nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2008-12-4-93-95nefr-1140Research ArticleДИСКУССИЯ И ИНФОРМАЦИЯDISCUSSION AND INFORMATIONНЕФРОПРОТЕКЦИЯ У БОЛЬНЫХ ХРОНИЧЕСКОЙ БОЛЕЗНЬЮ ПОЧЕК С ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ. МОНОТЕРАПИЯ ИНГИБИТОРАМИ АПФ ИЛИ АНТАГОНИСТАМИ РЕЦЕПТОРОВ АНГИОТЕНЗИНА II ИЛИ КОМБИНИРОВАННАЯ ТЕРАПИЯ?NEPHROPROTECTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE WITH CHRONIC CARDIAC INSUFFICIENCY. ACEI MONOTHERAPY WITH ARB OR COMBINATIONAL THERAPYШутовА. М.ShutovA. M.

кафедра терапии и профессиональных болезней медицинского факультета

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amshu@mail.ruУльяновский государственный университет, г. УльяновскРоссия2008100420081249395Copyright © Шутов А.М., 20082008Шутов А.М.Shutov A.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1140

При определении показаний к комбинированному лечению больных хронической болезнью почек (ХБП) ингибиторами ангиотензин I-превращающего фермента (иАПФ) и антагонистов рецепторов первого типа к ангиотензину II (АРА), необходимо учитывать наличие сопутствующей патологии, в том числе, хронической сердечной недостаточности (ХСН). Одним из возможных является междисциплинарный подход, который находит поддержку, как среди нефрологов, так и кардиологов. Необходимо широкое обсуждение возможностей и целесообразности комбинированной терапии иАПФ и АРА у больных ХБП с учетом сопутствующей патологии с выработкой мнения Российского общества нефрологов. Как следует из имеющихся данных, хроническая сердечная недостаточность не может служить причиной для отказа от такой терапии.

In determining the indications for combination treatment of patents with chronic kidney disease (CKD) with the blockers of angiotensin I-converting enzyme (ARB) and antagonists of the angiotensin II receptors (ACEI), it is necessary to keep in mind the concomitant pathology, especially chronic heart insufficiency. Interdisciplinary approach is one of the possibilities, which is supported not only by nephrologists but also cardiologists. A wide discussion of possibilities and reasonability of combinational therapy of ARB and (ACEI) in patients with CHD keeping in mind the concomitant pathology with the statement of Russian nephrologists association is necessary. As it comes from today data, chronic heart insufficiency is not the reason for the refusal of such therapy.

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