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"tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "76" "paginaFinal" => "77" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A.L. Blanco Taboada, J. Castilla Yélamos, S. Delgado Romero, J.L. García Garmendia" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A.L." "apellidos" => "Blanco Taboada" "email" => array:1 [ 0 => "blancoanalaura.92@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "J." "apellidos" => "Castilla Yélamos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "S." "apellidos" => "Delgado Romero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "J.L." "apellidos" => "García Garmendia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital San Juan de Dios de Aljarafe, Bormujos, Sevilla, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cuidados Críticos y Urgencias, Hospital San Juan de Dios de Aljarafe, Bormujos, Sevilla, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Acidosis láctica por metformina: ¿debemos ser más cautelosos con la disfunción renal?" ] ] "textoCompleto" => "We have read with interest the article by Boada Fernández del Campo et al.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> on metformin-associated lactic acidosis (MALA), where the authors performed an excellent analysis on its association with acute renal dysfunction, highlighting the creatinine levels detected in patients admitted with MALA. However, the authors did not analyze the previous renal dysfunction of the patients with metformin and hyperlactatemia, which is clearly related to this sometimes fatal complication.In a retrospective observational study from January 2016 to June 2018 in Hospital San Juan de Dios del Aljarafe, a district hospital that treats 294,000 inhabitants, with a rate of metformin use of 430/10,000 inhabitants/year, we analyzed 9283 emergency episodes of patients treated with metformin (10.6 emergency episodes/month/10,000 inhabitants). We detected 222 cases with lactate levels ≥2.7 mmol/L. In 56 cases, hyperlactatemia was associated with acidosis and renal failure, 17 of the which (30%) were diagnosed with MALA (5.4 cases/10,000 patients with metformin/year, similar to the study by Boada Fernández del Campo et al.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>). Of these, 10 were admitted to the ICU requiring dialysis,<a class="elsevierStyleCrossRef" href="#bib0010">2</a> with an overall mortality of 53%. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> lists the baseline glomerular filtration rates (GFR) of the treated patients, showing that 35% of those who presented hyperlactatemia, 53% of those with associated renal dysfunction and acidosis, and 76% of those who developed MALA had previous renal dysfunction.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>We observed that the incidence rate of hyperlactatemia in both studies was higher than that reported in the datasheet (<1:10,000 exposed individuals) and that reported in other studies.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Our study data also confirm that a high proportion of the patients with metformin-associated hyperlactatemia had a baseline GFR <60 mL/min/1.73 m2. Given the high associated mortality, we believe that precautions need to be taken in handling metformin in patients with renal dysfunction.<a class="elsevierStyleCrossRef" href="#bib0020">4</a>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Blanco Taboada AL, et al. Acidosis láctica por metformina: ¿debemos ser más cautelosos con la disfunción renal? Rev Clin Esp. 2020;220:76–76." ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "GFR, glomerular filtration rate estimated by the modification of diet in renal disease-4 formula; MALA, metformin-associated lactic acidosis." "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="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patients with hyperlactatemia (n = 222) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patients with hyperlactatemia, acidosis and renal failure (n = 56) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patients with MALA (n = 17) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline GFR <30 mL/min/1.73 m2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (11%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (11%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline GFR 30–60 mL/min/1.73 m2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 (30%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (42%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (65%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Baseline GFR >60 mL/min/1.73 m2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">145 (65%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (47%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (24%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2237774.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Baseline glomerular filtration rate of patients who take metformin and experience hyperlactatemia in the emergency department." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acidosis con hiperlactacidemia por metformina: frecuencia de su diagnóstico en la práctica clínica habitual y relación con la insuficiencia renal" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Boada Fernández del Campo" 1 => "C. Rodríguez Jiménez" 2 => "M.M. García Saiz" 3 => "A.M. Aldea Perona" 4 => "E.J. Sanz Álvarez" 5 => "E. Fernández Quintana" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rce.2018.11.006" "Revista" => array:7 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2019" "volumen" => "219" "numero" => "5" "paginaInicial" => "236" "paginaFinal" => "242" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30791973" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recomendaciones para el tratamiento de los pacientes críticos de los Grupos de Trabajo de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Hernández-Tejedor" 1 => "O. Peñuelas" 2 => "G. Sirgo Rodríguez" 3 => "J.A. Llompart-Pou" 4 => "E. Palencia Herrejón" 5 => "A. Estella" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2017.03.004" "Revista" => array:7 [ "tituloSerie" => "Med Intensiva" "fecha" => "2017" "volumen" => "41" "numero" => "5" "paginaInicial" => "285" "paginaFinal" => "305" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28476212" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metformin-associated lactic acidosis undergoing renal replacement therapy in intensive care units: a five-million population-based study in the North-West of Italy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Mariano" 1 => "M. Pozzato" 2 => "P. Inguaggiato" 3 => "C. Guarena" 4 => "E. Turello" 5 => "M. Manes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000471917" "Revista" => array:7 [ "tituloSerie" => "Blood Purif" "fecha" => "2017" "volumen" => "44" "numero" => "3" "paginaInicial" => "198" "paginaFinal" => "205" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28668963" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Use of metformin to treat diabetes now expanded to patients with moderately reduced kidney function. Recommendations for patients with kidney impairment updated in product information. European Medicines Agency, Dec 2016; 1-4. Disponible en <a target="_blank" href="https://www.ema.europa.eu/en/documents/referral/metformin-article-31-referral-use-metformin-treat-diabetes-now-expanded-patients-moderately-reduced">https://www.ema.europa.eu/en/documents/referral/metformin-article-31-referral-use-metformin-treat-diabetes-now-expanded-patients-moderately-reduced</a>." ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022000000001/v1_202002130124/S2254887419301791/v1_202002130124/en/main.assets" "Apartado" => array:4 [ "identificador" => "71813" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Correspondence" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022000000001/v1_202002130124/S2254887419301791/v1_202002130124/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887419301791?idApp=WRCEE"]

Revista Clínica Española (English Edition)

ISSN: 2254-8874

Revista Clínica Española published its first issue in 1940 and is the body of expression of the Spanish Society of Internal Medicine (SEMI).
The journal fully endorses the goals of updating knowledge and facilitating the acquisition of key developments in internal medicine applied to clinical practice. Revista Clínica Española is subject to a thorough double blind review of the received articles written in Spanish or English. Ten issues are published each year, including mostly originals, reviews and consensus documents.

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Current Contents / Clinical Medicine , JCR / SCI-Expanded, Index Medicus / Medline y Excerpta Medica / EMBASE

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Impact factor

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

Impact factor 2023

2.3

Citescore

CiteScore measures average citations received per document published.

Citescore 2023

0.7

SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR 2023

0.162

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2023

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