nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2008-12-2-29-35nefr-1047Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESМОЛЕКУЛЯРНЫЕ МЕХАНИЗМЫ ФУНКЦИОНИРОВАНИЯ КАНАЛЬЦЕВ ПОЧКИ ПРИ САХАРНОМ ДИАБЕТЕ: ВЫБОР НОВОЙ СТРАТЕГИИ ПРОФИЛАКТИКИ И ЛЕЧЕНИЯ ДИАБЕТИЧЕСКОЙ НЕФРОПАТИИMOLECULAR MECHANISMS OF FUNCTIONING RENAL TUBULES IN DIABETES MELLITUS: DECISION ON A NEW STRATEGY OF PROPHYLACTICS AND TREATMENT OF DIABETIC NEPHROPATHYБариновЭ. Ф.BarinovE. F.

Кафедра гистологии, цитологии и эмбриологии 

83003, Донецк, пр. Ильича, 16

СулаеваО. Н.SulaevaO. N.

Кафедра гистологии, цитологии и эмбриологии 

83003, Донецк, пр. Ильича, 16

До­нецкий национальный медицинский университет им. М. ГорькогоUkraine2008100220081222935Copyright © Баринов Э.Ф., Сулаева О.Н., 20082008Баринов Э.Ф., Сулаева О.Н.Barinov E.F., Sulaeva O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1047

В работе проанализированы формирующиеся в процессе развития диабетической нефропатии механизмы нарушения функций канальцевого аппарата, которые посредством тубуло-гломерулярной обратной связи могут вызывать прогрессирование патологического процесса в почечных тельцах и по сути определяют сроки манифестации ренальных дисфункций при сахарном диабете. В то же время состояние тубуло-интерстициального аппарата почки усугубляется при дисфункции сосудистых клубочков вследствие повышения объемной загрузки канальцев при гиперперфузии нефронов, прогрессирования протеинурии и увеличения продукции и фильтрации цитокинов. Приведенные в данном обзоре факты открывают новую страницу в молекулярной биологии транспортных процессов в почке, в частности при сахарном диабете. Выяснение механизмов молекулярного ремоделирования канальцев почки, индуцируемого патогенетическими факторами сахарного диабета, позволяет разработать тактику диагностики диабетической нефропатии на предклинической стадии и определить новую стратегию профилактики и коррекции тубулярных дисфункций при этом состоянии.

Cause-effect relations formed in the process of the development of diabetic nephropathy, dynamics and mechanisms of impairments of the tubular system were analyzed which by means of tubule-glomerular feedback can induce progress of the pathological process in renal corpuscles and in a matter of fact, determine the terms of manifestation of renal dysfunction in diabetes mellitus. At the same time the state of the tubule-interstitial apparatus of the kidney aggravated in dysfunction ofthe vascular glomerules due to the elevation of the volumetric loading of the tubules in hyperfusion of the nephrons, progress of proteinuria and increase production and filtration of cytokines. The presented facts open a new page in molecular biology of transport processes in the kidney, in particular with diabetes mellitus. The elucidation of the mechanisms of molecular remodeling of the renal; tubules, induced by pathogenetic factors of diabetes mellitus allows the strategy of diagnosis of diabetic nephropathy to be developed at the preclinical stage and to determine a new stratery of prophylactics and correction of tubular dysfunction in this condition.

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The authors declare that there are no conflicts of interest present.