nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2009-13-3-49-51nefr-1178Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESБИОХИМИЧЕСКИЕ ПОКАЗАТЕЛИ ФОСФОРНО-КАЛЬЦИЕВОГО ОБМЕНА У ПАЦИЕНТОВ С ХРОНИЧЕСКОЙ БОЛЕЗНЬЮ ПОЧЕК 1-5 СТАДИЙBIOCHEMICAL INDICES OF PHOSPHORUS-CALCIUM METABOLISM IN PATIENTS WITH CHRONIC KIDNEY DISEASE OF 1-5 STAGESВолковМ. М.VolkovM. M.

кафедра пропедевтики внутренних болезней

197022, Санкт-Петербург, ул. Л.Толстого, 17, СПбГМУ им. акад. И.П. Павлова, Нефрокорпус, тел.: (812)-234-69-46.

vmm58@mail.ruСанкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаRussian Federation2009100320091334951Copyright © Волков М.М., 20092009Волков М.М.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/1178

Риск развития кардиоваскулярной патологии повышается на ранних стадиях хронической болезни почек (ХБП) и, возможно, связан с нарушением фосфорно-кальциевого обмена: ранним снижением концентрации активной формы витамина D– 1,25(OH)2 D (кальцитриола) и повышением уровня паратгормона сыворотки крови. В обзоре рассмотрен патогенез развития вторичного гиперпаратиреоза, снижения концентрации кальцитриола сыворотки крови. Приведенные собственные данные подтверждают раннее нарушение гормональной регуляции фосфорно-кальциевого обмена (с 2 стадии ХБП). Впервые обнаружено, что кривая уровня фосфата сыворотки имеет U-образную форму: значения фосфата снижаются на 2-й стадии ХБП и затем быстро повышаются с 4 стадии. По мере прогрессирования ХБП происходит уменьшение экскреции кальция и фосфата с мочой, обусловленное, вероятно, снижением уровня кальцитриола крови.

The risk of development of cardiovascular pathology increases in early stages of chronic kidney disease (CKD) and probably is connected with phosphorus-calcium metabolic disorder - an early diminution in concentration of the active form of vitamin D – 1.25 (OH)2D (calcitriol) and a rise of parathormone serum level. Pathogenesis of secondary heperparathyroidism, a decrease of calcitriol serum concentration is discussed in the review. The own data confirm an early disorder of hormonal regulation of phosphorus-calcium metabolism (from the 2nd stage of CKD). It is found for the first time, that the curve of phosphate serum level has the U-shaped form, i.e. phosphate values decrease in the 2nd stage of CKD and then quickly rise from the 4th stage. As CKD progresses there is a decrease of calcium and phosphate excretion with urine, possibly caused by a decreased calcitriol blood level.

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