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array:23 [ "pii" => "S0014256514000162" "issn" => "00142565" "doi" => "10.1016/j.rce.2014.01.010" "estado" => "S300" "fechaPublicacion" => "2014-06-01" "aid" => "902" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2014" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Rev Clin Esp. 2014;214:282-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3483 "formatos" => array:2 [ "HTML" => 1094 "PDF" => 2389 ] ] "itemSiguiente" => array:18 [ "pii" => "S0014256514000691" "issn" => "00142565" "doi" => "10.1016/j.rce.2014.02.008" "estado" => "S300" "fechaPublicacion" => "2014-06-01" "aid" => "925" "copyright" => "Elsevier España, S.L." "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Rev Clin Esp. 2014;214:283-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 600 "formatos" => array:2 [ "HTML" => 392 "PDF" => 208 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Correspondencia</span>" "titulo" => "Pioderma gangrenoso tras cirugía de cadera" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "283" "paginaFinal" => "284" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pyoderma gangrenosum following a hip surgical procedure" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 430 "Ancho" => 850 "Tamanyo" => 75988 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En cara externa de muslo derecho se observan 3 lesiones ulcerosas confluentes que conforman una placa extensa, con borde eritemato-violáceo sobreelevado. La piel perilesional presentaba eritema, aumento de temperatura e induración.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.J. Concha-Garzón, G. Solano-López Morel, A. Pérez-Plaza, D. de Argila" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.J." "apellidos" => "Concha-Garzón" ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Solano-López Morel" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Pérez-Plaza" ] 3 => array:2 [ "nombre" => "D." "apellidos" => "de Argila" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256514000691?idApp=WRCEE" "url" => "/00142565/0000021400000005/v2_201406130025/S0014256514000691/v2_201406130025/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0014256514000617" "issn" => "00142565" "doi" => "10.1016/j.rce.2014.02.001" "estado" => "S300" "fechaPublicacion" => "2014-06-01" "aid" => "918" "copyright" => "Elsevier España, S.L." "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Rev Clin Esp. 2014;214:281-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1457 "formatos" => array:2 [ "HTML" => 797 "PDF" => 660 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Correspondencia</span>" "titulo" => "Enfermedad pulmonar obstructiva crónica y cardiopatía isquémica: una asociación no tan infrecuente" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "281" "paginaFinal" => "282" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Chronic obstructive pulmonary disease and ischemic heart disease: A not so rare association" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F. García Río" "autores" => array:1 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "García Río" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256514000617?idApp=WRCEE" "url" => "/00142565/0000021400000005/v2_201406130025/S0014256514000617/v2_201406130025/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Correspondencia</span>" "titulo" => "Carboximaltosa férrica intravenosa en el tratamiento de la anemia en enfermedad renal crónica" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Sr. Director:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "282" "paginaFinal" => "283" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.L. Merino, B. Bueno, M.A. Campos, Y. Amézquita" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J.L." "apellidos" => "Merino" "email" => array:1 [ 0 => "jluis.merino@salud.madrid.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "B." "apellidos" => "Bueno" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M.A." "apellidos" => "Campos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Y." "apellidos" => "Amézquita" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Sección de Nefrología, Hospital Universitario del Henares, Coslada, Madrid, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Farmacia, Hospital Universitario del Henares, Coslada, Madrid, España" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Intravenous ferric carboxymaltose for the treatment of anemia in chronic renal disease" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">La presencia de anemia en pacientes con enfermedad renal crónica (ERC) es un proceso multifactorial, entre los que destaca la ferropenia<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a>. La carboximaltosa férrica (CMF) es un tipo de hierro para administración intravenosa (iv) con una osmolaridad fisiológica y un pH casi neutro (5,0-7,0). No presenta reactividad cruzada con dextrano, su estructura es más estable que el gluconato férrico o el hierro sacarosa, y no requiere dosis de prueba, lo que permite administrar una dosis completa en un periodo de tiempo breve<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4–6</span></a>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Desde enero de 2012 hasta enero de 2013 hemos registrado los pacientes con ERC en estadios 3-4 (filtrado glomerular estimado por MDRD entre 60-15<span class="elsevierStyleHsp" style=""></span>ml/min) y anemia asociada (niveles de hemoglobina<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>mg/dl en varones y<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>11 en mujeres) y necesidad de aportes de hierro (índice de saturación de transferrina<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>30% y/o ferritina<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>200<span class="elsevierStyleHsp" style=""></span>ng/ml). Se administró CMF iv (Ferinject<span class="elsevierStyleSup">®</span>, Vifor Pharma Inc.) en dosis única, diluida en 250<span class="elsevierStyleHsp" style=""></span>cc de ClNa al 0,9%, durante 15<span class="elsevierStyleHsp" style=""></span>min. La dosis habitual era de 1.000<span class="elsevierStyleHsp" style=""></span>mg, sin superar 15<span class="elsevierStyleHsp" style=""></span>mg de hierro por kilogramo de peso corporal. Los resultados a los 6 meses se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>. Ningún paciente presentó reacciones adversas en el momento de la administración ni en las siguientes 24<span class="elsevierStyleHsp" style=""></span>h.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">La CMF es una molécula nueva, eficaz y con pocos efectos secundarios asociados<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a>. En nuestro caso esta eficacia se mantuvo a los 6 meses, sin necesidad de dosis suplementarias (<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>). La información acerca del tratamiento con CMF en pacientes con ERC es escasa<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,6–9</span></a>. Qunibi et al. evidenciaron una mayor eficacia de la CMF iv que una pauta estándar de ferroterapia oral<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>. Charytan et al. concluyeron que la administración de CMF a pacientes con ERC era al menos tan eficaz como otras formulaciones iv, con muy pocos efectos secundarios<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>. En nuestra serie no se observaron efectos destacables. Algunos trabajos han descrito tendencia a hipofosforemia, pero nosotros no lo evidenciamos, pudiendo tratarse de un efecto transitorio<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>. La administración única de ferroterapia iv supone una serie de ventajas sobre otras formulaciones iv. En primer lugar disminuye las visitas al centro (una dosis de CMF iv equivale a 10 sesiones con hierro dextrano, 8 sesiones con gluconato férrico y 5 con hierro sacarosa) y se alcanza antes una correcta repleción férrica. Además, la CMF iv conlleva un menor tiempo de administración y, por tanto, ahorro de tiempo del profesional sanitario. Otro aspecto relevante en pacientes con ERC es la conservación del árbol vascular, minimizando las venopunciones. A todas estas ventajas se añade la ausencia de efectos secundarios sin modificación de los marcadores inflamatorios<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>. Por tanto, el balance coste-efectividad puede ser mayor, por encima del del valor neto (1 vial = 96 €). En suma, la administración de CMF en dosis única iv a pacientes con ERC parece segura y eficaz, permitiendo una posología sencilla, con buena tolerancia que asegura el cumplimiento terapéutico. La eficiencia de la CMF iv, comparada con otras formulaciones de hierro parenteral, es importante en otras enfermedades que aconsejen esta forma de repleción de los depósitos de hierro. Los enfermos renales también pueden beneficiarse de esta posibilidad terapéutica.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Tabla 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Datos expresados en media y DE.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">FGE: filtrado glomerular estimado; IST: índice de saturación de transferrina.</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=""><tbody title="tbody"><tr title="table-row"><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"><span class="elsevierStyleItalic">Número de pacientes</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32</td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>Varones/mujeres \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 " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11/21</td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>Edad media (años) \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 " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>12</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Etiología de enfermedad renal crónica</span></td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus \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 " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5</td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>Glomerulonefritis \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 " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4</td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>Nefroangiosclerosis/isquémica \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 " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12</td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>Nefropatía tubulointersticial \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 " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4</td></tr><tr title="table-row"><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"><span class="elsevierStyleHsp" style=""></span>No filiada \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 " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><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"><span class="elsevierStyleItalic">Datos analíticos</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal \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 meses \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemoglobina (g/dl) \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">10,7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1,2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12,5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1,8<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hematocrito (%) \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">34<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">*</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ferritina (ng/ml) \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">92<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>100 \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">294<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>347<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">**</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IST (%) \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">11,4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>6 \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">20,7<span class="elsevierStyleHsp" style=""></span>±<span 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