nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2009-13-1-30-38nefr-1146Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESКАРДИОПРОТЕКТИВНЫЕ ЭФФЕКТЫ D-ГОРМОНА У БОЛЬНЫХ С ХРОНИЧЕСКОЙ БОЛЕЗНЬЮ ПОЧЕК: ОБЗОР ЛИТЕРАТУРЫ И СОБСТВЕННЫЕ ДАННЫЕCARDIOPROTECTIVE EFFECTS OF D-HORMONE IN PATIENTS WITH CHRONIC KIDNEY DISEASE: LITERATURE REVIEW AND PERSONAL DATAСмирновА. В.SmirnovA. V.

кафедра пропедевтики внутренних болезней;

Научно-исследовательский институт нефрологии

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

ДобронравовВ. А.DobronravovV. A.

кафедра пропедевтики внутренних болезней;

Научно-исследовательский институт нефрологии

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

Санкт-Петербургский государственный медицинский университет имени академика И.П. ПавловаRussian Federation2009100120091313038Copyright © Смирнов А.В., Волков М.М., Добронравов В.А., 20092009Смирнов А.В., Волков М.М., Добронравов В.А.Smirnov A.V., Volkov M.M., Dobronravov V.A.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/1146

Основной причиной смерти у пациентов с хронической болезнью почек являются сердечно-сосудистые болезни, риск развития которых повышается уже при незначительном снижении скорости клубочковой фильтрации. Причиной этого могут быть нарушения неэкскреторных функций почек, важное место среди которых занимает снижение синтеза в канальцах активной формы витамина D (ВД) – 1,25(OH)₂ витамина D – кальцитриола, который помимо регулирования фосфорно-кальциевого обмена оказывает важные эффекты на многие органы и ткани, включая сердечно-сосудистую систему. В обзоре рассмотрены результаты экспериментальных и клинических исследований, доказавших, что ВД тормозит активность ренин-ангиотензиновой системы, модулирует иммунную систему, что, в свою очередь, вызывает уменьшение системной воспалительной реакции, ингибирует пролиферацию и способствует дифференциации клеток. Эти механизмы приводят к торможению прогрессирования атеросклероза, гипертрофии левого желудочка, артериальной гипертензии, сердечной недостаточности и лежат в основе улучшения выживаемости пациентов, получающих лечение витамином D.

The main cause of death in patients with chronic kidney disease in cardiac illnesses, with the risk of their development increasing even at the low decrease levels of glomerular filtration. The cause of that could be the damage of nonexcretorial function of the kidney, one of which is decrease of the synthesis in the tubules of the active form of vitamin D (VD) – 1,25(OH)₂ - vitamin D – calcitriol, which besides regulating the phosphorus-calcium exchange has a great impact on various organs and tissues, including the cardiac system. In this review we discussed the results of clinical and experimental data, which proves that VD slows down the activity of the renin-angiotensin system, modulates the immune system, which in itself leads to a system inflammatory reaction, inhibits proliferation and helps in cell differentiation. This mechanisms lead to the atherosclerosis progression, left ventricular hypertrophy, arterial hypertension, cardiac insufficiency decrease and are in the base of better patients, receiving vitamin D therapy, survival.

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