nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical Universitynefr-108Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESСТАТУС ВИТАМИНА D И СОСТОЯНИЕ СЕРДЕЧНО-СОСУДИСТОЙ СИСТЕМЫ У ПАЦИЕНТОВ С ХРОНИЧЕСКОЙ БОЛЕЗНЬЮ ПОЧЕК С5Д СТАДИИVITAMIN D STATE AND CARDIOVASCULAR SYSTEM IN PATIENTS WITH CHRONIC KIDNEY DISEASE S5D STADEРафрафиХ. .RafrafiH. .noemail@neicon.ruРумянцевА. Ш.RumyantsevA. Sh.rash.56@mail.ruПервый Санкт-Петербургский государственный медицинский университет им.И.П.ПавловаРоссияPavlov First Saint Petersburg State Medical UniversityRussian FederationПервый Санкт-Петербургский государственный медицинский университет им.И.П.Павлова; Санкт-Петербургский государственный университетРоссияPavlov First Saint Petersburg State Medical University; Saint Petersburg State UniversityRussian Federation2015010720151945154Copyright © Рафрафи Х..., Румянцев А.Ш., 20152015Рафрафи Х..., Румянцев А.Ш.Rafrafi H..., Rumyantsev A.S.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/108

ЦЕЛЬ РАБОТЫ: определить взаимосвязь статуса витамина D у больных с ХБП С5д стадии и состояние сердечно-сосудистой системы. ПАЦИЕНТЫ И МЕТОДЫ. Обследовали 103 больных, получающих лечение программным гемодиализом (53 мужчины и 50 женщин, средний возраст 54,8±15,2 года). Определяли общепринятые клинические и лабораторные показатели, концентрацию в сыворотке крови паратиреоидного гормона (ПТГ), выполняли синхронное суточное мониторирование ЭКГ и АД, эхокардиографическое исследование, определяли толщину комплекса интима-медиа сонных артерий. У 79 больных иммуноферментным методом определяли показатели статуса витамина D. РЕЗУЛЬТАТЫ. Средняя концентрация кальцидола в сыворотке крови составила 33,3±13,8 нмоль/л, кальцитриола - 11,5±6,9 пмоль/л. Уровень ПТГ в сыворотке крови был снижен у 38, нормальным - у 25 и повышен у 40 пациентов. Дефицит витамина D был ассоциирован с увеличением риска ИБС в 3,9 раза. Нарушения суточного ритма АД ассоциировались с наиболее выраженным снижением концентрации кальцитриола в сыворотке крови: у диперов 15,9±9,2 пмоль/л, у нондиперов -9,3±5,1 пмоль/л, р=0,034 соответственно. ЗАКЛЮЧЕНИЕ. Определение концентрации кальцидола и кальцитриола в динамике необходимо для индивидуализированного назначения добавок витамна D пациентам с ХБП С5д стадии.

The AIM: to determine the relationship between vitamin D status and cardiovascular system state in patients with CKD S5d. PATIENTS AND METHODS. 103 patients receiving hemodialysis treatment (53 men and 50 women, mean age 54.8±15.2 years) were examined. Conventional clinical and laboratory parameters, serum parathyroid hormone (PTH) and carotid arteries intimamedia complex thickness were determined. 24-hour simultaneous ECG and blood pressure monitoring and echocardiography were performed. Vitamin D status indicators were determined by ELISA in 79 patients. RESULTS. The average serum calcidol concentration was 33.3±13,8 nmol/,l calcitriol - 11.5±6.9 pmol/l. Serum PTH level was decreased in 38 patients, normal - in 25 and increased in 40 patients. Vitamin D deficiency was associated with 3.9 times increased risk of coronary heart disease. Blood pressure circadian rhythm disturbances were associated with the most significant serum calcitriol concentration decrease: at diper - 15.9±9.2 pmol/l, at non-dipper - 9.3±5.1 pmol/l, p=0.034. CONCLUSION. Calcidol and calcitriol concentration overtime determining is necessary for personalized supplemental vitamin D prescription for patients with CKD S5d stade.

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