nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical Universitynefr-166Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESЛегочная гипертензия - новый аспект кардиоренального синдромаPulmonary Hypertension - a new aspect of cardiorenal syndromeРуденкоТатьяна ЕвгеньевнаKutyrinaIrina M.atatianaer@yandex.ruКутыринаИрина МихайловнаRudenkoTatiana E.noemail@neicon.ruВасильеваМария ПавловнаVasilyevaMaria P.noemail@neicon.ruСоломахинаНина ИосифовнаSolomakhinaNina I.noemail@neicon.ruПервый Московский государственный медицинский университет им. И.М. СеченоваРоссияSechenov First Moscow State Medical UniversityRussian Federation2016010320162024852Copyright © Руденко Т.Е., Кутырина И.М., Васильева М.П., Соломахина Н.И., 20162016Руденко Т.Е., Кутырина И.М., Васильева М.П., Соломахина Н.И.Kutyrina I.M., Rudenko T.E., Vasilyeva M.P., Solomakhina N.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/166

Нарушение функции почек ассоциировано с высокой частотой сердечно-сосудистых осложнений. В обзоре рассматривается новый аспект кардиоренального синдрома - развитие легочной гипертензии у больных с хронической болезнью почек (ХБП). Обсуждаются ее распространенность, возможные патогенетические механизмы, прогностическое значение и возможные методы лечения при ХБП.

Renal disorder is associated with high frequency of cardiovascular complications. The review summarizes data of a new entity of cardiorenal syndrome - pulmonary hypertension development in patients with chronic kidney disease (CKD). Its prevalence, potential pathogenic mechanisms, prognostic value and possible treatment in patients with CKD are discussed.

легочная гипертензияхроническая болезнь почекpulmonary hypertensionchronic kidney diseaseReferencesЧазова И.Е., Авдеев С.Н., Царева Н.А. и др. Клинические рекомендации по диагностике и лечению легочной гипертензии. Тер арх 2014; 9: 4-23Чазова И.Е., Авдеев С.Н., Царева Н.А. и др. Клинические рекомендации по диагностике и лечению легочной гипертензии. Тер арх 2014; 9: 4-23Galie N., Hoeper M.M., Humbert M. et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS)., endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 2009; 30: 2493-2537.doi:10.1093/eurheartj/ehp297Galie N., Hoeper M.M., Humbert M. et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS)., endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 2009; 30: 2493-2537.doi:10.1093/eurheartj/ehp297Simonneau G., Gatzoulis M.A., Adatia I et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013; 62: D34-D41. doi.org/10.1016/j.jacc.2013.10.029Simonneau G., Gatzoulis M.A., Adatia I et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013; 62: D34-D41. doi.org/10.1016/j.jacc.2013.10.029Fabbian F., Cantelli S., Molino C. et al. Pulmonary hypertension in dialysis patients: a cross-sectional Italian study. Int J Nephrol 2010; 2011: 283475. doi.org/10.4061/2011/Fabbian F., Cantelli S., Molino C. et al. Pulmonary hypertension in dialysis patients: a cross-sectional Italian study. Int J Nephrol 2010; 2011: 283475. doi.org/10.4061/2011/Yigla M., Fruchter O., Aharonson D. et al. Pulmonary hypertension is an independent predictor of mortality in hemodialysis patients. Kidney Int 2009; 75: 969-975 doi: 10.1038/ki.2009.10.Yigla M., Fruchter O., Aharonson D. et al. Pulmonary hypertension is an independent predictor of mortality in hemodialysis patients. Kidney Int 2009; 75: 969-975 doi: 10.1038/ki.2009.10.Ramasubbu K., Deswal A., Herdejurgen C. et al. A prospec tive echocardiographic evaluation of pulmonary hypertension in chronic hemodialysis patients in the United States: prevalence and clinical significance. Int J Gen Med 2010; 3: 279-286. doi: 10.2147/IJGM.S12946Ramasubbu K., Deswal A., Herdejurgen C. et al. A prospec tive echocardiographic evaluation of pulmonary hypertension in chronic hemodialysis patients in the United States: prevalence and clinical significance. Int J Gen Med 2010; 3: 279-286. doi: 10.2147/IJGM.S12946Unal A., Tasdemir K., Oymak S et al. The long-term effects of arteriovenous fistula creation on the development of pulmonary hypertension in hemodialysis patients. Hemodial Int 2010; 14: 398-402. DOI: 10.1111/j.1542-4758.2010.00478.xUnal A., Tasdemir K., Oymak S et al. The long-term effects of arteriovenous fistula creation on the development of pulmonary hypertension in hemodialysis patients. Hemodial Int 2010; 14: 398-402. DOI: 10.1111/j.1542-4758.2010.00478.xAgarwal R. Prevalence., determinants and prognosis of pulmonary hypertension among hemodialysis patients. Nephrol Dial Transpl 2012; 27: 3908-3914 doi: 10.1093/ndt/gfr661Agarwal R. Prevalence., determinants and prognosis of pulmonary hypertension among hemodialysis patients. Nephrol Dial Transpl 2012; 27: 3908-3914 doi: 10.1093/ndt/gfr661Бородулина E.O., Карпунин С.А., Шутов А.М. Легочная гипертензия у больных на гемодиализе. Клин нефрол 2015; (1):19-22Бородулина E.O., Карпунин С.А., Шутов А.М. Легочная гипертензия у больных на гемодиализе. Клин нефрол 2015; (1):19-22Unal A., Sipahioglu M., Oguz F. et al. Pulmonary hypertension in peritoneal dialysis patients: prevalence and risk factors. Perit Dial Int 2009; 29: 191-198Unal A., Sipahioglu M., Oguz F. et al. Pulmonary hypertension in peritoneal dialysis patients: prevalence and risk factors. Perit Dial Int 2009; 29: 191-198Kumbar L., Fein P.A., Rafiq M.A. et al. Pulmonary hypertension in peritoneal dialysis patients. Adv Perit Dial 2007; 23: 127-131Kumbar L., Fein P.A., Rafiq M.A. et al. Pulmonary hypertension in peritoneal dialysis patients. Adv Perit Dial 2007; 23: 127-131Yang Q.M., Bao X.R. Pulmonary hypertension in patients with stage 1-3 chronic kidney disease. Genetics and molecular research 2014; 13 (3): 5695-5703 DOI dx.doi.org/10.4238/2014. July.25.25Yang Q.M., Bao X.R. Pulmonary hypertension in patients with stage 1-3 chronic kidney disease. Genetics and molecular research 2014; 13 (3): 5695-5703 DOI dx.doi.org/10.4238/2014. July.25.25Li Z., Liang X., Liu S. et al. Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity. PLOS ONE 2014; 9 (12): e114392. DOI: 10.1371/ journal.pone.0114392Li Z., Liang X., Liu S. et al. Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity. PLOS ONE 2014; 9 (12): e114392. DOI: 10.1371/ journal.pone.0114392Bolignano D., Rastelli S., Agarwal R. et al. Pulmonary Hypertension in CKD. Am J Kidney dis 2013; 61(4): 612-622. http:// dx.doi.org/10.1053/j.ajkd.2012.07.029Bolignano D., Rastelli S., Agarwal R. et al. Pulmonary Hypertension in CKD. Am J Kidney dis 2013; 61(4): 612-622. http:// dx.doi.org/10.1053/j.ajkd.2012.07.029Моисеев B.C., Мухин Н.А., Смирнов А.В. и др. Сердечно-сосудистый риск и хроническая болезнь почек: стратегии кардио-нефропротекции. Росс кардиол журн 2014; 8 (112): 7-37Моисеев B.C., Мухин Н.А., Смирнов А.В. и др. Сердечно-сосудистый риск и хроническая болезнь почек: стратегии кардио-нефропротекции. Росс кардиол журн 2014; 8 (112): 7-37Kawar B., Ellam T., Jackson C., Kiely D. Pulmonary Hypertension in Renal Disease: Epidemiology., Potential Mechanisms and Implications. Am J Nephrol 2013; 37: 281-290. DOI: 10.1159/000348804Kawar B., Ellam T., Jackson C., Kiely D. Pulmonary Hypertension in Renal Disease: Epidemiology., Potential Mechanisms and Implications. Am J Nephrol 2013; 37: 281-290. DOI: 10.1159/000348804Zoccali C. Pulmonary hypertension in dialysis patients: a prevalent., risky but still uncharacterized disorder. Nephrol Dial Transpl 2012; 27: 3674-3677. doi: 10.1093/ndt/gfs425Zoccali C. Pulmonary hypertension in dialysis patients: a prevalent., risky but still uncharacterized disorder. Nephrol Dial Transpl 2012; 27: 3674-3677. doi: 10.1093/ndt/gfs425Havlucu Y., Kursat S., Ekmekci C. et al. Pulmonary hypertension in patients with chronic renal failure. Respiration 2007; 74: 503-510. DOI: 10.1159/000102953Havlucu Y., Kursat S., Ekmekci C. et al. Pulmonary hypertension in patients with chronic renal failure. Respiration 2007; 74: 503-510. DOI: 10.1159/000102953Kim S.C., Chang H.J., Kim M.G. et al. Relationship between pulmonary hypertension., peripheral vascular calcification., and major cardiovascular events in dialysis patients. Kidney Res Clin Pract 2015; 34: 28-34. doi:10.1016/j.krcp.2015.01.003Kim S.C., Chang H.J., Kim M.G. et al. Relationship between pulmonary hypertension., peripheral vascular calcification., and major cardiovascular events in dialysis patients. Kidney Res Clin Pract 2015; 34: 28-34. doi:10.1016/j.krcp.2015.01.003Nakhoul F., Yigla M., Gilman R. et al. The pathogenesis of pulmonary hypertension in haemodialysis patients via arterio-venous access. Nephrol Dial Transpl 2005; 20: 1686-1692. doi:10.1093/ ndt/gfh840Nakhoul F., Yigla M., Gilman R. et al. The pathogenesis of pulmonary hypertension in haemodialysis patients via arterio-venous access. Nephrol Dial Transpl 2005; 20: 1686-1692. doi:10.1093/ ndt/gfh840Yu T.M., Chen Y.H., Hsu J.Y. et el. Systemic inflammation is associated with pulmonary hypertension in patients undergoing haemodialysis. Nephrol Dial Transpl 2009; 24: 1946-1951. doi: 10.1093/ndt/gfn751Yu T.M., Chen Y.H., Hsu J.Y. et el. Systemic inflammation is associated with pulmonary hypertension in patients undergoing haemodialysis. Nephrol Dial Transpl 2009; 24: 1946-1951. doi: 10.1093/ndt/gfn751Yigla M., Banderski R., Azzam Z.S., et al. Arterio-venous access in end-stage renal disease patients and pulmonary hypertension. Ther Adv Respir Dis 2008; 2: 49-53 doi: 10.1177/ 1753465808089456Yigla M., Banderski R., Azzam Z.S., et al. Arterio-venous access in end-stage renal disease patients and pulmonary hypertension. Ther Adv Respir Dis 2008; 2: 49-53 doi: 10.1177/ 1753465808089456Kiykim A.A., Horoz M., Ozcan T. et al. Pulmonary hypertension in haemodialysis patients without arteriovenous fistula: the effect of dialyzer composition. Ren Fail2010; 23: 1148-1152. DO I: 10.3109/0886022X.2010.516854Kiykim A.A., Horoz M., Ozcan T. et al. Pulmonary hypertension in haemodialysis patients without arteriovenous fistula: the effect of dialyzer composition. Ren Fail2010; 23: 1148-1152. DO I: 10.3109/0886022X.2010.516854Zoccali C. Endothelial dysfunction and the kidney: emerging risk factors for renal insufficiency and cardiovascular outcomes in essential hypertension. J Am Soc Nephrol 2006; 17(4 Suppl 2):S61-63. doi:10.1681/ASN.2005121344Zoccali C. Endothelial dysfunction and the kidney: emerging risk factors for renal insufficiency and cardiovascular outcomes in essential hypertension. J Am Soc Nephrol 2006; 17(4 Suppl 2):S61-63. doi:10.1681/ASN.2005121344Смирнов А.В., Петрищев Н.Н., Мнускина М.М. и др. Дисфункция эндотелия и апоптоз на ранних стадиях хронической болезни почек. Тер арх 2012; 84 (6): 9-15Смирнов А.В., Петрищев Н.Н., Мнускина М.М. и др. Дисфункция эндотелия и апоптоз на ранних стадиях хронической болезни почек. Тер арх 2012; 84 (6): 9-15Эмануэль В.Л., Мнускина М.М., Смирнов А.В. и др. Аннексин-5 - биохимический маркер ранних сосудистых нарушений при хронической болезни почек. Клин лаб диагн 2013; (4): 9-10Эмануэль В.Л., Мнускина М.М., Смирнов А.В. и др. Аннексин-5 - биохимический маркер ранних сосудистых нарушений при хронической болезни почек. Клин лаб диагн 2013; (4): 9-10Abdelwhab S., Elshinnawy S. Pulmonary hypertension in chronic renal failure patients. Am J Nephrol 2008; 28: 990-997. DOI:10.1159/000146076Abdelwhab S., Elshinnawy S. Pulmonary hypertension in chronic renal failure patients. Am J Nephrol 2008; 28: 990-997. DOI:10.1159/000146076Dorfmuller P., Zarka V., Durand-Gasselin I. et al. Chemokine RANTES in severe pulmonary arterial hypertension. Am J Respir Crit Care Med 2002;165:534-539. doi: 10.1164/ ajrccm.165.4.2012112Dorfmuller P., Zarka V., Durand-Gasselin I. et al. Chemokine RANTES in severe pulmonary arterial hypertension. Am J Respir Crit Care Med 2002;165:534-539. doi: 10.1164/ ajrccm.165.4.2012112Joppa P., Petrasova D., Stancak B. et al. Systemic inflammation in patients with COPD and pulmonary hypertension. Chest 2006;130:326-333. DOI 10.1378/chest.130.2.326Joppa P., Petrasova D., Stancak B. et al. Systemic inflammation in patients with COPD and pulmonary hypertension. Chest 2006;130:326-333. DOI 10.1378/chest.130.2.326Carrero J.J., Stenvinkel Р. Persistent inflammation as a catalyst for other risk factors in chronic kidney disease: a hypothesis proposal. Clin J Am Soc Nephrol 2009; 4: S49-S55. doi: 10.2215/ CJN.02720409Carrero J.J., Stenvinkel Р. Persistent inflammation as a catalyst for other risk factors in chronic kidney disease: a hypothesis proposal. Clin J Am Soc Nephrol 2009; 4: S49-S55. doi: 10.2215/ CJN.02720409Нефрология. Национальное руководство, ред. Н.А. Мухин. ГЭОТАР-Медия, М., 2009. 720 с.Нефрология. Национальное руководство, ред. Н.А. Мухин. ГЭОТАР-Медия, М., 2009. 720 с.Akmal M., Barndt R.R., Ansari A.N. et al. Excess PTH in CRF induces pulmonary calcification, pulmonary hypertension and right ventricular hypertrophy. Kidney Int 1995; 47: 158-163. doi:10.1038/ki.1995.18Akmal M., Barndt R.R., Ansari A.N. et al. Excess PTH in CRF induces pulmonary calcification, pulmonary hypertension and right ventricular hypertrophy. Kidney Int 1995; 47: 158-163. doi:10.1038/ki.1995.18Issa N., Krowka M.J., Griffin M.D. et al. Pulmonary hypertension is associated with reduced patient survival after kidney transplantation. Transplantation 2008; 86: 1384-1388. DOI: 10.1097/ TP 0b013e318188d640Issa N., Krowka M.J., Griffin M.D. et al. Pulmonary hypertension is associated with reduced patient survival after kidney transplantation. Transplantation 2008; 86: 1384-1388. DOI: 10.1097/ TP 0b013e318188d640Zlotnick D.M., Axelrod D.A., Chobanian M.C. at al. Non-invasive detection of pulmonary hypertension prior to renal transplantation is a predictor of increased risk for early graft dysfunction. Nephrol Dial Transpl 2010; 25: 3090-3096. doi: 10.1093/ndt/gfq141Zlotnick D.M., Axelrod D.A., Chobanian M.C. at al. Non-invasive detection of pulmonary hypertension prior to renal transplantation is a predictor of increased risk for early graft dysfunction. Nephrol Dial Transpl 2010; 25: 3090-3096. doi: 10.1093/ndt/gfq141

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