nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2009-13-1-51-55nefr-1148Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESРОЛЬ ХРОНИЧЕСКОГО ВОСПАЛЕНИЯ В ПАТОГЕНЕЗЕ «УРЕМИЧЕСКОЙ НЕДОСТАТОЧНОСТИ ПИТАНИЯ» У ПАЦИЕНТОВ С ТЕРМИНАЛЬНОЙ ПОЧЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ, ПОЛУЧАЮЩИХ ЛЕЧЕНИЕ ХРОНИЧЕСКИМ ГЕМОДИАЛИЗОМTHE ROLE OF CHRONIC INFLAMMATION IN PATHOGENESIS OF «UREMIC MALNUTRITION» IN CHRONIC HEMODIALYSIS PATIENTS WITH END STAGE RENAL DISEASEЯковенкоА. А.YakovenkoA. A.

Кафедра пропедевтики внутренних болезней 

197022 Санкт-Петербург, ул. Л.Толстого 17, СПбГМУ им. акад. И.П.Павлова, Нефрокорпус, тел.: (812)-234-91-94, факс: (812)-234-91-91

leptin-rulit@mail.ruЯковлевВ. Д.YakovlevV. D.

Кафедра пропедевтики внутренних болезней

АсанинаЮ. Ю.AsaninaYu. Yu.КучерА. Г.KucherA. G.

Кафедра пропедевтики внутренних болезней

Санкт-Петербургский государственный медицинский университет имени академика И.П. ПавловаRussian FederationГородская поликлиника № 104, Санкт-ПетербургRussian Federation2009100120091315155Copyright © Яковенко А.А., Яковлев В.Д., Асанина Ю.Ю., Кучер А.Г., 20092009Яковенко А.А., Яковлев В.Д., Асанина Ю.Ю., Кучер А.Г.Yakovenko A.A., Yakovlev V.D., Asanina Y.Y., Kucher A.G.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/1148

Подробно описаны основные причины хронического воспаления у больных с терминальной почечной недостаточностью (ТПН), получающих лечение хроническим гемодиализом (ГД). Рассмотрены факторы хронического воспаления, как связанные с самой гемодиализной терапией, так и факторы, не связанные с гемодиализом. Детально показана связь «уремической недостаточности питания» у больных, получающих лечение хроническим ГД, и хронического воспаления. У гемодиализных больных при тяжелой «уремической недостаточности питания» имеет более высокий уровень основных маркеров воспаления, чем у больных с отсутствием нарушения питания. Ввиду того, что при хроническом воспалении активное воздействие на метаболизм оказывают провоспалительные цитокины, было сделано предположения, что хроническое воспаление, наблюдаемое у гемодиализных больных, является одним из причинных факторов для развития «уремической недостаточности питания» у этой группы пациентов. Теоретически эти взаимосвязи кажутся вполне логичными, однако результаты исследований в отношении связи хронического воспаления и выраженности «уремической недостаточности питания» при ТПН оказались противоречивыми. Наличие таких противоречий требует дальнейших научных изысканий в данном направлении.

The main causes of chronic inflammation in chronic hemodyalisis (HD) patients with end stage renal disease (ESRD) are described. The chronic inflammation factors, connected with hemodyalisis therapy in itself, as well as factors not related to hemodialysis are described. The connection between «uremic malnutrition» in chronic HD patients and chronic inflammation is shown in detail. In hemodyalisis patients with severe «uremic malnutrition» has a higher level of the main inflammation markers, than patients with no malnutrition signs. As a result of the fact that in chronic inflammation the active impact on the metabolism have anti-inflammatory cytokines, a proposition was made that chronic imflamation in hemodyalisis patients is one of the cause factors for the development of «uremic malnutrition» in this group of patients. Theoretically these interconnections seem very logical, although the results of the investigations in relation with chronic inflammation and the degree of «uremic malnutrition» in ESRD seem contradictory. The presence of this contradictions necessitate in further investigation in this direction.

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