nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2008-12-4-20-27nefr-1128Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESРОЛЬ ВИТАМИНА D В ЗАМЕДЛЕНИИ ПРОГРЕССИРОВАНИЯ ХРОНИЧЕСКОЙ БОЛЕЗНИ ПОЧЕКTHE ROLE OF VITAMIN D IN PROGRESSION OF CHRONIC KIDNEY DISEASEСмирновА. В.SmirnovA. V.

кафедра пропедевтики внутренних болезней

197022 Санкт-Петербург, ул. Л.Толстого 17, СПбГМУ им. акад. И.П. Павлова, тел.:  8-812-234-01-65

smirnov@nephrolog.ruВолковМ. М.VolkovM. M.

кафедра пропедевтики внутренних болезней

197022 Санкт-Петербург, ул. Л.Толстого 17, СПбГМУ им. акад. И.П. Павлова

Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаRussian Federation2008100420081242027Copyright © Смирнов А.В., Волков М.М., 20082008Смирнов А.В., Волков М.М.Smirnov A.V., Volkov M.M.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/1128

Дефицит активной формы витамина D - кальцитриола (КТ) определяется на ранних стадиях хронической болезни почек (ХБП) и прогрессирует по мере снижения скорости клубочковой фильтрации вследствие снижения его синтеза в проксимальных канальцах. Снижение уровня КТ является следствием ХБП и в то же время ускоряет ее прогрессирование. В экспериментальных работах и в опытах на животных определены механизмы действия КТ: противовоспалительный, торможение пролиферации мезангиальных клеток и подоцитов клубочков, снижение активности ренин-ангиотензиновой системы, предотвращение гипертрофии клубочков, снижение протеинурии, продукции фиброгенных цитокинов, блокада эпителиально-мезенхимальной трансформации тубулярного эпителия и активации миофибробластов. Благодаря этим эффектам КТ тормозит прогрессирование гломерулярного и тубулоинтерстициального фиброза и тем самым замедляет прогрессирование ХБП. Вместе с тем пока нет проспективных исследований, доказывающих ренопротективный эффект с использования надежных конечных результатов.

The deficiency of active form of vitamin D - calcitriol (CT) is determined on the early stages of chronic kidney disease (CKD) and progresses with the decrease of glomerular filtration rate as a result of its synthesis in proximal channels. The decrease of CT level is a result of CKD and at the same time speeds up its progression.  In investigational studies and in animal experiments the mechanisms of action of CT were determined: anti-inflammatory, inhibition of mesangial cell and glomerular podocytes proliferation, decrease in activity of rennin-angiotensin system,  prevention of glomerular hypertrophy,  decrease in proteinuria, production of fibrogenic cytokines, the block of epithelial-mesenchimal transformation of tubular epithelium and activation of myofibroblasts. Thanks to such effects, CT inhibits the progression of glomerular and tubulointestinal fibrosis and by that slows down the progression of CKD. With that there are no prospective studies, proving the renoprotective effect with the use of proven endpoint results.

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