

{"id":5930,"date":"2023-10-02T14:55:36","date_gmt":"2023-10-02T19:55:36","guid":{"rendered":"https:\/\/ami.advancedrenaleducation.com\/wparep\/?post_type=article&#038;p=5930"},"modified":"2025-05-09T13:16:04","modified_gmt":"2025-05-09T18:16:04","slug":"la-importancia-de-la-funcion-renal-residual-en-dialisis-sp","status":"publish","type":"article","link":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/","title":{"rendered":"La Importancia de la Funci\u00f3n Renal residual en Di\u00e1lisis"},"content":{"rendered":"<p>La insuficiencia renal cr\u00f3nica se caracteriza a menudo por una disminuci\u00f3n constante de la funci\u00f3n renal durante varios meses o a\u00f1os. La cantidad de funci\u00f3n renal residual (FRR) es importante para el bienestar del paciente y el resultado cl\u00ednico durante la predi\u00e1lisis e incluso despu\u00e9s de que ha comenzado la di\u00e1lisis<sup>1<\/sup>. La FRR proporciona importantes funciones metab\u00f3licas y hemodin\u00e1micas. No solo contribuye a la eliminaci\u00f3n de toxinas ur\u00e9micas, sino que tambi\u00e9n contribuye significativamente a la regulaci\u00f3n de los niveles de gl\u00f3bulos rojos, manteniendo el equilibrio de l\u00edquidos, el control del f\u00f3sforo y el estado nutricional<sup>2<\/sup>. Tambi\u00e9n juega un papel crucial en la preservaci\u00f3n de la salud cardiovascular general y la calidad de vida de los pacientes en di\u00e1lisis. Una preservaci\u00f3n m\u00e1s prolongada de la FRR puede proporcionar un mejor control de la presi\u00f3n arterial y reducir el riesgo de calcificaci\u00f3n vascular y valvular debido a una mejor eliminaci\u00f3n de fosfatos<sup>3<\/sup>. La FRR tambi\u00e9n es un pron\u00f3stico importante de la progresi\u00f3n de la enfermedad renal en pacientes en di\u00e1lisis. El deterioro de la FRR da como resultado un empeoramiento de la anemia, la inflamaci\u00f3n y la desnutrici\u00f3n. Por lo tanto, la presencia de la FRR puede tener un impacto significativo en la supervivencia de los pacientes en di\u00e1lisis y su p\u00e9rdida no puede reemplazarse simplemente aumentando la dosis de di\u00e1lisis<sup>4<\/sup>. En la tabla 1 se muestra un resumen de los efectos de la p\u00e9rdida de la FRR.<\/p>\n<p><strong>Tabla 1. Resumen de los efectos adversos de la p\u00e9rdida de la FRR en pacientes dializados.<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"205\"><strong>\u00a0<\/strong><\/td>\n<td width=\"212\"><strong>Aumento o Empeoramiento<\/strong><\/td>\n<td width=\"206\"><strong>Disminuida<\/strong><\/td>\n<\/tr>\n<tr>\n<td rowspan=\"5\" width=\"205\"><strong>Efectos primarios<\/strong><\/td>\n<td width=\"212\">Gasto energ\u00e9tico en reposo<\/td>\n<td width=\"206\">Eliminaci\u00f3n de mol\u00e9culas medianas<\/td>\n<\/tr>\n<tr>\n<td width=\"212\">Anemia<\/td>\n<td width=\"206\">Producci\u00f3n de eritropoyetina<\/td>\n<\/tr>\n<tr>\n<td width=\"212\">Inflamaci\u00f3n<\/td>\n<td width=\"206\">Aclaramiento de urea y creatinina<\/td>\n<\/tr>\n<tr>\n<td width=\"212\"><\/td>\n<td width=\"206\">Eliminaci\u00f3n de sodio y l\u00edquidos<\/td>\n<\/tr>\n<tr>\n<td width=\"212\"><\/td>\n<td width=\"206\">Aclaramiento de fosfato<\/td>\n<\/tr>\n<tr>\n<td width=\"205\"><strong>Efectos secundarios<\/strong><\/td>\n<td width=\"212\">Desnutrici\u00f3n<\/td>\n<td width=\"206\"><\/td>\n<\/tr>\n<tr>\n<td width=\"205\"><strong>\u00a0<\/strong><\/td>\n<td width=\"212\">Hipertrofia cardiaca\/falla cardiaca<\/td>\n<td width=\"206\"><\/td>\n<\/tr>\n<tr>\n<td width=\"205\"><strong>\u00a0<\/strong><\/td>\n<td width=\"212\">Aterosclerosis\/Arteriosclerosis<\/td>\n<td width=\"206\"><\/td>\n<\/tr>\n<tr>\n<td width=\"205\"><strong>\u00a0<\/strong><\/td>\n<td width=\"212\">Calcificac\u00edon Vascular\/valvular<\/td>\n<td width=\"206\"><\/td>\n<\/tr>\n<tr>\n<td width=\"205\"><strong>Efecto global<\/strong><\/td>\n<td width=\"212\">Mortalidad Cardiovascular<\/td>\n<td width=\"206\">Calidad de Vida<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h6>Adaptado de Wang and Lai, 2006 <sup>5<\/sup><\/h6>\n<p>Adem\u00e1s de los efectos anteriores, la FRR tambi\u00e9n contribuye a la eliminaci\u00f3n de fosfatos. En un estudio transversal retrospectivo con 79 pacientes cr\u00f3nicos en HD (N = 35 con TFG \u2265 3 ml\/min; N = 44 con TFG &lt;3 ml\/min) la TFG residual se correlacion\u00f3 de manera lineal con la excreci\u00f3n urinaria de fosfatos (r = 0,85, P &lt;0,001)<sup>6<\/sup>. Los pacientes con TFG \u22653 ml\/min eliminaron el doble de fosfato (2000,3 \u00b1 804,1 mg) por semana frente a una sola sesi\u00f3n de HD (1019,9 \u00b1 300 mg; P &lt;0,001) y en comparaci\u00f3n con pacientes con TFG &lt;3 ml\/min. Wang et al. Obtuvieron resultados similares, donde la excreci\u00f3n semanal de fosfato oscil\u00f3 entre 300 y 1500 mg en pacientes en HD con UO&gt; 200 ml frente a UO &lt;200 ml por d\u00eda<sup>7<\/sup>. Esto tambi\u00e9n condujo a una menor necesidad de aglutinantes de fosfato.<\/p>\n<p>Con respecto a la FRR y la aterosclerosis (&gt;10 mm de grosor de la \u00edntima media de la arteria car\u00f3tida y\/o formaci\u00f3n de placa por ecograf\u00eda), la FRR se asoci\u00f3 con un menor riesgo (OR: 0,95; P = 0,041). Los pacientes con UO &lt;200 mL\/d\u00eda presentaron mayor puntuaci\u00f3n de calcificaci\u00f3n y calcificaci\u00f3n a\u00f3rtica abdominal<sup>8<\/sup>.<\/p>\n<p><strong>FRR y calidad de vida (CdV)<\/strong><\/p>\n<p>El Estudio Cooperativo de los Pa\u00edses Bajos sobre la Adecuaci\u00f3n de la Di\u00e1lisis (NECOSAD) -2 mostr\u00f3 en 413 incidentes en pacientes con DP que la presencia de FRR mejoraba los par\u00e1metros de calidad de vida<sup>9<\/sup>. Los pacientes experimentaron un mejor funcionamiento f\u00edsico, mayor vitalidad, menos s\u00edntomas de enfermedad renal y una menor incidencia de trastornos del sue\u00f1o. El aumento del aclaramiento peritoneal no afect\u00f3 significativamente ning\u00fan aspecto de la calidad de vida relacionada con la salud de los pacientes<sup>9<\/sup>. Otro estudio inform\u00f3 que la puntuaci\u00f3n de la depresi\u00f3n, el s\u00edndrome de piernas inquietas y la calidad del sue\u00f1o eran deficientes en los pacientes con DP con una FRR m\u00e1s baja o m\u00e1s alta (TFG &lt;5 ml\/min \/ 1,73 m<sup>2<\/sup> frente a TFG \u2265 5 ml\/min \/ 1,73 m<sup>2<\/sup>)<sup>10<\/sup>. Tambi\u00e9n se observ\u00f3 una mejor nutrici\u00f3n y una reducci\u00f3n de las infecciones, la depresi\u00f3n y los niveles de fosfatasa alcalina en aquellos con FRR m\u00e1s alta. Por el contrario, Zhou y cols. informaron que no hab\u00eda correlaci\u00f3n entre FRR y CdV en 120 pacientes con di\u00e1lisis peritoneal ambulatoria continua DPAC; aunque se identificaron correlaciones entre la puntuaci\u00f3n SF-36 y la prote\u00edna C reactiva, la creatinina, el cociente cardiotor\u00e1cico, la alb\u00famina y el volumen de UF<sup>11<\/sup>. En particular, este fue un peque\u00f1o estudio observacional basado en datos informados por los pacientes. En pacientes en HD, tambi\u00e9n se demostr\u00f3 que tener un UO &gt;300 ml\/d\u00eda tiene un impacto positivo en la calidad de vida de los pacientes incidentes<sup>12<\/sup>. El estudio CHOICE (N = 734) inform\u00f3 que la FRR al inicio del estudio se asoci\u00f3 con una mejor calidad de vida en pacientes con HD: las categor\u00edas de salud general, funcionamiento f\u00edsico y social, vitalidad y dolor corporal fueron significativamente diferentes frente a la ausencia de FRR<sup>13<\/sup>. Los datos a 1 a\u00f1o no mostraron una asociaci\u00f3n significativa en los par\u00e1metros de calidad de vida, excepto para las finanzas<sup>14<\/sup>.<\/p>\n<div class=\"vcex-module vcex-divider vcex-divider-solid\" style=\"width:100%;margin-top:20px;margin-bottom:20px;border-top-width:1px;border-color:#dddddd;\"><\/div>\n<p><strong>Referencias<\/strong>:<\/p>\n<ol>\n<li>Brener ZZ, Kotanko P, Thijssen S, Winchester JF, Bergman M. Clinical benefit of preserving residual renal function in dialysis patients: An update for clinicians. <em>Am J Med Sci<\/em>. 2010;339(5):453-456. doi:10.1097\/MAJ.0b013e3181cf7d5b<\/li>\n<li>Kong J, Davies M, Mount P. The importance of residual kidney function in haemodialysis patients. <em>Nephrology<\/em>. 2018;23(12):1073-1080. doi:10.1111\/nep.13427<\/li>\n<li>R\u0103dulescu D, Ferechide D. The importance of residual renal function in chronic dialysed patients. <em>J Med Life<\/em>. 2009;2(2):199-206. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20108541. Accessed June 2, 2020.<\/li>\n<li>Chen CH, Perl J, Teitelbaum I. Prescribing high-quality peritoneal dialysis: The role of preserving residual kidney function. <em>Perit Dial Int<\/em>. 2020;40(3):274-281. doi:10.1177\/0896860819893821<\/li>\n<li>Wang AYM, Lai KN. The importance of residual renal function in dialysis patients. <em>Kidney Int<\/em>. 2006;69(10):1726-1732. doi:10.1038\/sj.ki.5000382<\/li>\n<li>Iwasawa H, Nakao T, Matsumoto H, Okada T, Nagaoka Y, Wada T. Phosphate handling by end-stage kidneys and benefits of residual renal function on phosphate removal in patients on haemodialysis. <em>Nephrology<\/em>. 2013;18(4):285-291. doi:10.1111\/nep.12039<\/li>\n<li>Wang M, You L, Li H, et al. Association of circulating fibroblast growth factor-23 with renal phosphate excretion among hemodialysis patients with residual renal function. <em>Clin J Am Soc Nephrol<\/em>. 2013;8(1):116-125. doi:10.2215\/CJN.00230112<\/li>\n<li>Chen HC, Chou CY, Jheng JS, et al. Loss of Residual Renal Function is Associated With Vascular Calcification in Hemodialysis Patients. <em>Ther Apher Dial<\/em>. 2016;20(1):27-30. doi:10.1111\/1744-9987.12376<\/li>\n<li>Termorshuizen F, Korevaar JC, Dekker FW, van Manen JG, Boeschoten EW, Krediet RT. The relative importance of residual renal function compared with peritoneal clearance for patient survival and quality of life: an analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD )-2. <em>Am J Kidney Dis<\/em>. 2003;41(6):1293-1302. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12776283. Accessed September 24, 2014.<\/li>\n<li>John MM, Gupta A, Sharma RK, Kaul A. Impact of residual renal function on clinical outcome and quality of life in patients on peritoneal dialysis. <em>Saudi J Kidney Dis Transpl<\/em>. 2017;28(1):30-35. doi:10.4103\/1319-2442.198109<\/li>\n<li>Zhou W, Hu W, Han G, Wang H, Zhang J, Mei C. The impact of residual renal function on quality of life in patients with peritoneal dialysis. <em>Clin Nephrol<\/em>. 2018;90(2):106-111. doi:10.5414\/CN109064<\/li>\n<li>Poulsen CG, Kjaergaard KD, Peters CD, Jespersen B, Jensen JD. Quality of life development during initial hemodialysis therapy and association with loss of residual renal function. <em>Hemodial Int<\/em>. 2017;21(3):409-421. doi:10.1111\/hdi.12505<\/li>\n<li>Shafi T, Jaar BG, Plantinga LC, et al. Association of residual urine output with mortality, quality of life, and inflammation in incident hemodialysis patients: The Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) study. <em>Am J Kidney Dis<\/em>. 2010;56(2):348-358. doi:10.1053\/j.ajkd.2010.03.020<\/li>\n<li>Shafi T, Plantinga LC, Powe NR, Coresh J. In reply to \u201cresidual kidney function and quality of life in incident hemodialysis patients.\u201d <em>Am J Kidney Dis<\/em>. 2011;57(1):179-180. doi:10.1053\/j.ajkd.2010.10.006<\/li>\n<\/ol>\n<p>P\/N 101663-01S Rev B 02\/2023<\/p>\n<div class=\"vcex-spacing\" style=\"height:30px\"><\/div>\n","protected":false},"featured_media":0,"template":"","format":"standard","meta":{"_acf_changed":false},"categories":[274],"tags":[205],"language":[42],"articles":[231],"class_list":["post-5930","article","type-article","status-publish","format-standard","hentry","category-articulos","tag-rrf-sp","language-spanish","articles-erc-ert","entry","no-media"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>La Importancia de la Funci\u00f3n Renal residual en Di\u00e1lisis - Advanced Renal Education Program<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"La Importancia de la Funci\u00f3n Renal residual en Di\u00e1lisis - Advanced Renal Education Program\" \/>\n<meta property=\"og:description\" content=\"La insuficiencia renal cr\u00f3nica se caracteriza a menudo por una disminuci\u00f3n constante de la funci\u00f3n renal durante varios meses o a\u00f1os. La cantidad de funci\u00f3n renal residual (FRR) es importante para el bienestar del paciente y el resultado cl\u00ednico durante&hellip;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/\" \/>\n<meta property=\"og:site_name\" content=\"Advanced Renal Education Program\" \/>\n<meta property=\"article:modified_time\" content=\"2025-05-09T18:16:04+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/\",\"name\":\"La Importancia de la Funci\u00f3n Renal residual en Di\u00e1lisis - Advanced Renal Education Program\",\"isPartOf\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website\"},\"datePublished\":\"2023-10-02T19:55:36+00:00\",\"dateModified\":\"2025-05-09T18:16:04+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"La Importancia de la Funci\u00f3n Renal residual en Di\u00e1lisis\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/\",\"name\":\"Advanced Renal Education Program\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization\",\"name\":\"Advanced Renal Education Program\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg\",\"contentUrl\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg\",\"width\":1965,\"height\":381,\"caption\":\"Advanced Renal Education Program\"},\"image\":{\"@id\":\"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"La Importancia de la Funci\u00f3n Renal residual en Di\u00e1lisis - Advanced Renal Education Program","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/","og_locale":"en_US","og_type":"article","og_title":"La Importancia de la Funci\u00f3n Renal residual en Di\u00e1lisis - Advanced Renal Education Program","og_description":"La insuficiencia renal cr\u00f3nica se caracteriza a menudo por una disminuci\u00f3n constante de la funci\u00f3n renal durante varios meses o a\u00f1os. La cantidad de funci\u00f3n renal residual (FRR) es importante para el bienestar del paciente y el resultado cl\u00ednico durante&hellip;","og_url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/","og_site_name":"Advanced Renal Education Program","article_modified_time":"2025-05-09T18:16:04+00:00","twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"7 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/","name":"La Importancia de la Funci\u00f3n Renal residual en Di\u00e1lisis - Advanced Renal Education Program","isPartOf":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website"},"datePublished":"2023-10-02T19:55:36+00:00","dateModified":"2025-05-09T18:16:04+00:00","breadcrumb":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/article\/la-importancia-de-la-funcion-renal-residual-en-dialisis-sp\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/ami.advancedrenaleducation.com\/wparep\/"},{"@type":"ListItem","position":2,"name":"La Importancia de la Funci\u00f3n Renal residual en Di\u00e1lisis"}]},{"@type":"WebSite","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#website","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/","name":"Advanced Renal Education Program","description":"","publisher":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/ami.advancedrenaleducation.com\/wparep\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#organization","name":"Advanced Renal Education Program","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/","url":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg","contentUrl":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-content\/uploads\/2023\/03\/1Asset-1.jpg","width":1965,"height":381,"caption":"Advanced Renal Education Program"},"image":{"@id":"https:\/\/ami.advancedrenaleducation.com\/wparep\/#\/schema\/logo\/image\/"}}]}},"distributor_meta":false,"distributor_terms":false,"distributor_media":false,"distributor_original_site_name":"Advanced Renal Education Program","distributor_original_site_url":"https:\/\/ami.advancedrenaleducation.com\/wparep","push-errors":false,"_links":{"self":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/article\/5930","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/article"}],"about":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/types\/article"}],"wp:attachment":[{"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/media?parent=5930"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/categories?post=5930"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/tags?post=5930"},{"taxonomy":"language","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/language?post=5930"},{"taxonomy":"articles","embeddable":true,"href":"https:\/\/ami.advancedrenaleducation.com\/wparep\/wp-json\/wp\/v2\/articles?post=5930"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}