593222013837/v1_202212011403/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222013837?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 9 | 0 | 9 |
| 2024 October | 74 | 35 | 109 |
| 2024 September | 65 | 33 | 98 |
| 2024 August | 66 | 22 | 88 |
| 2024 July | 60 | 33 | 93 |
| 2024 June | 55 | 16 | 71 |
| 2024 May | 38 | 17 | 55 |
| 2024 April | 27 | 20 | 47 |
| 2024 March | 39 | 25 | 64 |
| 2024 February | 28 | 8 | 36 |
| 2024 January | 60 | 15 | 75 |
| 2023 December | 57 | 20 | 77 |
| 2023 November | 26 | 18 | 44 |
| 2023 October | 16 | 19 | 35 |
| 2023 September | 8 | 8 | 16 |
| 2023 August | 7 | 3 | 10 |
| 2023 July | 8 | 14 | 22 |
| 2023 June | 6 | 1 | 7 |
| 2023 May | 5 | 1 | 6 |
| 2023 April | 2 | 0 | 2 |
| 2023 March | 6 | 2 | 8 |
| 2023 February | 7 | 0 | 7 |
| 2023 January | 1 | 5 | 6 |
| 2022 December | 34 | 2 | 36 |
Show all