УПРАВЛЕНИЕ ПОЧЕЧНЫМИ РИСКАМИ В КЛИНИЧЕСКОЙ ПРАКТИКЕ. СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ НЕФРОПРОТЕКЦИИ
Обзорная статья
Дата публикации: февраля 9, 2023
Ключевые слова
хроническая болезнь почек
кардио-нефропротекция
дапаглифлозин
кардио-нефропротекция
дапаглифлозин
Как цитировать
Сарычева А. А., Давиташвили С. А. УПРАВЛЕНИЕ ПОЧЕЧНЫМИ РИСКАМИ В КЛИНИЧЕСКОЙ ПРАКТИКЕ. СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ НЕФРОПРОТЕКЦИИ // Кремлевская медицина. Клинический вестник. 2023. Т. № 4. С. 53-59.
Аннотация
Хроническая болезнь почек (ХБП) - распространенное заболевание с общемировой тенденцией к росту числа пациентов на заместительной почечной терапии. Большинство исследований продемонстрировало, что ХБП является мощным фактором риска развития и прогрессирования кардиальной патологии. Поэтому для лечения пациентов с ХБП выбор препаратов должен быть ориентирован на кардио-ренальную протекцию, на снижение риска не только почечного повреждения, но и уменьшения сердечно-сосудистого риска. Современная медицина открывает нам такую возможность с появлением нового класса препаратов ингибиторов натрий-глюкозного котранспортера 2-го типа (иНГЛТ2). В обзоре представлены основные современные направления нефропротекции у пациентов с ХБП. Нефропротекция у пациентов с ХБП должна быть начата на ранних стадиях заболевания, а такие пациенты как правило наблюдаются не у нефрологов, а у врачей терапевтов и кардиологов. В настоящее время эта проблема является междисциплинарной и требует включения в ее реализацию врачей основных терапевтических специальностей.Литература
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17. Matsushita K. et al. Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate //Jama. – 2012. – V. 307. – №. 18. – P. 1941-1951.
18. Zhang M. et al. Clinical evaluation of serum cystatin C and creatinine in patients with chronic kidney disease: a meta-analysis //Journal of international medical research. – 2013. – V. 41. – №. 4. – P. 944-955. doi: 10.1177/0300060513480922.
19. Adeera L. et al. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease //Kidney Int Suppl. – 2013. – V. 3. – P. 1-150.
20. Батюшин М. М. Хроническая болезнь почек: современное состояние проблемы //Рациональная фармакотерапия в кардиологии. – 2020. – Т. 16. – №. 6. – С. 938-947. [Batyushin M. M. Chronic kidney disease: the current state of the problem // Rational pharmacotherapy in cardiology. – 2020. – V. 16. – №. 6. – P. 938-947. In Russian].
21. Késői I. et al. Cardiorenal syndromes //Orvosi Hetilap. – 2011. – V. 152. – №. 38. – P. 1520-1527.
22. Галушкин А. А. и др. Комплексная оценка сердечно-сосудистых факторов риска, как инструмент прогнозирования развития хронической болезни почек //Нефрология. – 2013. – Т. 17. – №. 5. – С. 49-54. [Galushkin A. A. et al. Comprehensive assessment of cardiovascular risk factors as a tool for predicting the development of chronic kidney disease // Nephrology. – 2013. – V. 17. – №. 5. – P. 49-54. In Russian].
23. Heerspink H. J. L., Gansevoort R. T. Albuminuria is an appropriate therapeutic target in patients with CKD: the pro view //Clinical Journal of the American Society of Nephrology. – 2015. – V. 10. – №. 6. – P. 1079-1088. doi:10.2215/ CJN.11511114
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