Clinicopathological relationship in Colombian patients with lupus nephritis | Revista Colombiana de Reumatología (English Edition)

array:25 ["pii" => "S244444051730078X" "issn" => "24444405" "doi" => "10.1016/j.rcreue.2017.12.004" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "155" "copyright" => "Asociación Colombiana de Reumatología" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Colomb Reumatol. 2017;24:211-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 625 "formatos" => array:3 [ "EPUB" => 54 "HTML" => 412 "PDF" => 159 ] ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S0121812317301068" "issn" => "01218123" "doi" => "10.1016/j.rcreu.2017.10.001" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "155" "copyright" => "Asociación Colombiana de Reumatología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Colomb Reumatol. 2017;24:211-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 937 "formatos" => array:3 [ "EPUB" => 2 "HTML" => 688 "PDF" => 247 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Investigation" "titulo" => "Clinicopathological relationship in Colombian patients with lupus nephritis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "211" "paginaFinal" => "218" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Relación clínicopatológica en pacientes colombianos con nefritis lúpica" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 943 "Ancho" => 2940 "Tamanyo" => 80921 ] ] "descripcion" => array:1 [ "en" => "Frequency of histological types according to the 2003 ISN/RPS Classification: (A) NPLN and PLN in 116 patients without mixed histological features. (B) Distribution of histological types in NPLN and PLN patients." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carlos Jaime Velásquez-Franco, Yerlin Andrés Colina Vargas, Sara Correa Pérez, Felipe Osorio Ospina, Mariana Tamayo Correa, Juliana Madrid Vargas, Aura Ligia Zapata-Castellanos, Libia María Rodríguez Padilla, Luis Fernando Pinto Peñaranda, Miguel Antonio Mesa Navas" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Carlos Jaime" "apellidos" => "Velásquez-Franco" ] 1 => array:2 [ "nombre" => "Yerlin Andrés" "apellidos" => "Colina Vargas" ] 2 => array:2 [ "nombre" => "Sara Correa" "apellidos" => "Pérez" ] 3 => array:2 [ "nombre" => "Felipe Osorio" "apellidos" => "Ospina" ] 4 => array:2 [ "nombre" => "Mariana Tamayo" "apellidos" => "Correa" ] 5 => array:2 [ "nombre" => "Juliana Madrid" "apellidos" => "Vargas" ] 6 => array:2 [ "nombre" => "Aura Ligia" "apellidos" => "Zapata-Castellanos" ] 7 => array:2 [ "nombre" => "Libia María" "apellidos" => "Rodríguez Padilla" ] 8 => array:2 [ "nombre" => "Luis Fernando" "apellidos" => "Pinto Peñaranda" ] 9 => array:2 [ "nombre" => "Miguel Antonio" "apellidos" => "Mesa Navas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S244444051730078X" "doi" => "10.1016/j.rcreue.2017.12.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S244444051730078X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0121812317301068?idApp=UINPBA00004N" "url" => "/01218123/0000002400000004/v2_201801120646/S0121812317301068/v2_201801120646/en/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2444440518300128" "issn" => "24444405" "doi" => "10.1016/j.rcreue.2018.05.001" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "157" "copyright" => "Asociación Colombiana de Reumatología" "documento" => "article" "crossmark" => 1 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "ssu" "cita" => "Rev Colomb Reumatol. 2017;24:219-29" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4432 "formatos" => array:3 [ "EPUB" => 43 "HTML" => 4186 "PDF" => 203 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Review Article" "titulo" => "Gout and pregnancy: A report of a new case and systematic review" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "219" "paginaFinal" => "229" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Gota y embarazo: revisión sistemática, incluyendo el reporte de un nuevo caso" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2242 "Ancho" => 2333 "Tamanyo" => 361377 ] ] "descripcion" => array:1 [ "en" => "(A and B) AP view of the right foot, which shows an increase in volume of the tarsus and ankle, erythema in the right tarsus. (C) AP view after the infiltration of intra-articular dexamethasone." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Gabriel Horta-Baas, María Fernanda Hernández-Cabrera, Imelda Vergara-Sánchez, María del Socorro Romero-Figueroa" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Gabriel" "apellidos" => "Horta-Baas" ] 1 => array:2 [ "nombre" => "María Fernanda" "apellidos" => "Hernández-Cabrera" ] 2 => array:2 [ "nombre" => "Imelda" "apellidos" => "Vergara-Sánchez" ] 3 => array:2 [ "nombre" => "María del Socorro" "apellidos" => "Romero-Figueroa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0121812317301214" "doi" => "10.1016/j.rcreu.2017.10.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0121812317301214?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444440518300128?idApp=UINPBA00004N" "url" => "/24444405/0000002400000004/v1_201806020530/S2444440518300128/v1_201806020530/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2444440517300778" "issn" => "24444405" "doi" => "10.1016/j.rcreue.2017.12.003" "estado" => "S300" "fechaPublicacion" => "2017-10-01" "aid" => "142" "copyright" => "Asociación Colombiana de Reumatología" "documento" => "article" "crossmark" => 1 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Colomb Reumatol. 2017;24:205-10" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 623 "formatos" => array:3 [ "EPUB" => 84 "HTML" => 439 "PDF" => 100 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Investigation" "titulo" => "Prevalence of vitamin D levels in patients with autoimmune diseases in Ecuador: A retrospective study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "205" "paginaFinal" => "210" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia de vitamina D en pacientes con enfermedades autoinmunes en Ecuador: estudio restrospectivo" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1368 "Ancho" => 1593 "Tamanyo" => 117149 ] ] "descripcion" => array:1 [ "en" => "Vitamin D levels according to DXA diagnoses: Osteopenia and Osteoporosis." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Génessis Maldonado, Roberto Guerrero, Carlos Ríos" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Génessis" "apellidos" => "Maldonado" ] 1 => array:2 [ "nombre" => "Roberto" "apellidos" => "Guerrero" ] 2 => array:2 [ "nombre" => "Carlos" "apellidos" => "Ríos" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0121812317300890" "doi" => "10.1016/j.rcreu.2017.08.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0121812317300890?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444440517300778?idApp=UINPBA00004N" "url" => "/24444405/0000002400000004/v1_201806020530/S2444440517300778/v1_201806020530/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Original Investigation" "titulo" => "Clinicopathological relationship in Colombian patients with lupus nephritis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "211" "paginaFinal" => "218" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carlos Jaime Velásquez-Franco, Yerlin Andrés Colina Vargas, Sara Correa Pérez, Felipe Osorio Ospina, Mariana Tamayo Correa, Juliana Madrid Vargas, Aura Ligia Zapata-Castellanos, Libia María Rodríguez Padilla, Luis Fernando Pinto Peñaranda, Miguel Antonio Mesa Navas" "autores" => array:10 [ 0 => array:4 [ "nombre" => "Carlos Jaime" "apellidos" => "Velásquez-Franco" "email" => array:1 [ 0 => "carjaivel@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Yerlin Andrés" "apellidos" => "Colina Vargas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Sara Correa" "apellidos" => "Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Felipe Osorio" "apellidos" => "Ospina" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Mariana Tamayo" "apellidos" => "Correa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Juliana Madrid" "apellidos" => "Vargas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "Aura Ligia" "apellidos" => "Zapata-Castellanos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 7 => array:3 [ "nombre" => "Libia María" "apellidos" => "Rodríguez Padilla" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 8 => array:3 [ "nombre" => "Luis Fernando" "apellidos" => "Pinto Peñaranda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 9 => array:3 [ "nombre" => "Miguel Antonio" "apellidos" => "Mesa Navas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Clinical Immunology and Rheumatology Research Group, Clinica Universitaria Bolivariana, Professor of School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Rheumatology Department, Hospital Pablo Tobón Uribe, Medellín, Colombia" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Relación clínicopatológica en pacientes colombianos con nefritis lúpica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 943 "Ancho" => 2940 "Tamanyo" => 80579 ] ] "descripcion" => array:1 [ "en" => "Frequency of histological types according to the 2003 ISN/RPS Classification: (A) NPLN and PLN in 116 patients without mixed histological features. (B) Distribution of histological types in NPLN and PLN patients." ] ] ] "textoCompleto" => "IntroductionSystemic lupus erythematosus (SLE) is a chronic, complex, multisystem autoimmune disease with protean clinical manifestations, which are modulated by genetic, environmental, hormonal, and immunological factors.<a class="elsevierStyleCrossRefs" href="#bib0205">1,2</a> Renal involvement accounts for 51–60% of SLE patients<a class="elsevierStyleCrossRefs" href="#bib0215">3–5</a>; it is one of the leading causes of morbidity and mortality,<a class="elsevierStyleCrossRef" href="#bib0230">6</a> with about 10–30% of subjects progressing to end-stage renal disease (ESRD), despite current treatment.<a class="elsevierStyleCrossRefs" href="#bib0235">7–10</a> Considering these aspects, early diagnosis and treatment of lupus nephritis (LN) are mandatory, which is one of the main recommendations of the “treat to target” strategy in Systemic Lupus Erythematosus (T2T/SLE) International Task Force.<a class="elsevierStyleCrossRef" href="#bib0255">11</a>Renal biopsy (RB) is considered the gold standard to diagnose LN.<a class="elsevierStyleCrossRefs" href="#bib0260">12–15</a> Biopsy findings are classified according to the International Society of Nephrology/Renal Pathology Society (ISN/RPS), issued in 2003. This classification includes six types of nephritis established through light, electronic, and immunofluorescence microscopy findings. Besides type VI, which denotes an irreversible stage of fibrosis, the histological types can be broadly dichotomized into non-proliferative and proliferative lupus nephritis (NPLN and PLN, respectively). PLN is constituted by types III and IV, which are characterized by endothelial proliferation which damages the glomerulus and can rapidly progress to ESRD, requiring immediate and aggressive immunosuppression. In addition to current classification, RB provides information about vascular, tubular, and interstitial affection and estimates the degree of activity and chronicity; both indices are important from a therapeutic and prognostic point of view.<a class="elsevierStyleCrossRef" href="#bib0280">16</a>Despite all its benefits, RB is not usually available at the moment of defining immunosuppression as it requires specialized equipment and is associated with significant clinical risks; thus, it is contraindicated in individuals with certain clinical conditions, such as anemia or thrombocytopenia. Consequently, the physician must rely on clinical aspects which can help determine the diagnosis, such as proteinuria, abnormal urinary sediment, and an increase in serum creatinine, supported by markers of lupus activity, such as anti-ds DNA high titers<a class="elsevierStyleCrossRef" href="#bib0285">17</a> or hypocomplementemia.<a class="elsevierStyleCrossRef" href="#bib0290">18</a> From a pragmatic point of view, the important decision is to define the presence of PLN. Taking these considerations into account, different authors have tried to establish the relationship between clinical, laboratory, and histological findings in both adult<a class="elsevierStyleCrossRefs" href="#bib0295">19–26</a> and pediatric<a class="elsevierStyleCrossRefs" href="#bib0335">27,28</a> population, with conflicting results. To our knowledge, in Latin America, there is only one study that uses the current LN classification.<a class="elsevierStyleCrossRef" href="#bib0295">19</a> For this reason, we decided to establish the clinicopathological relationship in patients with LN, emphasizing the difference between PLN and NPLN in Colombian patients.Materials and methodsWe conducted an analytical cross-sectional study, which included all patients with SLE according to the 1997 American College of Rheumatology revised criteria<a class="elsevierStyleCrossRef" href="#bib0345">29</a> with biopsy-proven LN in agreement with the 2003 ISN/RPS classification,<a class="elsevierStyleCrossRef" href="#bib0280">16</a> who were treated at two reference centers in the city of Medellín, Colombia, between 2004 and 2012. Subjects with kidney transplantation, coexistence of other autoimmune diseases, or medical records with missing data on the main variables of interest were excluded. Treatment and time of renal biopsy were in consonance with usual clinical practice.After receiving approval from the ethics committees of each institution, the information was retrieved from the patients’ medical records at the time of renal biopsy and was registered in a Microsoft Excel® 2010 worksheet, containing the following variables: demographic (age at diagnosis of SLE, gender); clinical (time from onset of symptoms and LN diagnosis, arterial hypertension, nephritic and nephrotic syndromes, acute and chronic renal failure, as defined by the KDIGO guidelines<a class="elsevierStyleCrossRefs" href="#bib0350">30,31</a>; paraclinical (hematuria, pyuria, cylindruria, serum creatinine, positive anti-DNA antibodies, C3 and C4 hypocomplementemia – values below 90 and 10mg/dL, respectively) and histopathological classification of LN, along with activity and chronicity indices.<a class="elsevierStyleCrossRef" href="#bib0280">16</a>Statistical analysesQualitative variables were described using absolute and relative frequencies, and quantitative variables by medians with interquartile range (IQR) due to non-compliance of normality assumption. In individuals with a single histological type, the relationship with clinical findings was explored using the chi-square or exact Fisher's test for qualitative variables, initially comparing each class (from I to V) separately and later grouped in proliferative (III and IV) vs. non-proliferative types (I–II–V). The difference of proportions between the comparison groups and their respective confidence intervals at 95% was determined.Mann–Whitney test was used for comparison of quantitative variables. The relationship between activity and chronicity indices with complement values, 24-h proteinuria, and serum creatinine was determined using Spearman's correlation coefficient. In addition, activity index values were compared according to the presence or absence of anti-DNA antibodies, using the Mann–Whitney test. For all analyses, a p value of <0.05 was considered statistically significant. The processing of information was carried out in the statistical package SPSS version 22.Bias controlPopulation selection bias decreased by including all patients with LN that met eligibility criteria during the study period. To control information bias by observers, a comprehensive review of the multiple information sources was performed, as well as the standardization of the collection process before researchers began to review medical records. In addition, information bias was controlled by excluding incomplete medical records or those with doubtful results in the variables of interest. Additionally, both centers referred the RB to the same pathologist for interpretation, which minimizes the possibility of interobserver variability.ResultsA total of 132 patients were included, of whom 110 (83%) were female. The median age was 24 years (IQR: 19–37) and the median elapsed time between diagnosis of SLE and LN was 4.5 months (IQR: 0–66). The median serum creatinine was 0.9mg/dL (IQR: 0.7–1.3). Ninety-six (73%) patients had positive anti-DNA antibodies; 85 (64%) and 44 (33%) had C3 and C4 hypocomplementemia, respectively. Proteinuria was observed in 105 individuals (80%), while hematuria was the most common urine sediment alteration, which was present in 85 subjects (64%). Regarding the clinical presentation, nephritic syndrome was the most common, followed by nephrotic syndrome with 46 and 38%, respectively (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Histopathological findingsFifteen (11.4%) patients had mixed histological types (III–V: n=7; IV–V: n=8) and were not included in the final analysis. Of the remaining 116 patients, 86 (74%) had PLN, where type IV was the most common as it was observed in 71 (82.6%) of the subjects (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). None of the patients had type VI nephritis.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The median of activity and chronicity indices were 5 (IQR: 1.3–9) and 1 (IQR: 0–3), respectively. When activity and chronicity indices were compared, PLN had a higher activity index, with a median of 7.5 (IQR: 4–11.3), compared to NPLN (median: 0; IQR: 0–1.25; p<0.0001). The chronicity index was also higher in PLN (median 1; IQR 0–3) compared to NPLN (median 0; IQR 0–1.25; p=0.015).Clinicopathological relationshipNo association was found between arterial hypertension or any clinical syndrome (nephritic, nephrotic, acute, or chronic renal failure) with the presence of either PLN or NPLN (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Nonetheless, in patients with PLN, there was a higher presence of hematuria (72.1 vs. 46.7%; p=0.012), C3 hypocomplementemia (70.9 vs. 43.3%; p=0.007), 24-h proteinuria (2560 vs 741mg; p=0.001), and serum creatinine (1 vs. 0.77mg/dL; p=0.006), when compared with NPLN (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia>When assessing the relationship between clinical variables with activity and chronicity indices, positive correlations were found between activity index with serum creatinine values (Spearman's Rho: 0.40; 95% CI: 0.25–0.55; p<0.0001) and 24-h proteinuria (Spearman's Rho: 0.37; 95% CI: 0.18–0.55; p<0.0001), whereas a negative correlation was described amongst activity index and serum complement levels (C3 Spearman's Rho: 0.31; 95% CI: −0.47 to −0.13; p=0.001; C4 Spearman's Rho: −0.24; 95% CI: −0.41 to −0054; p=0.01); no correlations were detected for chronicity index. Additionally, the activity index values were higher in patients with positive anti-DNA antibodies, compared to subjects without them (median: 6; IQR: 3–11 vs. 3; IQR: 0–5.5; p=0.001).DiscussionIn the present study, we found a clinicopathological relationship between PLN and hematuria, 24-h proteinuria, elevated serum creatinine, and C3 hypocomplementemia; nonetheless, no association was found with any clinical syndrome or other variables. This relationship is logical since proliferative forms are related to increased deposition of immune complexes in the glomeruli, with subsequent complement consumption and alterations in kidney function.<a class="elsevierStyleCrossRef" href="#bib0360">32</a> These results are similar to those reported by Okpechi et al.,<a class="elsevierStyleCrossRef" href="#bib0310">22</a> where they found that PLN was linked to hematuria on dipstick and C3 hypocomplementemia in a South African lupus population. Conversely, Wen, in Taiwan, found no clinicopathological relationship, except for anti-DNA antibodies and C4 hypocomplementemia with PLN. One possible explanation for this difference when compared with our study is the inclusion of mixed LN forms in the study of Wen et al., which could obscure this association.When analyzing specific results, the correlation of hematuria with PLN is expected since the endothelial damage caused by immune complexes can lead to extravasation of red blood cells into Bowman's space, with its subsequent urinary excretion.<a class="elsevierStyleCrossRef" href="#bib0220">4</a> Even though leukocyturia would be expected to behave in the same way, we did not find statistical association, albeit there was a clinically significant difference (46.5 vs. 26.7% in PLN and NPLN, respectively) with a borderline statistically significant p value (0.057), which probably reflects lack of power of our study to detect such difference and could also be explained by the many causes other than glomerular damage, which could cause leukocyturia. Since the sample in this study was a convenience one with the total of the detected subjects, there were no other interventions that could be implemented to mitigate this problem. It would be important to consider the inclusion of additional rheumatology centers in the future to increase the sample size and clarify this borderline finding.Concerning the lack of correlation between the clinical syndromes and histological types, renal biopsy was performed in a systematic manner in patients with 24-h proteinuria greater than 500mg or persistent alterations in urinary sediment, instead of waiting until renal function was impaired, which could explain the lack of correlation (at least partially), since prompt treatment was initiated. This was evidenced through nephritic and nephrotic syndrome rates in our study (46 and 38%, respectively).When compared with other authors, the frequency of nephrotic and nephritic syndromes is variable in non-proliferative and proliferative forms.<a class="elsevierStyleCrossRefs" href="#bib0310">22,33</a> For instance, in the study of Shariati-Sarabi et al.,<a class="elsevierStyleCrossRef" href="#bib0370">34</a> the overall prevalence of nephrotic syndrome was only 8.5%, compared to 38% in our study, yet they did not analyze PLN versus NPLN, and criteria to perform renal biopsy were also different; thus, the comparison of both studies is not possible. It is important to remember that the definition of these syndromes are composite measures of different clinical variables (dyslipidemia, edema, hypertension, among others), susceptible to variation between observers, which constitutes a confounding factor when comparing with other studies, in addition to the inclusion, in some studies, of mixed forms of lupus nephritis.<a class="elsevierStyleCrossRef" href="#bib0365">33</a>One of the striking features of the results of this investigation is the greater range of 24-h proteinuria in proliferative forms, as opposed to that described in other lupus nephritis cohorts.<a class="elsevierStyleCrossRefs" href="#bib0290">18,35</a> One of the possible explanations for this finding is that, in our cohort, 40% of non-proliferative forms corresponded to histological types I and II, in which proteinuria is minimal and generally would not be included in normal clinical practice studies, which require a minimum threshold of proteinuria and urinalysis abnormalities to perform RB. Additionally, one could then argue that class V was shadowed by classes I and II when grouped in the NPLN for analysis; nonetheless, we analyzed each class separately and class V had a lower 24-h proteinuria compared with class III and IV and analysis was unchanged whether we analyzed PLN versus NPLN or each class separately (data not shown). We did not find a satisfactory explanation for these phenomena other than the inherent variation of RB, which analyses a limited number of glomeruli and may not reflect the entire renal histopathology.The other possible reason is that, in literature, there are descriptions of important podocytopathy in PLN, which shows, in some series, that proteinuria is higher in these histological subtypes. Rsende et al. found, in a four-year follow-up, a tendency toward lower mean levels of proteinuria in patients with NPLN, in relation to a preserved synaptopodin, Wilms tumor protein 1, glomerular epithelial protein 1 and nephrin, suggesting structural podocyte damage and higher proteinuria in proliferative types.<a class="elsevierStyleCrossRef" href="#bib0380">36</a>One of the difficulties in trying to compare the findings of this study with previous reports is that the 1977 WHO histological classification was used in these surveys and does not include activity and chronicity indices evaluated in this research.<a class="elsevierStyleCrossRefs" href="#bib0385">37,38</a> Due to the type of population and the adoption of the current classification of lupus nephritis, the present study is similar to Polanco et al.<a class="elsevierStyleCrossRef" href="#bib0295">19</a>; correspondingly, the most common clinical syndrome was nephritic, while proliferative forms occurred with a similar frequency (77 vs. 79%), although the nephritic syndrome was higher in Polanco's study (46 vs. 63%), probably attributed to a longer history of nephritis (13.1±28.1 vs. 4.5 months in this study, although it must be clarified that times were calculated as means and medians, respectively). Unfortunately, Polanco et al. did not refer to anti-DNA titers or activity and chronicity indices. The clinical resemblance of both studies might indirectly suggest a comparable behavior of PLN in Latin American patients. Such findings could be explained by the early aggressive treatment, as well as the prompt diagnosis of lupus nephritis, and the rapid onset of immunosuppressive therapy in these patients.We explored the relationship between activity and chronicity scores of renal biopsies with PLN and NPLN. Like the results of Mavragani et al.,<a class="elsevierStyleCrossRef" href="#bib0290">18</a> an elevated serum creatinine was associated with a high activity index; an identical finding was reported in the study of Shariati-Sarabi<a class="elsevierStyleCrossRef" href="#bib0370">34</a>); additionally, they found a higher frequency of anti-DNA antibodies in PLN. It should be noted that, in the work of these authors, the presence of patients with type VI nephritis constituted 7.1% of its population and that, presumably, it had clearly higher creatinine levels than other types of nephritis.Certain specific limitations were recognized in this study, such as the high frequency of proliferative forms; therefore, the external validity of the results can only be inferred to these specific types. Furthermore, as a cross-sectional study design, there is no data concerning monitoring or treatment response, which are relevant aspects from a clinical perspective. We understand that this design overrepresents chronic and less severe cases, and excludes both extremely ill patients and those who had a fatal outcome. Moreover, despite having included the entire population that met eligibility criteria for a period of eight years in two high-complexity institutions, only 132 patients were admitted, which could affect the power of the study to detect any clinical differences between them; this aspect also limits the conclusions of this paper. However, with the available information, relationships were explored using appropriate statistical analyses.We recognize the possibility of reference bias; it is nonetheless unavoidable, since renal biopsy can only be performed in reference centers and the international criteria by which this procedure was performed already generates a selection bias per se.<a class="elsevierStyleCrossRefs" href="#bib0395">39,40</a> This limitation could also be one of the strengths of our study since this survey was carried out under real-life conditions; we believe that our results can be transferred into clinical care, due to the inclusion of a significant number of individuals using the current histological classification. To our knowledge, this is the first study which adopts this classification at the local level.Finally, even though our results could guide the clinicians in order to define immunosuppression in situ, renal biopsy continues to be of paramount importance in order to correctly classify patients as well as rule out other causes of renal involvement, such as antiphospholipid syndrome nephropathy or thrombotic microangiopathy.ConclusionIn a population of Colombian patients with lupus nephritis, there is a clinicopathological relationship between proliferative types and certain laboratory features, such as hematuria, elevated 24-h protein excretion, serum creatinine level, and C3 hypocomplementemia; nonetheless, no association was found with any other clinical syndrome nor other variables. Renal biopsy continues to be the gold standard in the classification and correct evaluation of lupus nephritis.Conflicts of interestThe authors declare no conflicts of interest of finantial disclosures." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1033529" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec990240" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1033528" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec990241" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistical analyses" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Bias control" ] ] ] 6 => array:3 [ "identificador" => "sec0025" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Histopathological findings" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Clinicopathological relationship" ] ] ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0045" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0050" "titulo" => "Conflicts of interest" ] 10 => array:2 [ "identificador" => "xack349113" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-05-10" "fechaAceptado" => "2017-10-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec990240" "palabras" => array:6 [ 0 => "Lupus nephritis" 1 => "Systemic lupus erythematosus" 2 => "Biopsy" 3 => "Proteinuria" 4 => "Creatinine" 5 => "Hispanic Americans" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec990241" "palabras" => array:6 [ 0 => "Nefritis lúpica" 1 => "Lupus eritematoso sistémico" 2 => "Biopsia" 3 => "Proteinuria" 4 => "Creatinina" 5 => "Hispanoamericanos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "BackgroundThere are several clinical and laboratory features for lupus nephritis diagnosis; however, renal biopsy remains as the gold standard. Different series have tried to establish the relationship between these findings, with conflicting results. ObjectiveTo describe the correlation between clinical and laboratory variables with histological biopsy-proven lupus nephritis. MethodsAn analytical cross-sectional study was conducted, between January, 2004 and December, 2012. Qualitative variables were described using absolute and relative frequencies, while quantitative variables were assessed by medians with interquartile range. The relationship with clinical findings was explored using chi-square maximum likelihood test, adjusted standardized residuals, hierarchical Kruskal–Wallis test, homogeneity of variance in data, post hoc Dunn's test, Spearman's correlation coefficient, and Mann–Whitney test. Results132 patients were included. Proliferative lupus nephritis was the most frequent (74%). The most common clinical condition was nephritic syndrome (46%); proteinuria was observed in 80%. No relationship was found between clinical syndromes and histological types; only statistically significant differences were observed between proliferative and non-proliferative forms regarding hematuria (72.1 vs. 46.7%; p=0.012), C3 hypocomplementemia (70.9 vs. 43.3%; p=0.007), 24-h proteinuria (2560 vs 741mg; p=0.001), and serum creatinine (1 vs. 0.77mg/dL; p=0.006). We found positive correlations between activity index and serum creatinine values, 24-h proteinuria, C3 hypocomplementemia, along with positive anti-DNA antibodies. ConclusionThere is a clinicopathological relationship within proliferative types and certain laboratory features (hematuria, elevated 24-h protein excretion, serum creatinine level, and C3 hypocomplementemia) in a mestizo population with lupus nephritis; nonetheless, no association was found with any other variables." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónExisten varias características clínicas y de laboratorio para el diagnóstico de la nefritis lúpica; sin embargo, la biopsia renal sigue siendo el estándar de oro. Diferentes series han tratado de establecer la relación entre estos hallazgos, con resultados contradictorios. ObjetivoDescribir la correlación entre variables clínicas y de laboratorio con los hallazgos histológicos de nefritis lúpica comprobados por biopsia. MétodosSe realizó un estudio transversal analítico entre enero de 2004 y diciembre de 2012. Se describieron las variables cualitativas utilizando frecuencias absolutas y relativas, mientras que las variables cuantitativas fueron evaluadas por medianas con rango intercuartílico. La relación con los hallazgos clínicos se exploró utilizando: prueba de probabilidad máxima de Chi-cuadrado, residuos estandarizados ajustados, prueba jerárquica de Kruskal-Wallis, homogeneidad en los datos de la varianza, prueba de Dunn post hoc, coeficiente de correlación de Spearman y prueba de Mann-Whitney. ResultadosSe incluyeron 132 pacientes. La nefritis lúpica proliferativa fue la más frecuente (74%). La condición clínica más común fue el síndrome nefrítico (46%); Se observó proteinuria en el 80%. No se encontró relación entre los síndromes clínicos y los tipos histológicos; solo se observaron diferencias estadísticamente significativas entre las formas proliferativa y no proliferativa con respecto a: hematuria (72,1 vs. 46,7%; p=0,012), hipocomplementemia C3 (70,9 vs. 43,3%; p=0,007), proteinuria de 24h (2.560 vs. 741mg; p=0,001) y creatinina sérica (1 vs. 0,77mg/dl; p=0,006). Se encontraron correlaciones positivas entre el índice de actividad y los valores de creatinina sérica, proteinuria de 24h, hipocomplementemia C3, junto con anticuerpos anti-DNA positivos. ConclusiónExiste una relación clínico-patológica entre los tipos proliferativos y ciertos hallazgos paraclínicos (hematuria, elevación de 24h de proteína, nivel de creatinina sérica e hipocomplementemia C3) en una población mestiza con nefritis lúpica; sin embargo, no se encontró asociación con ninguna otra variable." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusión" ] ] ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<elsevierMultimedia ident="upi0005"></elsevierMultimedia>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0060" ] ] ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 943 "Ancho" => 2940 "Tamanyo" => 80579 ] ] "descripcion" => array:1 [ "en" => "Frequency of histological types according to the 2003 ISN/RPS Classification: (A) NPLN and PLN in 116 patients without mixed histological features. (B) Distribution of histological types in NPLN and PLN patients." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Abbreviations: LN, lupus nephritis; SLE, systemic lupus erythematosus." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">n (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">110 (83) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at diagnosis of SLE (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.5 (16–31)<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Time elapsed between SLE diagnosis and LN (months) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.5 (0–66)<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arterial hypertension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 (20) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nephritic syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61 (46) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nephrotic syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50 (38) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Acute renal failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 (17) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic renal failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (11) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hematuria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">85 (64) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leukocyturia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53 (40) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Proteinuria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">105 (80) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cylindruria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 (20) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Telescopic urine sediment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 (15) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Serum creatinine (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.9 (0.7–1.3)<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">24-hour proteinuria (mg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2450 (813–4995)<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Positive anti-DNA antibodies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96 (73) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C3 levels (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">78 (54–97)<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C4 levels (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (9–21)<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1759911.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "Median (IQR)." ] ] ] "descripcion" => array:1 [ "en" => "Sociodemographic, clinical, and paraclinical features of patients with LN." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Histological types</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PLN:86 n (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">NPLN:30 n (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">(%PLN–%NPLN)<a class="elsevierStyleCrossRef" href="#tblfn0030">‡‡</a> (95%CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SBP (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">120 (110–140)<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">120(109–130)<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.088<a class="elsevierStyleCrossRef" href="#tblfn0015">†</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DBP (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">80 (70–83)<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">74(69–80)<a class="elsevierStyleCrossRef" href="#tblfn0010">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.262<a class="elsevierStyleCrossRef" href="#tblfn0015">†</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nephritic syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 (46.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (43.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.2 (−17.5 to 23.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.764<a class="elsevierStyleCrossRef" href="#tblfn0020">‡</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nephrotic syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35(40.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (30.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.7 (−8.7 to 30.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.300<a class="elsevierStyleCrossRef" href="#tblfn0020">‡</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Acute renal failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14(16.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.3 (−6.9 to 19.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.6105<a class="elsevierStyleCrossRef" href="#tblfn0025">¶</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic renal failure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (10.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5(16.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">−6.2 (−21.0 to 8.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.555<a class="elsevierStyleCrossRef" href="#tblfn0025">¶</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1759910.png" ] ] ] "notaPie" => array:5 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "*" "nota" => "Median (IQR)." ] 1 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "†" "nota" => "Mann–Whitney test." ] 2 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "‡" "nota" => "Chi-square test." ] 3 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "¶" "nota" => "Fisher's exact test." ] 4 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "‡‡" "nota" => "(%PLN–%NPLN): Difference between % of patients with PLN and % of patients with NPLN. Abbreviations: NPLN, non-proliferative lupus nephritis; PLN, proliferative lupus nephritis; SBP, systolic blood pressure; DBP, diastolic blood pressure." ] ] ] "descripcion" => array:1 [ "en" => "Clinicopathological relationship of patients with lupus nephritis." ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Histological types</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PLN:86 n (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">NPNL:30 n (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">(%PLN–%NPLN)<a class="elsevierStyleCrossRef" href="#tblfn0055">‡‡</a> (95% CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hematuria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62 (72.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14(46.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25.4 (5.2 to 45.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.012<a class="elsevierStyleCrossRef" href="#tblfn0045">‡</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leukocyturia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 (46.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (26.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19.8 (0.83 to 38.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.057<a class="elsevierStyleCrossRef" href="#tblfn0045">‡</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Proteinuria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">69 (80.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 (70.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10.2 (−8.2 to 28.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.247<a class="elsevierStyleCrossRef" href="#tblfn0045">‡</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cylindruria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (20.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (16.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.3 (−11.6 to 20.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.614<a class="elsevierStyleCrossRef" href="#tblfn0045">‡</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Active urinary sediment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (18.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">11.9 (−0.20 to 24.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.198<a class="elsevierStyleCrossRef" href="#tblfn0050">¶</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">24-hour proteinuria (mg)<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2560 (1349–5028) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">741 (493–3546) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.001<a class="elsevierStyleCrossRef" href="#tblfn0040">†</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">24-hour proteinuria (mg)<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><500 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.009 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">501–3499 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45 (52.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (43.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">≥3500 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 (40.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (26.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Serum creatinine (mg/dL)<a class="elsevierStyleCrossRef" href="#tblfn0035">*</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.0 (0.73–1.39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.77(0.60–1.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N/A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.006<a class="elsevierStyleCrossRef" href="#tblfn0040">†</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Positive anti-DNA antibodies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 (77.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (60.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17.9 (−1.7 to 37.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.056<a class="elsevierStyleCrossRef" href="#tblfn0045">‡</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C3 hypocomplementemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61 (70.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (43.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">27.6 (7.4 to 47.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.007<a class="elsevierStyleCrossRef" href="#tblfn0045">‡</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C4 hypocomplementemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 (37.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (20.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17.2 (−0.38 to 34.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.084<a class="elsevierStyleCrossRef" href="#tblfn0045">‡</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1759909.png" ] ] ] "notaPie" => array:5 [ 0 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "*" "nota" => "Median (IQR)." ] 1 => array:3 [ "identificador" => "tblfn0040" "etiqueta" => "†" "nota" => "Mann–Whitney test." ] 2 => array:3 [ "identificador" => "tblfn0045" "etiqueta" => "‡" "nota" => "Chi-square test." ] 3 => array:3 [ "identificador" => "tblfn0050" "etiqueta" => "¶" "nota" => "Fisher's exact test." ] 4 => array:3 [ "identificador" => "tblfn0055" "etiqueta" => "‡‡" "nota" => "(%PLN–%NPLN), difference between % of patients with PLN and % of patients with NPLN. Abbreviations: NPLN, non-proliferative lupus nephritis; PLN, proliferative lupus nephritis." ] ] ] "descripcion" => array:1 [ "en" => "Laboratory features of patients with lupus nephritis according to histological type." ] ] 4 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.docx" "ficheroTamanyo" => 17472 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:40 [ 0 => array:3 [ "identificador" => "bib0205" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systemic lupus erythematosus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Lisnevskaia" 1 => "G. Murphy" 2 => "D. Isenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(14)60128-8" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2014" "volumen" => "384" "paginaInicial" => "1878" "paginaFinal" => "1888" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24881804" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0210" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systemic lupus erythematosus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.C. Tsokos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra1100359" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2011" "volumen" => "365" "paginaInicial" => "2110" "paginaFinal" => "2121" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22129255" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0215" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "What is damaging the kidney in lupus nephritis?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Davidson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nrrheum.2015.159" "Revista" => array:6 [ "tituloSerie" => "Nat Rev Rheumatol" "fecha" => "2016" "volumen" => "12" "paginaInicial" => "143" "paginaFinal" => "153" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26581344" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0220" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renal disease in systemic lupus erythematosus with emphasis on classification of lupus glomerulonephritis: advances and implications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.V.S. Seshan" 1 => "J.C. Jennette" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1043/1543-2165-133.2.233" "Revista" => array:6 [ "tituloSerie" => "Arch Pathol Lab Med" "fecha" => "2009" "volumen" => "133" "paginaInicial" => "233" "paginaFinal" => "248" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19195967" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0225" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lupus nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.S. Cameron" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "1999" "volumen" => "10" "paginaInicial" => "413" "paginaFinal" => "424" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10215343" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0230" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic factors for treatment response in patients with lupus nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D. Miranda-Hernández" 1 => "C. Cruz-Reyes" 2 => "U. Angeles" 3 => "L.J. Jara" 4 => "M.A. Saavedra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2013.08.001" "Revista" => array:7 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2014" "volumen" => "10" "paginaInicial" => "164" "paginaFinal" => "169" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24269071" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0190962216307381" "estado" => "S300" "issn" => "01909622" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0235" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of one-year outcome in lupus nephritis: the importance of renal biopsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.M. Esdaile" 1 => "W. Federgreen" 2 => "H. Quintal" 3 => "S. Suissa" 4 => "J.P. Hayslett" 5 => "M. Kashgarian" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Q J Med" "fecha" => "1991" "volumen" => "81" "paginaInicial" => "907" "paginaFinal" => "918" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1808631" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0196070914000076" "estado" => "S300" "issn" => "01960709" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0240" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic factors in lupus nephritis: diagnostic and therapeutic delay increases the risk of terminal renal failure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Faurschou" 1 => "H. Starklint" 2 => "P. Halberg" 3 => "S. Jacobsen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Rheumatol" "fecha" => "2006" "volumen" => "33" "paginaInicial" => "1563" "paginaFinal" => "1569" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16881113" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0245" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lupus nephritis and end-stage kidney disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N. Maroz" 1 => "M.S. Segal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MAJ.0b013e31827f4ee3" "Revista" => array:6 [ "tituloSerie" => "Am J Med Sci" "fecha" => "2013" "volumen" => "346" "paginaInicial" => "319" "paginaFinal" => "323" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23370533" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0250" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term outcomes of end-stage kidney disease for patients with lupus nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Zhang" 1 => "G. Lee" 2 => "X. Liu" 3 => "E.M. Pascoe" 4 => "S.V. Badve" 5 => "N.C. Boudville" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.kint.2016.02.014" "Revista" => array:6 [ "tituloSerie" => "Kidney Int" "fecha" => "2016" "volumen" => "89" "paginaInicial" => "1337" "paginaFinal" => "1345" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27165824" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0255" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treat-to-target in systemic lupus erythematosus: recommendations from an international task force" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.F. van Vollenhoven" 1 => "M. Mosca" 2 => "G. Bertsias" 3 => "D. Isenberg" 4 => "A. Kuhn" 5 => "K. Lerstrøm" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/annrheumdis-2013-205139" "Revista" => array:6 [ "tituloSerie" => "Ann Rheum Dis" "fecha" => "2014" "volumen" => "73" "paginaInicial" => "958" "paginaFinal" => "967" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24739325" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0260" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renal biopsy at the onset of clinical lupus nephritis: can it yield useful information?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Oates" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Rheumatol" "fecha" => "2007" "volumen" => "34" "paginaInicial" => "256" "paginaFinal" => "258" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17304650" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0265" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcomes in biopsy-proven lupus nephritis: evaluation of 190 white patients from a single center" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Sisó" 1 => "M. Ramos-Casals" 2 => "A. Bové" 3 => "P. Brito-Zerón" 4 => "N. Soria" 5 => "Nardi N." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Medicine (Baltimore)" "fecha" => "2010" "volumen" => "89" "paginaInicial" => "300" "paginaFinal" => "307" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0270" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contribution of renal biopsy data in predicting outcome in lupus nephritis. Analysis of 116 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H.C. Nossent" 1 => "S.C. Henzen-Logmans" 2 => "T.M. Vroom" 3 => "J.H. Berden" 4 => "T.J. Swaak" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arthritis Rheum" "fecha" => "1990" "volumen" => "33" "paginaInicial" => "970" "paginaFinal" => "977" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2369432" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0275" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relation between serological data at the time of biopsy and renal histology in lupus nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.C. Nossent" 1 => "S.C. Henzen-Logmans" 2 => "T.M. Vroom" 3 => "V. Huysen" 4 => "J.H. Berden" 5 => "A.J. Swaak" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rheumatol Int" "fecha" => "1991" "volumen" => "11" "paginaInicial" => "77" "paginaFinal" => "82" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1947673" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0280" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The classification of glomerulonephritis in systemic lupus erythematosus revisited" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.J. Weening" 1 => "V.D. D’Agati" 2 => "M.M. Schwartz" 3 => "S.V. Seshan" 4 => "C.E. Alpers" 5 => "G.B. Appel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "2004" "volumen" => "15" "paginaInicial" => "241" "paginaFinal" => "250" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14747370" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0285" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of anti-DNA antibodies in the development of lupus nephritis: a complementary, or alternative, viewpoint?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. Goilav" 1 => "C. Putterman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.semnephrol.2015.08.005" "Revista" => array:6 [ "tituloSerie" => "Semin Nephrol" "fecha" => "2015" "volumen" => "35" "paginaInicial" => "439" "paginaFinal" => "443" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26573546" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0290" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and laboratory predictors of distinct histopathogical features of lupus nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.P. Mavragani" 1 => "G.E. Fragoulis" 2 => "G. Somarakis" 3 => "A. Drosos" 4 => "A.G. Tzioufas" 5 => "H.M. Moutsopoulos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Medicine (Baltimore)" "fecha" => "2015" "volumen" => "94" "paginaInicial" => "e829" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0295" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathological presentation of lupus nephritis: experience in a Mexican center" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N.A. Polanco-Flores" 1 => "M.V. Soto-Abraham" 2 => "F.E. Rodríguez-Castellanos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Colomb Reumatol" "fecha" => "2013" "volumen" => "20" "paginaInicial" => "80" "paginaFinal" => "90" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0300" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathological correlations and prognostic factors in lupus nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Mitjavila" 1 => "V. Pac" 2 => "I. Moga" 3 => "R. Poveda" 4 => "A. Vidaller" 5 => "M. Carrera" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Clin Exp Rheumatol" "fecha" => "1997" "volumen" => "15" "paginaInicial" => "625" "paginaFinal" => "631" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9444418" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S019096221502366X" "estado" => "S300" "issn" => "01909622" ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0305" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathological correlation in Asian patients with biopsy-proven lupus nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Satirapoj" 1 => "P. Tasanavipas" 2 => "O. Supasyndh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2015/857316" "Revista" => array:5 [ "tituloSerie" => "Int J Nephrol" "fecha" => "2015" "volumen" => "2015" "paginaInicial" => "857316" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25874130" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0310" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathological insights into lupus nephritis in South Africans: a study of 251 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I.G. Okpechi" 1 => "C.R. Swanepoel" 2 => "N. Tiffin" 3 => "M. Duffield" 4 => "B.L. Rayner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0961203312441981" "Revista" => array:6 [ "tituloSerie" => "Lupus" "fecha" => "2012" "volumen" => "21" "paginaInicial" => "1017" "paginaFinal" => "1024" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22451603" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0315" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Morphological parameters in lupus nephritis: their relevance for classification and relationship with clinical and histological findings and outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Banfi" 1 => "G. Mazzucco" 2 => "G. Barbiano di Belgiojoso" 3 => "M. Bestetti Bosisio" 4 => "P. Stratta" 5 => "R. Confalonieri" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Q J Med" "fecha" => "1985" "volumen" => "55" "paginaInicial" => "153" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3159033" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0320" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lupus nephritis: clinical and pathological correlation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Leaker" 1 => "K.F. Fairley" 2 => "J. Dowling" 3 => "P. Kincaid-Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Q J Med" "fecha" => "1987" "volumen" => "62" "paginaInicial" => "163" "paginaFinal" => "179" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3659257" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0325" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lupus nephritis. Clinicopathological correlation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "I.H. Al-Zahrani" 1 => "A. Qayyum" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Saudi Med J" "fecha" => "2007" "volumen" => "28" "paginaInicial" => "1503" "paginaFinal" => "1505" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17914508" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0330" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predicting renal outcomes in severe lupus nephritis: contributions of clinical and histologic data" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H.A. Austin" 1 => "D.T. Boumpas" 2 => "E.M. Vaughan" 3 => "J.E. Balow" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Kidney Int" "fecha" => "1994" "volumen" => "45" "paginaInicial" => "544" "paginaFinal" => "550" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8164443" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0335" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathological correlation of biopsy proven lupus nephritis in children and treatment response with mycophenolate moefetil" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Mutalik" 1 => "S. Pradhan" 2 => "J. Satapathy" 3 => "A. Swain" 4 => "A. Mohanty" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Minerva Pediatr" "fecha" => "2016" "volumen" => "68" "paginaInicial" => "70" "paginaFinal" => "72" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25018082" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0340" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lupus nephritis in children – 10 years’ experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Szymanik-Grzelak" 1 => "E. Kuźma-Mroczkowska" 2 => "J. Małdyk" 3 => "M. Pańczyk-Tomaszewska" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5114/ceji.2016.63123" "Revista" => array:7 [ "tituloSerie" => "Cent Eur J Immunol" "fecha" => "2016" "volumen" => "41" "paginaInicial" => "248" "paginaFinal" => "254" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27833441" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0190962213005240" "estado" => "S300" "issn" => "01909622" ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0345" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.C. Hochberg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/1529-0131(199709)40:9<1725::AID-ART29>3.0.CO;2-Y" "Revista" => array:5 [ "tituloSerie" => "Arthritis Rheum" "fecha" => "1997" "volumen" => "40" "paginaInicial" => "1725" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9324033" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0350" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.E. Stevens" 1 => "A. Levin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7326/0003-4819-158-11-201306040-00007" "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "2013" "volumen" => "158" "paginaInicial" => "825" "paginaFinal" => "830" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23732715" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0355" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A European Renal Best Practice (ERBP) position statement on the Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guidelines on acute kidney injury: part 1: definitions, conservative management and contrast-induced nephropathy" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Ad-hoc working group of ERBP" "etal" => true "autores" => array:5 [ 0 => "D. Fliser" 1 => "M. Laville" 2 => "A. Covic" 3 => "D. Fouque" 4 => "R. Vanholder" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transpl" "fecha" => "2012" "volumen" => "27" "paginaInicial" => "4263" "paginaFinal" => "4272" ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0360" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A pathophysiology-based approach to the diagnosis and treatment of lupus nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.J. Anders" 1 => "B. Rovin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.kint.2016.05.017" "Revista" => array:6 [ "tituloSerie" => "Kidney Int" "fecha" => "2016" "volumen" => "90" "paginaInicial" => "493" "paginaFinal" => "501" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27378475" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0365" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renal biopsy findings in new-onset systemic lupus erythematosus with clinical renal disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Y.K. Wen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11255-011-9911-3" "Revista" => array:6 [ "tituloSerie" => "Int Urol Nephrol" "fecha" => "2011" "volumen" => "43" "paginaInicial" => "801" "paginaFinal" => "806" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21336956" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0370" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Analysis of clinicopathologic correlations in Iranian patients with lupus nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Z. Shariati-Sarabi" 1 => "A. Ranjbar" 2 => "S.M. Monzavi" 3 => "H. Esmaily" 4 => "M. Farzadnia" 5 => "A.A. Zeraatis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1756-185X.12059" "Revista" => array:6 [ "tituloSerie" => "Int J Rheum Dis" "fecha" => "2013" "volumen" => "16" "paginaInicial" => "731" "paginaFinal" => "738" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24382282" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0375" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Correlation of clinical and pathological findings in patients with lupus nephritis: a five-year experience in Iran" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.T. Nezhad" 1 => "R. Sepaskhah" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Saudi J Kidney Dis Transpl" "fecha" => "2008" "volumen" => "19" "paginaInicial" => "32" "paginaFinal" => "40" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18087120" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0380" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Podocyte injury in pure membranous and proliferative lupus nephritis: distinct underlying mechanisms of proteinuria?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.M. Rezende" 1 => "V.S. Viana" 2 => "D.M. Malheiros" 3 => "E.F. Borba" 4 => "N.A. Silva" 5 => "C. Silva" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0961203313517152" "Revista" => array:6 [ "tituloSerie" => "Lupus" "fecha" => "2014" "volumen" => "23" "paginaInicial" => "255" "paginaFinal" => "262" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24356611" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0385" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lupus nephritis among Arabs – differences with other races; emphasis on clinicopathological and serological perspectives" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H.M. Al Attia" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Saudi J Kidney Dis Transpl" "fecha" => "2000" "volumen" => "11" "paginaInicial" => "370" "paginaFinal" => "380" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18209329" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0390" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathologic correlations in lupus nephritis in Lima, Peru" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Hurtado" 1 => "C. Asato" 2 => "E. Escudero" 3 => "C.S. Stromquist" 4 => "J. Urcia" 5 => "M.E. Hurtado" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000045424" "Revista" => array:6 [ "tituloSerie" => "Nephron" "fecha" => "1999" "volumen" => "83" "paginaInicial" => "323" "paginaFinal" => "330" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10575294" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0395" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "American College of Rheumatology: American College of Rheumatology Guidelines for Screening, Treatment, and Management of Lupus Nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.H. Hahn" 1 => "M. McMahon" 2 => "A. Wilkinson" 3 => "W.D. Wallace" 4 => "D.I. Daikh" 5 => "J.D. Fitzgerald" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arthritis Care Res" "fecha" => "2012" "volumen" => "64" "paginaInicial" => "797" "paginaFinal" => "808" ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0400" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association: Joint European League Against Rheumatism and European Renal Association–European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.K. Bertsias" 1 => "M. Tektonidou" 2 => "Z. Amoura" 3 => "M. Aringer" 4 => "I. Bajema" 5 => "J.H. Berden" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/annrheumdis-2012-201940" "Revista" => array:6 [ "tituloSerie" => "Ann Rheum Dis" "fecha" => "2012" "volumen" => "71" "paginaInicial" => "1771" "paginaFinal" => "1782" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22851469" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack349113" "titulo" => "Acknowledgements" "texto" => "The authors would like to thank to Clinica Universitaria Bolivariana and Hospital Pablo Tobón Uribe for their support in the development of this study." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/24444405/0000002400000004/v1_201806020530/S244444051730078X/v1_201806020530/en/main.assets" "Apartado" => array:4 [ "identificador" => "53648" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Investigation" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24444405/0000002400000004/v1_201806020530/S244444051730078X/v1_201806020530/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S244444051730078X?idApp=UINPBA00004N"]

Statistics

Original Investigation

Clinicopathological relationship in Colombian patients with lupus nephritis

Relación clínicopatológica en pacientes colombianos con nefritis lúpica

Carlos Jaime Velásquez-Francoa,

Corresponding author

carjaivel@hotmail.com

Corresponding author.

, Yerlin Andrés Colina Vargasb, Sara Correa Pérezb, Felipe Osorio Ospinab, Mariana Tamayo Correab, Juliana Madrid Vargasb, Aura Ligia Zapata-Castellanosa, Libia María Rodríguez Padillaa, Luis Fernando Pinto Peñarandac, Miguel Antonio Mesa Navasa

a Clinical Immunology and Rheumatology Research Group, Clinica Universitaria Bolivariana, Professor of School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia

b School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia

c Rheumatology Department, Hospital Pablo Tobón Uribe, Medellín, Colombia

Read

2299

Times
was read the article

557

Total PDF

1742

Total HTML

Share statistics

 array:25 [
  "pii" => "S244444051730078X"
  "issn" => "24444405"
  "doi" => "10.1016/j.rcreue.2017.12.004"
  "estado" => "S300"
  "fechaPublicacion" => "2017-10-01"
  "aid" => "155"
  "copyright" => "Asociaci&#243;n Colombiana de Reumatolog&#237;a"
  "copyrightAnyo" => "2017"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Colomb Reumatol. 2017;24:211-8"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 625
    "formatos" => array:3 [
      "EPUB" => 54
      "HTML" => 412
      "PDF" => 159
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S0121812317301068"
      "issn" => "01218123"
      "doi" => "10.1016/j.rcreu.2017.10.001"
      "estado" => "S300"
      "fechaPublicacion" => "2017-10-01"
      "aid" => "155"
      "copyright" => "Asociaci&#243;n Colombiana de Reumatolog&#237;a"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Rev Colomb Reumatol. 2017;24:211-8"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 937
        "formatos" => array:3 [
          "EPUB" => 2
          "HTML" => 688
          "PDF" => 247
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Investigation</span>"
        "titulo" => "Clinicopathological relationship in Colombian patients with lupus nephritis"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "211"
            "paginaFinal" => "218"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Relaci&#243;n cl&#237;nicopatol&#243;gica en pacientes colombianos con nefritis l&#250;pica"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Fig&#46; 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 943
                "Ancho" => 2940
                "Tamanyo" => 80921
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Frequency of histological types according to the 2003 ISN&#47;RPS Classification&#58; &#40;A&#41; NPLN and PLN in 116 patients without mixed histological features&#46; &#40;B&#41; Distribution of histological types in NPLN and PLN patients&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Carlos Jaime Vel&#225;squez-Franco, Yerlin Andr&#233;s Colina Vargas, Sara Correa P&#233;rez, Felipe Osorio Ospina, Mariana Tamayo Correa, Juliana Madrid Vargas, Aura Ligia Zapata-Castellanos, Libia Mar&#237;a Rodr&#237;guez Padilla, Luis Fernando Pinto Pe&#241;aranda, Miguel Antonio Mesa Navas"
            "autores" => array:10 [
              0 => array:2 [
                "nombre" => "Carlos Jaime"
                "apellidos" => "Vel&#225;squez-Franco"
              ]
              1 => array:2 [
                "nombre" => "Yerlin Andr&#233;s"
                "apellidos" => "Colina Vargas"
              ]
              2 => array:2 [
                "nombre" => "Sara Correa"
                "apellidos" => "P&#233;rez"
              ]
              3 => array:2 [
                "nombre" => "Felipe Osorio"
                "apellidos" => "Ospina"
              ]
              4 => array:2 [
                "nombre" => "Mariana Tamayo"
                "apellidos" => "Correa"
              ]
              5 => array:2 [
                "nombre" => "Juliana Madrid"
                "apellidos" => "Vargas"
              ]
              6 => array:2 [
                "nombre" => "Aura Ligia"
                "apellidos" => "Zapata-Castellanos"
              ]
              7 => array:2 [
                "nombre" => "Libia Mar&#237;a"
                "apellidos" => "Rodr&#237;guez Padilla"
              ]
              8 => array:2 [
                "nombre" => "Luis Fernando"
                "apellidos" => "Pinto Pe&#241;aranda"
              ]
              9 => array:2 [
                "nombre" => "Miguel Antonio"
                "apellidos" => "Mesa Navas"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S244444051730078X"
          "doi" => "10.1016/j.rcreue.2017.12.004"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S244444051730078X?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0121812317301068?idApp=UINPBA00004N"
      "url" => "/01218123/0000002400000004/v2_201801120646/S0121812317301068/v2_201801120646/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2444440518300128"
    "issn" => "24444405"
    "doi" => "10.1016/j.rcreue.2018.05.001"
    "estado" => "S300"
    "fechaPublicacion" => "2017-10-01"
    "aid" => "157"
    "copyright" => "Asociaci&#243;n Colombiana de Reumatolog&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "ssu"
    "cita" => "Rev Colomb Reumatol. 2017;24:219-29"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 4432
      "formatos" => array:3 [
        "EPUB" => 43
        "HTML" => 4186
        "PDF" => 203
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review Article</span>"
      "titulo" => "Gout and pregnancy&#58; A report of a new case and systematic review"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "219"
          "paginaFinal" => "229"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Gota y embarazo&#58; revisi&#243;n sistem&#225;tica&#44; incluyendo el reporte de un nuevo caso"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2242
              "Ancho" => 2333
              "Tamanyo" => 361377
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">&#40;A and B&#41; AP view of the right foot&#44; which shows an increase in volume of the tarsus and ankle&#44; erythema in the right tarsus&#46; &#40;C&#41; AP view after the infiltration of intra-articular dexamethasone&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Gabriel Horta-Baas, Mar&#237;a Fernanda Hern&#225;ndez-Cabrera, Imelda Vergara-S&#225;nchez, Mar&#237;a del Socorro Romero-Figueroa"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Gabriel"
              "apellidos" => "Horta-Baas"
            ]
            1 => array:2 [
              "nombre" => "Mar&#237;a Fernanda"
              "apellidos" => "Hern&#225;ndez-Cabrera"
            ]
            2 => array:2 [
              "nombre" => "Imelda"
              "apellidos" => "Vergara-S&#225;nchez"
            ]
            3 => array:2 [
              "nombre" => "Mar&#237;a del Socorro"
              "apellidos" => "Romero-Figueroa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0121812317301214"
        "doi" => "10.1016/j.rcreu.2017.10.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0121812317301214?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444440518300128?idApp=UINPBA00004N"
    "url" => "/24444405/0000002400000004/v1_201806020530/S2444440518300128/v1_201806020530/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2444440517300778"
    "issn" => "24444405"
    "doi" => "10.1016/j.rcreue.2017.12.003"
    "estado" => "S300"
    "fechaPublicacion" => "2017-10-01"
    "aid" => "142"
    "copyright" => "Asociaci&#243;n Colombiana de Reumatolog&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Colomb Reumatol. 2017;24:205-10"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 623
      "formatos" => array:3 [
        "EPUB" => 84
        "HTML" => 439
        "PDF" => 100
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Investigation</span>"
      "titulo" => "Prevalence of vitamin D levels in patients with autoimmune diseases in Ecuador&#58; A retrospective study"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "205"
          "paginaFinal" => "210"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Prevalencia de vitamina D en pacientes con enfermedades autoinmunes en Ecuador&#58; estudio restrospectivo"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Fig&#46; 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1368
              "Ancho" => 1593
              "Tamanyo" => 117149
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Vitamin D levels according to DXA diagnoses&#58; Osteopenia and Osteoporosis&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "G&#233;nessis Maldonado, Roberto Guerrero, Carlos R&#237;os"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "G&#233;nessis"
              "apellidos" => "Maldonado"
            ]
            1 => array:2 [
              "nombre" => "Roberto"
              "apellidos" => "Guerrero"
            ]
            2 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "R&#237;os"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0121812317300890"
        "doi" => "10.1016/j.rcreu.2017.08.001"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0121812317300890?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444440517300778?idApp=UINPBA00004N"
    "url" => "/24444405/0000002400000004/v1_201806020530/S2444440517300778/v1_201806020530/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Investigation</span>"
    "titulo" => "Clinicopathological relationship in Colombian patients with lupus nephritis"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "211"
        "paginaFinal" => "218"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Carlos Jaime Vel&#225;squez-Franco, Yerlin Andr&#233;s Colina Vargas, Sara Correa P&#233;rez, Felipe Osorio Ospina, Mariana Tamayo Correa, Juliana Madrid Vargas, Aura Ligia Zapata-Castellanos, Libia Mar&#237;a Rodr&#237;guez Padilla, Luis Fernando Pinto Pe&#241;aranda, Miguel Antonio Mesa Navas"
        "autores" => array:10 [
          0 => array:4 [
            "nombre" => "Carlos Jaime"
            "apellidos" => "Vel&#225;squez-Franco"
            "email" => array:1 [
              0 => "carjaivel&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Yerlin Andr&#233;s"
            "apellidos" => "Colina Vargas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Sara Correa"
            "apellidos" => "P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Felipe Osorio"
            "apellidos" => "Ospina"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Mariana Tamayo"
            "apellidos" => "Correa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Juliana Madrid"
            "apellidos" => "Vargas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Aura Ligia"
            "apellidos" => "Zapata-Castellanos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Libia Mar&#237;a"
            "apellidos" => "Rodr&#237;guez Padilla"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Luis Fernando"
            "apellidos" => "Pinto Pe&#241;aranda"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Miguel Antonio"
            "apellidos" => "Mesa Navas"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Clinical Immunology and Rheumatology Research Group&#44; Clinica Universitaria Bolivariana&#44; Professor of School of Health Sciences&#44; Universidad Pontificia Bolivariana&#44; Medell&#237;n&#44; Colombia"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "School of Health Sciences&#44; Universidad Pontificia Bolivariana&#44; Medell&#237;n&#44; Colombia"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Rheumatology Department&#44; Hospital Pablo Tob&#243;n Uribe&#44; Medell&#237;n&#44; Colombia"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Relaci&#243;n cl&#237;nicopatol&#243;gica en pacientes colombianos con nefritis l&#250;pica"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 943
            "Ancho" => 2940
            "Tamanyo" => 80579
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Frequency of histological types according to the 2003 ISN&#47;RPS Classification&#58; &#40;A&#41; NPLN and PLN in 116 patients without mixed histological features&#46; &#40;B&#41; Distribution of histological types in NPLN and PLN patients&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Systemic lupus erythematosus &#40;SLE&#41; is a chronic&#44; complex&#44; multisystem autoimmune disease with protean clinical manifestations&#44; which are modulated by genetic&#44; environmental&#44; hormonal&#44; and immunological factors&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;2</span></a> Renal involvement accounts for 51&#8211;60&#37; of SLE patients<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">3&#8211;5</span></a>&#59; it is one of the leading causes of morbidity and mortality&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">6</span></a> with about 10&#8211;30&#37; of subjects progressing to end-stage renal disease &#40;ESRD&#41;&#44; despite current treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">7&#8211;10</span></a> Considering these aspects&#44; early diagnosis and treatment of lupus nephritis &#40;LN&#41; are mandatory&#44; which is one of the main recommendations of the &#8220;treat to target&#8221; strategy in Systemic Lupus Erythematosus &#40;T2T&#47;SLE&#41; International Task Force&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">11</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Renal biopsy &#40;RB&#41; is considered the gold standard to diagnose LN&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#8211;15</span></a> Biopsy findings are classified according to the International Society of Nephrology&#47;Renal Pathology Society &#40;ISN&#47;RPS&#41;&#44; issued in 2003&#46; This classification includes six types of nephritis established through light&#44; electronic&#44; and immunofluorescence microscopy findings&#46; Besides type VI&#44; which denotes an irreversible stage of fibrosis&#44; the histological types can be broadly dichotomized into non-proliferative and proliferative lupus nephritis &#40;NPLN and PLN&#44; respectively&#41;&#46; PLN is constituted by types III and IV&#44; which are characterized by endothelial proliferation which damages the glomerulus and can rapidly progress to ESRD&#44; requiring immediate and aggressive immunosuppression&#46; In addition to current classification&#44; RB provides information about vascular&#44; tubular&#44; and interstitial affection and estimates the degree of activity and chronicity&#59; both indices are important from a therapeutic and prognostic point of view&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Despite all its benefits&#44; RB is not usually available at the moment of defining immunosuppression as it requires specialized equipment and is associated with significant clinical risks&#59; thus&#44; it is contraindicated in individuals with certain clinical conditions&#44; such as anemia or thrombocytopenia&#46; Consequently&#44; the physician must rely on clinical aspects which can help determine the diagnosis&#44; such as proteinuria&#44; abnormal urinary sediment&#44; and an increase in serum creatinine&#44; supported by markers of lupus activity&#44; such as anti-ds DNA high titers<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a> or hypocomplementemia&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a> From a pragmatic point of view&#44; the important decision is to define the presence of PLN&#46; Taking these considerations into account&#44; different authors have tried to establish the relationship between clinical&#44; laboratory&#44; and histological findings in both adult<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">19&#8211;26</span></a> and pediatric<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">27&#44;28</span></a> population&#44; with conflicting results&#46; To our knowledge&#44; in Latin America&#44; there is only one study that uses the current LN classification&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">19</span></a> For this reason&#44; we decided to establish the clinicopathological relationship in patients with LN&#44; emphasizing the difference between PLN and NPLN in Colombian patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Materials and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted an analytical cross-sectional study&#44; which included all patients with SLE according to the 1997 American College of Rheumatology revised criteria<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">29</span></a> with biopsy-proven LN in agreement with the 2003 ISN&#47;RPS classification&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a> who were treated at two reference centers in the city of Medell&#237;n&#44; Colombia&#44; between 2004 and 2012&#46; Subjects with kidney transplantation&#44; coexistence of other autoimmune diseases&#44; or medical records with missing data on the main variables of interest were excluded&#46; Treatment and time of renal biopsy were in consonance with usual clinical practice&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">After receiving approval from the ethics committees of each institution&#44; the information was retrieved from the patients&#8217; medical records at the time of renal biopsy and was registered in a Microsoft Excel<span class="elsevierStyleSup">&#174;</span> 2010 worksheet&#44; containing the following variables&#58; demographic &#40;age at diagnosis of SLE&#44; gender&#41;&#59; clinical &#40;time from onset of symptoms and LN diagnosis&#44; arterial hypertension&#44; nephritic and nephrotic syndromes&#44; acute and chronic renal failure&#44; as defined by the KDIGO guidelines<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">30&#44;31</span></a>&#59; paraclinical &#40;hematuria&#44; pyuria&#44; cylindruria&#44; serum creatinine&#44; positive anti-DNA antibodies&#44; C3 and C4 hypocomplementemia &#8211; values below 90 and 10<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; respectively&#41; and histopathological classification of LN&#44; along with activity and chronicity indices&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analyses</span><p id="par0030" class="elsevierStylePara elsevierViewall">Qualitative variables were described using absolute and relative frequencies&#44; and quantitative variables by medians with interquartile range &#40;IQR&#41; due to non-compliance of normality assumption&#46; In individuals with a single histological type&#44; the relationship with clinical findings was explored using the chi-square or exact Fisher&#39;s test for qualitative variables&#44; initially comparing each class &#40;from I to V&#41; separately and later grouped in proliferative &#40;III and IV&#41; vs&#46; non-proliferative types &#40;I&#8211;II&#8211;V&#41;&#46; The difference of proportions between the comparison groups and their respective confidence intervals at 95&#37; was determined&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Mann&#8211;Whitney test was used for comparison of quantitative variables&#46; The relationship between activity and chronicity indices with complement values&#44; 24-h proteinuria&#44; and serum creatinine was determined using Spearman&#39;s correlation coefficient&#46; In addition&#44; activity index values were compared according to the presence or absence of anti-DNA antibodies&#44; using the Mann&#8211;Whitney test&#46; For all analyses&#44; a <span class="elsevierStyleItalic">p</span> value of &#60;0&#46;05 was considered statistically significant&#46; The processing of information was carried out in the statistical package SPSS version 22&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Bias control</span><p id="par0040" class="elsevierStylePara elsevierViewall">Population selection bias decreased by including all patients with LN that met eligibility criteria during the study period&#46; To control information bias by observers&#44; a comprehensive review of the multiple information sources was performed&#44; as well as the standardization of the collection process before researchers began to review medical records&#46; In addition&#44; information bias was controlled by excluding incomplete medical records or those with doubtful results in the variables of interest&#46; Additionally&#44; both centers referred the RB to the same pathologist for interpretation&#44; which minimizes the possibility of interobserver variability&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">A total of 132 patients were included&#44; of whom 110 &#40;83&#37;&#41; were female&#46; The median age was 24 years &#40;IQR&#58; 19&#8211;37&#41; and the median elapsed time between diagnosis of SLE and LN was 4&#46;5 months &#40;IQR&#58; 0&#8211;66&#41;&#46; The median serum creatinine was 0&#46;9<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;IQR&#58; 0&#46;7&#8211;1&#46;3&#41;&#46; Ninety-six &#40;73&#37;&#41; patients had positive anti-DNA antibodies&#59; 85 &#40;64&#37;&#41; and 44 &#40;33&#37;&#41; had C3 and C4 hypocomplementemia&#44; respectively&#46; Proteinuria was observed in 105 individuals &#40;80&#37;&#41;&#44; while hematuria was the most common urine sediment alteration&#44; which was present in 85 subjects &#40;64&#37;&#41;&#46; Regarding the clinical presentation&#44; nephritic syndrome was the most common&#44; followed by nephrotic syndrome with 46 and 38&#37;&#44; respectively &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Histopathological findings</span><p id="par0050" class="elsevierStylePara elsevierViewall">Fifteen &#40;11&#46;4&#37;&#41; patients had mixed histological types &#40;III&#8211;V&#58; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#59; IV&#8211;V&#58; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41; and were not included in the final analysis&#46; Of the remaining 116 patients&#44; 86 &#40;74&#37;&#41; had PLN&#44; where type IV was the most common as it was observed in 71 &#40;82&#46;6&#37;&#41; of the subjects &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; None of the patients had type VI nephritis&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The median of activity and chronicity indices were 5 &#40;IQR&#58; 1&#46;3&#8211;9&#41; and 1 &#40;IQR&#58; 0&#8211;3&#41;&#44; respectively&#46; When activity and chronicity indices were compared&#44; PLN had a higher activity index&#44; with a median of 7&#46;5 &#40;IQR&#58; 4&#8211;11&#46;3&#41;&#44; compared to NPLN &#40;median&#58; 0&#59; IQR&#58; 0&#8211;1&#46;25&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; The chronicity index was also higher in PLN &#40;median 1&#59; IQR 0&#8211;3&#41; compared to NPLN &#40;median 0&#59; IQR 0&#8211;1&#46;25&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;015&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Clinicopathological relationship</span><p id="par0060" class="elsevierStylePara elsevierViewall">No association was found between arterial hypertension or any clinical syndrome &#40;nephritic&#44; nephrotic&#44; acute&#44; or chronic renal failure&#41; with the presence of either PLN or NPLN &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Nonetheless&#44; in patients with PLN&#44; there was a higher presence of hematuria &#40;72&#46;1 vs&#46; 46&#46;7&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;012&#41;&#44; C3 hypocomplementemia &#40;70&#46;9 vs&#46; 43&#46;3&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#44; 24-h proteinuria &#40;2560 vs 741<span class="elsevierStyleHsp" style=""></span>mg&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; and serum creatinine &#40;1 vs&#46; 0&#46;77<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41;&#44; when compared with NPLN &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">When assessing the relationship between clinical variables with activity and chronicity indices&#44; positive correlations were found between activity index with serum creatinine values &#40;Spearman&#39;s Rho&#58; 0&#46;40&#59; 95&#37; CI&#58; 0&#46;25&#8211;0&#46;55&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41; and 24-h proteinuria &#40;Spearman&#39;s Rho&#58; 0&#46;37&#59; 95&#37; CI&#58; 0&#46;18&#8211;0&#46;55&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#44; whereas a negative correlation was described amongst activity index and serum complement levels &#40;C3 Spearman&#39;s Rho&#58; 0&#46;31&#59; 95&#37; CI&#58; &#8722;0&#46;47 to &#8722;0&#46;13&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#59; C4 Spearman&#39;s Rho&#58; &#8722;0&#46;24&#59; 95&#37; CI&#58; &#8722;0&#46;41 to &#8722;0054&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#59; no correlations were detected for chronicity index&#46; Additionally&#44; the activity index values were higher in patients with positive anti-DNA antibodies&#44; compared to subjects without them &#40;median&#58; 6&#59; IQR&#58; 3&#8211;11 vs&#46; 3&#59; IQR&#58; 0&#8211;5&#46;5&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">In the present study&#44; we found a clinicopathological relationship between PLN and hematuria&#44; 24-h proteinuria&#44; elevated serum creatinine&#44; and C3 hypocomplementemia&#59; nonetheless&#44; no association was found with any clinical syndrome or other variables&#46; This relationship is logical since proliferative forms are related to increased deposition of immune complexes in the glomeruli&#44; with subsequent complement consumption and alterations in kidney function&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">32</span></a> These results are similar to those reported by Okpechi <span class="elsevierStyleItalic">et al&#46;</span>&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">22</span></a> where they found that PLN was linked to hematuria on dipstick and C3 hypocomplementemia in a South African lupus population&#46; Conversely&#44; Wen&#44; in Taiwan&#44; found no clinicopathological relationship&#44; except for anti-DNA antibodies and C4 hypocomplementemia with PLN&#46; One possible explanation for this difference when compared with our study is the inclusion of mixed LN forms in the study of Wen <span class="elsevierStyleItalic">et al&#46;</span>&#44; which could obscure this association&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">When analyzing specific results&#44; the correlation of hematuria with PLN is expected since the endothelial damage caused by immune complexes can lead to extravasation of red blood cells into Bowman&#39;s space&#44; with its subsequent urinary excretion&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">4</span></a> Even though leukocyturia would be expected to behave in the same way&#44; we did not find statistical association&#44; albeit there was a clinically significant difference &#40;46&#46;5 vs&#46; 26&#46;7&#37; in PLN and NPLN&#44; respectively&#41; with a borderline statistically significant <span class="elsevierStyleItalic">p</span> value &#40;0&#46;057&#41;&#44; which probably reflects lack of power of our study to detect such difference and could also be explained by the many causes other than glomerular damage&#44; which could cause leukocyturia&#46; Since the sample in this study was a convenience one with the total of the detected subjects&#44; there were no other interventions that could be implemented to mitigate this problem&#46; It would be important to consider the inclusion of additional rheumatology centers in the future to increase the sample size and clarify this borderline finding&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Concerning the lack of correlation between the clinical syndromes and histological types&#44; renal biopsy was performed in a systematic manner in patients with 24-h proteinuria greater than 500<span class="elsevierStyleHsp" style=""></span>mg or persistent alterations in urinary sediment&#44; instead of waiting until renal function was impaired&#44; which could explain the lack of correlation &#40;at least partially&#41;&#44; since prompt treatment was initiated&#46; This was evidenced through nephritic and nephrotic syndrome rates in our study &#40;46 and 38&#37;&#44; respectively&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">When compared with other authors&#44; the frequency of nephrotic and nephritic syndromes is variable in non-proliferative and proliferative forms&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">22&#44;33</span></a> For instance&#44; in the study of Shariati-Sarabi <span class="elsevierStyleItalic">et al&#46;</span>&#44;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a> the overall prevalence of nephrotic syndrome was only 8&#46;5&#37;&#44; compared to 38&#37; in our study&#44; yet they did not analyze PLN versus NPLN&#44; and criteria to perform renal biopsy were also different&#59; thus&#44; the comparison of both studies is not possible&#46; It is important to remember that the definition of these syndromes are composite measures of different clinical variables &#40;dyslipidemia&#44; edema&#44; hypertension&#44; among others&#41;&#44; susceptible to variation between observers&#44; which constitutes a confounding factor when comparing with other studies&#44; in addition to the inclusion&#44; in some studies&#44; of mixed forms of lupus nephritis&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">33</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">One of the striking features of the results of this investigation is the greater range of 24-h proteinuria in proliferative forms&#44; as opposed to that described in other lupus nephritis cohorts&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">18&#44;35</span></a> One of the possible explanations for this finding is that&#44; in our cohort&#44; 40&#37; of non-proliferative forms corresponded to histological types I and II&#44; in which proteinuria is minimal and generally would not be included in normal clinical practice studies&#44; which require a minimum threshold of proteinuria and urinalysis abnormalities to perform RB&#46; Additionally&#44; one could then argue that class V was shadowed by classes I and II when grouped in the NPLN for analysis&#59; nonetheless&#44; we analyzed each class separately and class V had a lower 24-h proteinuria compared with class III and IV and analysis was unchanged whether we analyzed PLN versus NPLN or each class separately &#40;data not shown&#41;&#46; We did not find a satisfactory explanation for these phenomena other than the inherent variation of RB&#44; which analyses a limited number of glomeruli and may not reflect the entire renal histopathology&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The other possible reason is that&#44; in literature&#44; there are descriptions of important podocytopathy in PLN&#44; which shows&#44; in some series&#44; that proteinuria is higher in these histological subtypes&#46; Rsende <span class="elsevierStyleItalic">et al&#46;</span> found&#44; in a four-year follow-up&#44; a tendency toward lower mean levels of proteinuria in patients with NPLN&#44; in relation to a preserved synaptopodin&#44; Wilms tumor protein 1&#44; glomerular epithelial protein 1 and nephrin&#44; suggesting structural podocyte damage and higher proteinuria in proliferative types&#46;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">36</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">One of the difficulties in trying to compare the findings of this study with previous reports is that the 1977 WHO histological classification was used in these surveys and does not include activity and chronicity indices evaluated in this research&#46;<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">37&#44;38</span></a> Due to the type of population and the adoption of the current classification of lupus nephritis&#44; the present study is similar to Polanco <span class="elsevierStyleItalic">et al&#46;</span><a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">19</span></a>&#59; correspondingly&#44; the most common clinical syndrome was nephritic&#44; while proliferative forms occurred with a similar frequency &#40;77 vs&#46; 79&#37;&#41;&#44; although the nephritic syndrome was higher in Polanco&#39;s study &#40;46 vs&#46; 63&#37;&#41;&#44; probably attributed to a longer history of nephritis &#40;13&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>28&#46;1 vs&#46; 4&#46;5 months in this study&#44; although it must be clarified that times were calculated as means and medians&#44; respectively&#41;&#46; Unfortunately&#44; Polanco <span class="elsevierStyleItalic">et al&#46;</span> did not refer to anti-DNA titers or activity and chronicity indices&#46; The clinical resemblance of both studies might indirectly suggest a comparable behavior of PLN in Latin American patients&#46; Such findings could be explained by the early aggressive treatment&#44; as well as the prompt diagnosis of lupus nephritis&#44; and the rapid onset of immunosuppressive therapy in these patients&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">We explored the relationship between activity and chronicity scores of renal biopsies with PLN and NPLN&#46; Like the results of Mavragani <span class="elsevierStyleItalic">et al&#46;</span>&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a> an elevated serum creatinine was associated with a high activity index&#59; an identical finding was reported in the study of Shariati-Sarabi<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a>&#41;&#59; additionally&#44; they found a higher frequency of anti-DNA antibodies in PLN&#46; It should be noted that&#44; in the work of these authors&#44; the presence of patients with type VI nephritis constituted 7&#46;1&#37; of its population and that&#44; presumably&#44; it had clearly higher creatinine levels than other types of nephritis&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Certain specific limitations were recognized in this study&#44; such as the high frequency of proliferative forms&#59; therefore&#44; the external validity of the results can only be inferred to these specific types&#46; Furthermore&#44; as a cross-sectional study design&#44; there is no data concerning monitoring or treatment response&#44; which are relevant aspects from a clinical perspective&#46; We understand that this design overrepresents chronic and less severe cases&#44; and excludes both extremely ill patients and those who had a fatal outcome&#46; Moreover&#44; despite having included the entire population that met eligibility criteria for a period of eight years in two high-complexity institutions&#44; only 132 patients were admitted&#44; which could affect the power of the study to detect any clinical differences between them&#59; this aspect also limits the conclusions of this paper&#46; However&#44; with the available information&#44; relationships were explored using appropriate statistical analyses&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">We recognize the possibility of reference bias&#59; it is nonetheless unavoidable&#44; since renal biopsy can only be performed in reference centers and the international criteria by which this procedure was performed already generates a selection bias per se&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">39&#44;40</span></a> This limitation could also be one of the strengths of our study since this survey was carried out under real-life conditions&#59; we believe that our results can be transferred into clinical care&#44; due to the inclusion of a significant number of individuals using the current histological classification&#46; To our knowledge&#44; this is the first study which adopts this classification at the local level&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Finally&#44; even though our results could guide the clinicians in order to define immunosuppression in situ&#44; renal biopsy continues to be of paramount importance in order to correctly classify patients as well as rule out other causes of renal involvement&#44; such as antiphospholipid syndrome nephropathy or thrombotic microangiopathy&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusion</span><p id="par0125" class="elsevierStylePara elsevierViewall">In a population of Colombian patients with lupus nephritis&#44; there is a clinicopathological relationship between proliferative types and certain laboratory features&#44; such as hematuria&#44; elevated 24-h protein excretion&#44; serum creatinine level&#44; and C3 hypocomplementemia&#59; nonetheless&#44; no association was found with any other clinical syndrome nor other variables&#46; Renal biopsy continues to be the gold standard in the classification and correct evaluation of lupus nephritis&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of interest</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest of finantial disclosures&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres1033529"
          "titulo" => "Abstract"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Background"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Objective"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Methods"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Results"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Conclusion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec990240"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1033528"
          "titulo" => "Resumen"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Objetivo"
            ]
            2 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "M&#233;todos"
            ]
            3 => array:2 [
              "identificador" => "abst0045"
              "titulo" => "Resultados"
            ]
            4 => array:2 [
              "identificador" => "abst0050"
              "titulo" => "Conclusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec990241"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Materials and methods"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Statistical analyses"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Bias control"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0025"
          "titulo" => "Results"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Histopathological findings"
            ]
            1 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Clinicopathological relationship"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conclusion"
        ]
        9 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:2 [
          "identificador" => "xack349113"
          "titulo" => "Acknowledgements"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2017-05-10"
    "fechaAceptado" => "2017-10-12"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec990240"
          "palabras" => array:6 [
            0 => "Lupus nephritis"
            1 => "Systemic lupus erythematosus"
            2 => "Biopsy"
            3 => "Proteinuria"
            4 => "Creatinine"
            5 => "Hispanic Americans"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec990241"
          "palabras" => array:6 [
            0 => "Nefritis l&#250;pica"
            1 => "Lupus eritematoso sist&#233;mico"
            2 => "Biopsia"
            3 => "Proteinuria"
            4 => "Creatinina"
            5 => "Hispanoamericanos"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">There are several clinical and laboratory features for lupus nephritis diagnosis&#59; however&#44; renal biopsy remains as the gold standard&#46; Different series have tried to establish the relationship between these findings&#44; with conflicting results&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To describe the correlation between clinical and laboratory variables with histological biopsy-proven lupus nephritis&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">An analytical cross-sectional study was conducted&#44; between January&#44; 2004 and December&#44; 2012&#46; Qualitative variables were described using absolute and relative frequencies&#44; while quantitative variables were assessed by medians with interquartile range&#46; The relationship with clinical findings was explored using chi-square maximum likelihood test&#44; adjusted standardized residuals&#44; hierarchical Kruskal&#8211;Wallis test&#44; homogeneity of variance in data&#44; post hoc Dunn&#39;s test&#44; Spearman&#39;s correlation coefficient&#44; and Mann&#8211;Whitney test&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">132 patients were included&#46; Proliferative lupus nephritis was the most frequent &#40;74&#37;&#41;&#46; The most common clinical condition was nephritic syndrome &#40;46&#37;&#41;&#59; proteinuria was observed in 80&#37;&#46; No relationship was found between clinical syndromes and histological types&#59; only statistically significant differences were observed between proliferative and non-proliferative forms regarding hematuria &#40;72&#46;1 vs&#46; 46&#46;7&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;012&#41;&#44; C3 hypocomplementemia &#40;70&#46;9 vs&#46; 43&#46;3&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41;&#44; 24-h proteinuria &#40;2560 vs 741<span class="elsevierStyleHsp" style=""></span>mg&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; and serum creatinine &#40;1 vs&#46; 0&#46;77<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;006&#41;&#46; We found positive correlations between activity index and serum creatinine values&#44; 24-h proteinuria&#44; C3 hypocomplementemia&#44; along with positive anti-DNA antibodies&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">There is a clinicopathological relationship within proliferative types and certain laboratory features &#40;hematuria&#44; elevated 24-h protein excretion&#44; serum creatinine level&#44; and C3 hypocomplementemia&#41; in a mestizo population with lupus nephritis&#59; nonetheless&#44; no association was found with any other variables&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objective"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Existen varias caracter&#237;sticas cl&#237;nicas y de laboratorio para el diagn&#243;stico de la nefritis l&#250;pica&#59; sin embargo&#44; la biopsia renal sigue siendo el est&#225;ndar de oro&#46; Diferentes series han tratado de establecer la relaci&#243;n entre estos hallazgos&#44; con resultados contradictorios&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Describir la correlaci&#243;n entre variables cl&#237;nicas y de laboratorio con los hallazgos histol&#243;gicos de nefritis l&#250;pica comprobados por biopsia&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio transversal anal&#237;tico entre enero de 2004 y diciembre de 2012&#46; Se describieron las variables cualitativas utilizando frecuencias absolutas y relativas&#44; mientras que las variables cuantitativas fueron evaluadas por medianas con rango intercuart&#237;lico&#46; La relaci&#243;n con los hallazgos cl&#237;nicos se explor&#243; utilizando&#58; prueba de probabilidad m&#225;xima de Chi-cuadrado&#44; residuos estandarizados ajustados&#44; prueba jer&#225;rquica de Kruskal-Wallis&#44; homogeneidad en los datos de la varianza&#44; prueba de Dunn <span class="elsevierStyleItalic">post hoc</span>&#44; coeficiente de correlaci&#243;n de Spearman y prueba de Mann-Whitney&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 132 pacientes&#46; La nefritis l&#250;pica proliferativa fue la m&#225;s frecuente &#40;74&#37;&#41;&#46; La condici&#243;n cl&#237;nica m&#225;s com&#250;n fue el s&#237;ndrome nefr&#237;tico &#40;46&#37;&#41;&#59; Se observ&#243; proteinuria en el 80&#37;&#46; No se encontr&#243; relaci&#243;n entre los s&#237;ndromes cl&#237;nicos y los tipos histol&#243;gicos&#59; solo se observaron diferencias estad&#237;sticamente significativas entre las formas proliferativa y no proliferativa con respecto a&#58; hematuria &#40;72&#44;1 vs&#46; 46&#44;7&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;012&#41;&#44; hipocomplementemia C3 &#40;70&#44;9 vs&#46; 43&#44;3&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41;&#44; proteinuria de 24<span class="elsevierStyleHsp" style=""></span>h &#40;2&#46;560 vs&#46; 741<span class="elsevierStyleHsp" style=""></span>mg&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y creatinina s&#233;rica &#40;1 vs&#46; 0&#44;77<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#46; Se encontraron correlaciones positivas entre el &#237;ndice de actividad y los valores de creatinina s&#233;rica&#44; proteinuria de 24<span class="elsevierStyleHsp" style=""></span>h&#44; hipocomplementemia C3&#44; junto con anticuerpos anti-DNA positivos&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusi&#243;n</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Existe una relaci&#243;n cl&#237;nico-patol&#243;gica entre los tipos proliferativos y ciertos hallazgos paracl&#237;nicos &#40;hematuria&#44; elevaci&#243;n de 24<span class="elsevierStyleHsp" style=""></span>h de prote&#237;na&#44; nivel de creatinina s&#233;rica e hipocomplementemia C3&#41; en una poblaci&#243;n mestiza con nefritis l&#250;pica&#59; sin embargo&#44; no se encontr&#243; asociaci&#243;n con ninguna otra variable&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0145" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0060"
          ]
        ]
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 943
            "Ancho" => 2940
            "Tamanyo" => 80579
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Frequency of histological types according to the 2003 ISN&#47;RPS Classification&#58; &#40;A&#41; NPLN and PLN in 116 patients without mixed histological features&#46; &#40;B&#41; Distribution of histological types in NPLN and PLN patients&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; LN&#44; lupus nephritis&#59; SLE&#44; systemic lupus erythematosus&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">110 &#40;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age at diagnosis of SLE &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;5 &#40;16&#8211;31&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Time elapsed between SLE diagnosis and LN &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;5 &#40;0&#8211;66&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arterial hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nephritic syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nephrotic syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Acute renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hematuria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85 &#40;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Leukocyturia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Proteinuria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105 &#40;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cylindruria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Telescopic urine sediment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Serum creatinine &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;9 &#40;0&#46;7&#8211;1&#46;3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">24-hour proteinuria &#40;mg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2450 &#40;813&#8211;4995&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Positive anti-DNA antibodies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96 &#40;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C3 levels &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78 &#40;54&#8211;97&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">C4 levels &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;9&#8211;21&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1759911.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Median &#40;IQR&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Sociodemographic&#44; clinical&#44; and paraclinical features of patients with LN&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Histological types</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PLN&#58;86<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">NPLN&#58;30<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">&#40;&#37;PLN&#8211;&#37;NPLN&#41;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">&#8225;&#8225;</span></a> &#40;95&#37;CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">SBP &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">120 &#40;110&#8211;140&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">120&#40;109&#8211;130&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">N&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;088<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DBP &#40;mmHg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80 &#40;70&#8211;83&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74&#40;69&#8211;80&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">N&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;262<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nephritic syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;46&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;43&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;2 &#40;&#8722;17&#46;5 to 23&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;764<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nephrotic syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#40;40&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;30&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;7 &#40;&#8722;8&#46;7 to 30&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;300<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Acute renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#40;16&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#46;3 &#40;&#8722;6&#46;9 to 19&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;6105<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#182;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Chronic renal failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8722;6&#46;2 &#40;&#8722;21&#46;0 to 8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;555<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#182;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1759910.png"
              ]
            ]
          ]
          "notaPie" => array:5 [
            0 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Median &#40;IQR&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "&#8224;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Mann&#8211;Whitney test&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "&#8225;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Chi-square test&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "&#182;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Fisher&#39;s exact test&#46;</p>"
            ]
            4 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "&#8225;&#8225;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">&#40;&#37;PLN&#8211;&#37;NPLN&#41;&#58; Difference between &#37; of patients with PLN and &#37; of patients with NPLN&#46;</p> <p class="elsevierStyleNotepara" id="npar0035"><span class="elsevierStyleItalic">Abbreviations</span>&#58; NPLN&#44; non-proliferative lupus nephritis&#59; PLN&#44; proliferative lupus nephritis&#59; SBP&#44; systolic blood pressure&#59; DBP&#44; diastolic blood pressure&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Clinicopathological relationship of patients with lupus nephritis&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Histological types</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">PLN&#58;86<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">NPNL&#58;30<br><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">&#40;&#37;PLN&#8211;&#37;NPLN&#41;<a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">&#8225;&#8225;</span></a> &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hematuria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;72&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#40;46&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#46;4 &#40;5&#46;2 to 45&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;012<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Leukocyturia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;46&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;26&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">19&#46;8 &#40;0&#46;83 to 38&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;057<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Proteinuria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;80&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;70&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#46;2 &#40;&#8722;8&#46;2 to 28&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;247<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cylindruria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;20&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;3 &#40;&#8722;11&#46;6 to 20&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;614<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Active urinary sediment</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;18&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#46;9 &#40;&#8722;0&#46;20 to 24&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;198<a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">&#182;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">24-hour proteinuria &#40;mg&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2560 &#40;1349&#8211;5028&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">741 &#40;493&#8211;3546&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">N&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">24-hour proteinuria &#40;mg&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>501&#8211;3499&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;52&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;43&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;3500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;40&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;26&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Serum creatinine &#40;mg&#47;dL&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0 &#40;0&#46;73&#8211;1&#46;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;77&#40;0&#46;60&#8211;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">N&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;006<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">&#8224;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Positive anti-DNA antibodies</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67 &#40;77&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;60&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;9 &#40;&#8722;1&#46;7 to 37&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;056<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">C3 hypocomplementemia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;70&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;43&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#46;6 &#40;7&#46;4 to 47&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;007<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">C4 hypocomplementemia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32 &#40;37&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;20&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17&#46;2 &#40;&#8722;0&#46;38 to 34&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;084<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">&#8225;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1759909.png"
              ]
            ]
          ]
          "notaPie" => array:5 [
            0 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Median &#40;IQR&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0040"
              "etiqueta" => "&#8224;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Mann&#8211;Whitney test&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0045"
              "etiqueta" => "&#8225;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Chi-square test&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0050"
              "etiqueta" => "&#182;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0055">Fisher&#39;s exact test&#46;</p>"
            ]
            4 => array:3 [
              "identificador" => "tblfn0055"
              "etiqueta" => "&#8225;&#8225;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0060"><span class="elsevierStyleSup">&#40;</span>&#37;PLN&#8211;&#37;NPLN&#41;&#44; difference between &#37; of patients with PLN and &#37; of patients with NPLN&#46;</p> <p class="elsevierStyleNotepara" id="npar0065"><span class="elsevierStyleItalic">Abbreviations</span>&#58; NPLN&#44; non-proliferative lupus nephritis&#59; PLN&#44; proliferative lupus nephritis&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Laboratory features of patients with lupus nephritis according to histological type&#46;</p>"
        ]
      ]
      4 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.docx"
          "ficheroTamanyo" => 17472
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:40 [
            0 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systemic lupus erythematosus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Lisnevskaia"
                            1 => "G&#46; Murphy"
                            2 => "D&#46; Isenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(14)60128-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2014"
                        "volumen" => "384"
                        "paginaInicial" => "1878"
                        "paginaFinal" => "1888"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24881804"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systemic lupus erythematosus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46;C&#46; Tsokos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMra1100359"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2011"
                        "volumen" => "365"
                        "paginaInicial" => "2110"
                        "paginaFinal" => "2121"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22129255"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "What is damaging the kidney in lupus nephritis&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Davidson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/nrrheum.2015.159"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nat Rev Rheumatol"
                        "fecha" => "2016"
                        "volumen" => "12"
                        "paginaInicial" => "143"
                        "paginaFinal" => "153"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26581344"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Renal disease in systemic lupus erythematosus with emphasis on classification of lupus glomerulonephritis&#58; advances and implications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;V&#46;S&#46; Seshan"
                            1 => "J&#46;C&#46; Jennette"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1043/1543-2165-133.2.233"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Pathol Lab Med"
                        "fecha" => "2009"
                        "volumen" => "133"
                        "paginaInicial" => "233"
                        "paginaFinal" => "248"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19195967"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lupus nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;S&#46; Cameron"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Nephrol"
                        "fecha" => "1999"
                        "volumen" => "10"
                        "paginaInicial" => "413"
                        "paginaFinal" => "424"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10215343"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognostic factors for treatment response in patients with lupus nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46; Miranda-Hern&#225;ndez"
                            1 => "C&#46; Cruz-Reyes"
                            2 => "U&#46; Angeles"
                            3 => "L&#46;J&#46; Jara"
                            4 => "M&#46;A&#46; Saavedra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.reuma.2013.08.001"
                      "Revista" => array:7 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2014"
                        "volumen" => "10"
                        "paginaInicial" => "164"
                        "paginaFinal" => "169"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24269071"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962216307381"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of one-year outcome in lupus nephritis&#58; the importance of renal biopsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Esdaile"
                            1 => "W&#46; Federgreen"
                            2 => "H&#46; Quintal"
                            3 => "S&#46; Suissa"
                            4 => "J&#46;P&#46; Hayslett"
                            5 => "M&#46; Kashgarian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Q J Med"
                        "fecha" => "1991"
                        "volumen" => "81"
                        "paginaInicial" => "907"
                        "paginaFinal" => "918"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1808631"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0196070914000076"
                          "estado" => "S300"
                          "issn" => "01960709"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prognostic factors in lupus nephritis&#58; diagnostic and therapeutic delay increases the risk of terminal renal failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Faurschou"
                            1 => "H&#46; Starklint"
                            2 => "P&#46; Halberg"
                            3 => "S&#46; Jacobsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2006"
                        "volumen" => "33"
                        "paginaInicial" => "1563"
                        "paginaFinal" => "1569"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16881113"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lupus nephritis and end-stage kidney disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46; Maroz"
                            1 => "M&#46;S&#46; Segal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MAJ.0b013e31827f4ee3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med Sci"
                        "fecha" => "2013"
                        "volumen" => "346"
                        "paginaInicial" => "319"
                        "paginaFinal" => "323"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23370533"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcomes of end-stage kidney disease for patients with lupus nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Zhang"
                            1 => "G&#46; Lee"
                            2 => "X&#46; Liu"
                            3 => "E&#46;M&#46; Pascoe"
                            4 => "S&#46;V&#46; Badve"
                            5 => "N&#46;C&#46; Boudville"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.kint.2016.02.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Kidney Int"
                        "fecha" => "2016"
                        "volumen" => "89"
                        "paginaInicial" => "1337"
                        "paginaFinal" => "1345"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27165824"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treat-to-target in systemic lupus erythematosus&#58; recommendations from an international task force"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;F&#46; van Vollenhoven"
                            1 => "M&#46; Mosca"
                            2 => "G&#46; Bertsias"
                            3 => "D&#46; Isenberg"
                            4 => "A&#46; Kuhn"
                            5 => "K&#46; Lerstr&#248;m"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2013-205139"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2014"
                        "volumen" => "73"
                        "paginaInicial" => "958"
                        "paginaFinal" => "967"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24739325"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Renal biopsy at the onset of clinical lupus nephritis&#58; can it yield useful information&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Oates"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2007"
                        "volumen" => "34"
                        "paginaInicial" => "256"
                        "paginaFinal" => "258"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17304650"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcomes in biopsy-proven lupus nephritis&#58; evaluation of 190 white patients from a single center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Sis&#243;"
                            1 => "M&#46; Ramos-Casals"
                            2 => "A&#46; Bov&#233;"
                            3 => "P&#46; Brito-Zer&#243;n"
                            4 => "N&#46; Soria"
                            5 => "Nardi N&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "2010"
                        "volumen" => "89"
                        "paginaInicial" => "300"
                        "paginaFinal" => "307"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Contribution of renal biopsy data in predicting outcome in lupus nephritis&#46; Analysis of 116 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46;C&#46; Nossent"
                            1 => "S&#46;C&#46; Henzen-Logmans"
                            2 => "T&#46;M&#46; Vroom"
                            3 => "J&#46;H&#46; Berden"
                            4 => "T&#46;J&#46; Swaak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "1990"
                        "volumen" => "33"
                        "paginaInicial" => "970"
                        "paginaFinal" => "977"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2369432"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relation between serological data at the time of biopsy and renal histology in lupus nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;C&#46; Nossent"
                            1 => "S&#46;C&#46; Henzen-Logmans"
                            2 => "T&#46;M&#46; Vroom"
                            3 => "V&#46; Huysen"
                            4 => "J&#46;H&#46; Berden"
                            5 => "A&#46;J&#46; Swaak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatol Int"
                        "fecha" => "1991"
                        "volumen" => "11"
                        "paginaInicial" => "77"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1947673"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The classification of glomerulonephritis in systemic lupus erythematosus revisited"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; Weening"
                            1 => "V&#46;D&#46; D&#8217;Agati"
                            2 => "M&#46;M&#46; Schwartz"
                            3 => "S&#46;V&#46; Seshan"
                            4 => "C&#46;E&#46; Alpers"
                            5 => "G&#46;B&#46; Appel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Nephrol"
                        "fecha" => "2004"
                        "volumen" => "15"
                        "paginaInicial" => "241"
                        "paginaFinal" => "250"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14747370"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of anti-DNA antibodies in the development of lupus nephritis&#58; a complementary&#44; or alternative&#44; viewpoint&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46; Goilav"
                            1 => "C&#46; Putterman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.semnephrol.2015.08.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Nephrol"
                        "fecha" => "2015"
                        "volumen" => "35"
                        "paginaInicial" => "439"
                        "paginaFinal" => "443"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26573546"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical and laboratory predictors of distinct histopathogical features of lupus nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46;P&#46; Mavragani"
                            1 => "G&#46;E&#46; Fragoulis"
                            2 => "G&#46; Somarakis"
                            3 => "A&#46; Drosos"
                            4 => "A&#46;G&#46; Tzioufas"
                            5 => "H&#46;M&#46; Moutsopoulos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "2015"
                        "volumen" => "94"
                        "paginaInicial" => "e829"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinicopathological presentation of lupus nephritis&#58; experience in a Mexican center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46;A&#46; Polanco-Flores"
                            1 => "M&#46;V&#46; Soto-Abraham"
                            2 => "F&#46;E&#46; Rodr&#237;guez-Castellanos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Colomb Reumatol"
                        "fecha" => "2013"
                        "volumen" => "20"
                        "paginaInicial" => "80"
                        "paginaFinal" => "90"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinicopathological correlations and prognostic factors in lupus nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Mitjavila"
                            1 => "V&#46; Pac"
                            2 => "I&#46; Moga"
                            3 => "R&#46; Poveda"
                            4 => "A&#46; Vidaller"
                            5 => "M&#46; Carrera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "1997"
                        "volumen" => "15"
                        "paginaInicial" => "625"
                        "paginaFinal" => "631"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9444418"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S019096221502366X"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinicopathological correlation in Asian patients with biopsy-proven lupus nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46; Satirapoj"
                            1 => "P&#46; Tasanavipas"
                            2 => "O&#46; Supasyndh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1155/2015/857316"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Nephrol"
                        "fecha" => "2015"
                        "volumen" => "2015"
                        "paginaInicial" => "857316"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25874130"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinicopathological insights into lupus nephritis in South Africans&#58; a study of 251 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46;G&#46; Okpechi"
                            1 => "C&#46;R&#46; Swanepoel"
                            2 => "N&#46; Tiffin"
                            3 => "M&#46; Duffield"
                            4 => "B&#46;L&#46; Rayner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0961203312441981"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lupus"
                        "fecha" => "2012"
                        "volumen" => "21"
                        "paginaInicial" => "1017"
                        "paginaFinal" => "1024"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22451603"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Morphological parameters in lupus nephritis&#58; their relevance for classification and relationship with clinical and histological findings and outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Banfi"
                            1 => "G&#46; Mazzucco"
                            2 => "G&#46; Barbiano di Belgiojoso"
                            3 => "M&#46; Bestetti Bosisio"
                            4 => "P&#46; Stratta"
                            5 => "R&#46; Confalonieri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Q J Med"
                        "fecha" => "1985"
                        "volumen" => "55"
                        "paginaInicial" => "153"
                        "paginaFinal" => "168"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3159033"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lupus nephritis&#58; clinical and pathological correlation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46; Leaker"
                            1 => "K&#46;F&#46; Fairley"
                            2 => "J&#46; Dowling"
                            3 => "P&#46; Kincaid-Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Q J Med"
                        "fecha" => "1987"
                        "volumen" => "62"
                        "paginaInicial" => "163"
                        "paginaFinal" => "179"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3659257"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lupus nephritis&#46; Clinicopathological correlation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "I&#46;H&#46; Al-Zahrani"
                            1 => "A&#46; Qayyum"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Saudi Med J"
                        "fecha" => "2007"
                        "volumen" => "28"
                        "paginaInicial" => "1503"
                        "paginaFinal" => "1505"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17914508"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predicting renal outcomes in severe lupus nephritis&#58; contributions of clinical and histologic data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46;A&#46; Austin"
                            1 => "D&#46;T&#46; Boumpas"
                            2 => "E&#46;M&#46; Vaughan"
                            3 => "J&#46;E&#46; Balow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Kidney Int"
                        "fecha" => "1994"
                        "volumen" => "45"
                        "paginaInicial" => "544"
                        "paginaFinal" => "550"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8164443"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinicopathological correlation of biopsy proven lupus nephritis in children and treatment response with mycophenolate moefetil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46; Mutalik"
                            1 => "S&#46; Pradhan"
                            2 => "J&#46; Satapathy"
                            3 => "A&#46; Swain"
                            4 => "A&#46; Mohanty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Minerva Pediatr"
                        "fecha" => "2016"
                        "volumen" => "68"
                        "paginaInicial" => "70"
                        "paginaFinal" => "72"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25018082"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lupus nephritis in children &#8211; 10 years&#8217; experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Szymanik-Grzelak"
                            1 => "E&#46; Ku&#378;ma-Mroczkowska"
                            2 => "J&#46; Ma&#322;dyk"
                            3 => "M&#46; Pa&#324;czyk-Tomaszewska"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5114/ceji.2016.63123"
                      "Revista" => array:7 [
                        "tituloSerie" => "Cent Eur J Immunol"
                        "fecha" => "2016"
                        "volumen" => "41"
                        "paginaInicial" => "248"
                        "paginaFinal" => "254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27833441"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0190962213005240"
                          "estado" => "S300"
                          "issn" => "01909622"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;C&#46; Hochberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/1529-0131(199709)40:9&lt;1725::AID-ART29&gt;3.0.CO;2-Y"
                      "Revista" => array:5 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "1997"
                        "volumen" => "40"
                        "paginaInicial" => "1725"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9324033"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation and management of chronic kidney disease&#58; synopsis of the kidney disease&#58; improving global outcomes 2012 clinical practice guideline"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;E&#46; Stevens"
                            1 => "A&#46; Levin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7326/0003-4819-158-11-201306040-00007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2013"
                        "volumen" => "158"
                        "paginaInicial" => "825"
                        "paginaFinal" => "830"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23732715"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A European Renal Best Practice &#40;ERBP&#41; position statement on the Kidney Disease Improving Global Outcomes &#40;KDIGO&#41; clinical practice guidelines on acute kidney injury&#58; part 1&#58; definitions&#44; conservative management and contrast-induced nephropathy"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Ad-hoc working group of ERBP"
                          "etal" => true
                          "autores" => array:5 [
                            0 => "D&#46; Fliser"
                            1 => "M&#46; Laville"
                            2 => "A&#46; Covic"
                            3 => "D&#46; Fouque"
                            4 => "R&#46; Vanholder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Nephrol Dial Transpl"
                        "fecha" => "2012"
                        "volumen" => "27"
                        "paginaInicial" => "4263"
                        "paginaFinal" => "4272"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A pathophysiology-based approach to the diagnosis and treatment of lupus nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;J&#46; Anders"
                            1 => "B&#46; Rovin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.kint.2016.05.017"
                      "Revista" => array:6 [
                        "tituloSerie" => "Kidney Int"
                        "fecha" => "2016"
                        "volumen" => "90"
                        "paginaInicial" => "493"
                        "paginaFinal" => "501"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27378475"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Renal biopsy findings in new-onset systemic lupus erythematosus with clinical renal disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "Y&#46;K&#46; Wen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11255-011-9911-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Urol Nephrol"
                        "fecha" => "2011"
                        "volumen" => "43"
                        "paginaInicial" => "801"
                        "paginaFinal" => "806"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21336956"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Analysis of clinicopathologic correlations in Iranian patients with lupus nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Z&#46; Shariati-Sarabi"
                            1 => "A&#46; Ranjbar"
                            2 => "S&#46;M&#46; Monzavi"
                            3 => "H&#46; Esmaily"
                            4 => "M&#46; Farzadnia"
                            5 => "A&#46;A&#46; Zeraatis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1756-185X.12059"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Rheum Dis"
                        "fecha" => "2013"
                        "volumen" => "16"
                        "paginaInicial" => "731"
                        "paginaFinal" => "738"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24382282"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correlation of clinical and pathological findings in patients with lupus nephritis&#58; a five-year experience in Iran"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;T&#46; Nezhad"
                            1 => "R&#46; Sepaskhah"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Saudi J Kidney Dis Transpl"
                        "fecha" => "2008"
                        "volumen" => "19"
                        "paginaInicial" => "32"
                        "paginaFinal" => "40"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18087120"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Podocyte injury in pure membranous and proliferative lupus nephritis&#58; distinct underlying mechanisms of proteinuria&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;M&#46; Rezende"
                            1 => "V&#46;S&#46; Viana"
                            2 => "D&#46;M&#46; Malheiros"
                            3 => "E&#46;F&#46; Borba"
                            4 => "N&#46;A&#46; Silva"
                            5 => "C&#46; Silva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0961203313517152"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lupus"
                        "fecha" => "2014"
                        "volumen" => "23"
                        "paginaInicial" => "255"
                        "paginaFinal" => "262"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24356611"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lupus nephritis among Arabs &#8211; differences with other races&#59; emphasis on clinicopathological and serological perspectives"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46;M&#46; Al Attia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Saudi J Kidney Dis Transpl"
                        "fecha" => "2000"
                        "volumen" => "11"
                        "paginaInicial" => "370"
                        "paginaFinal" => "380"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18209329"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinicopathologic correlations in lupus nephritis in Lima&#44; Peru"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Hurtado"
                            1 => "C&#46; Asato"
                            2 => "E&#46; Escudero"
                            3 => "C&#46;S&#46; Stromquist"
                            4 => "J&#46; Urcia"
                            5 => "M&#46;E&#46; Hurtado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000045424"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nephron"
                        "fecha" => "1999"
                        "volumen" => "83"
                        "paginaInicial" => "323"
                        "paginaFinal" => "330"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10575294"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "American College of Rheumatology&#58; American College of Rheumatology Guidelines for Screening&#44; Treatment&#44; and Management of Lupus Nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;H&#46; Hahn"
                            1 => "M&#46; McMahon"
                            2 => "A&#46; Wilkinson"
                            3 => "W&#46;D&#46; Wallace"
                            4 => "D&#46;I&#46; Daikh"
                            5 => "J&#46;D&#46; Fitzgerald"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arthritis Care Res"
                        "fecha" => "2012"
                        "volumen" => "64"
                        "paginaInicial" => "797"
                        "paginaFinal" => "808"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association&#58; Joint European League Against Rheumatism and European Renal Association&#8211;European Dialysis and Transplant Association &#40;EULAR&#47;ERA-EDTA&#41; recommendations for the management of adult and paediatric lupus nephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;K&#46; Bertsias"
                            1 => "M&#46; Tektonidou"
                            2 => "Z&#46; Amoura"
                            3 => "M&#46; Aringer"
                            4 => "I&#46; Bajema"
                            5 => "J&#46;H&#46; Berden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2012-201940"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2012"
                        "volumen" => "71"
                        "paginaInicial" => "1771"
                        "paginaFinal" => "1782"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22851469"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack349113"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0150" class="elsevierStylePara elsevierViewall">The authors would like to thank to Clinica Universitaria Bolivariana and Hospital Pablo Tob&#243;n Uribe for their support in the development of this study&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/24444405/0000002400000004/v1_201806020530/S244444051730078X/v1_201806020530/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "53648"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Investigation"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/24444405/0000002400000004/v1_201806020530/S244444051730078X/v1_201806020530/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S244444051730078X?idApp=UINPBA00004N"
]

Article information

ISSN: 24444405
Original language: English

DOI:10.1016/j.rcreue.2017.12.004

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 October	11	1	12
2024 September	28	4	32
2024 August	14	2	16
2024 July	17	10	27
2024 June	21	3	24
2024 May	43	2	45
2024 April	53	4	57
2024 March	17	6	23
2024 February	18	3	21
2024 January	57	4	61
2023 December	28	15	43
2023 November	41	8	49
2023 October	49	7	56
2023 September	36	7	43
2023 August	30	2	32
2023 July	19	2	21
2023 June	39	6	45
2023 May	45	2	47
2023 April	57	3	60
2023 March	39	1	40
2023 February	28	7	35
2023 January	19	3	22
2022 December	20	7	27
2022 November	16	5	21
2022 October	20	11	31
2022 September	23	9	32
2022 August	20	15	35
2022 July	20	11	31
2022 June	24	6	30
2022 May	25	13	38
2022 April	15	8	23
2022 March	24	11	35
2022 February	22	7	29
2022 January	37	2	39
2021 December	17	13	30
2021 November	14	12	26
2021 October	12	8	20
2021 September	20	12	32
2021 August	11	11	22
2021 July	10	8	18
2021 June	11	7	18
2021 May	37	15	52
2021 April	26	21	47
2021 March	19	8	27
2021 February	18	4	22
2021 January	14	8	22
2020 December	16	7	23
2020 November	11	8	19
2020 October	12	9	21
2020 September	18	9	27
2020 August	12	5	17
2020 July	10	7	17
2020 June	16	3	19
2020 May	15	6	21
2020 April	8	3	11
2020 March	21	6	27
2020 February	18	2	20
2020 January	13	8	21
2019 December	28	8	36
2019 November	11	6	17
2019 October	10	7	17
2019 September	19	3	22
2019 August	13	0	13
2019 July	16	19	35
2019 June	33	19	52
2019 May	99	32	131
2019 April	41	7	48
2019 March	8	3	11
2019 February	12	8	20
2019 January	5	6	11
2018 December	5	0	5
2018 November	16	4	20
2018 October	10	14	24
2018 September	28	3	31
2018 August	5	3	8
2018 July	14	3	17
2018 June	15	5	20

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter