nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2023-27-3-11-22AECCBLnefr-2236Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESДефицит тестостерона у пациентов с хронической болезнью почек: распространенность и клиническое значение (обзор литературы)Testosterone deficiency in patients with chronic kidney disease: prevalence and clinical significance (literature review)https://orcid.org/0000-0001-5251-145XЛитвиновА. С.LitvinovA. S.

Литвинов Александр Сергеевич, канд. мед. наук, 362047, г. Владикавказ, ул. Морских Пехотинцев, д. 15 «Б»;

г. Лондон, Великобритания

Alexander S. Litvinov, MD, PhD, Leading Scientific Specialist, researcher, 362047, Vladikavkaz, st. Morskih Pehotincev, 15 «B»;

Deputy Medical Director, London, United Kingdom

dirge@yandex.ruhttps://orcid.org/0000-0001-5963-6634КухтинаА. А.KukhtinaA. A.

Кухтина Алина Алексеевна, отделение нефрологии, врач-нефролог, 

115446, Москва, Коломенский проезд, д. 4

Alina A. Kukhtina, resident, department of nephrology,

115446, Moscow, 4 Kolomensky st. 

dr.alina.a@mail.ruhttps://orcid.org/0000-0002-5740-3009КузнецоваЮ. В.KuznetsovaYu. V.

Кузнецова Юлия Витальевна, студентка, кафедра внутренних болезней №1,

344022, г. Ростов-на-Дону, пер. Нахичеванский, д. 29

Yulia V. Kuznetsova, student, Department of Internal Medicine №1,

344022, Rostov-on-Don, 29 Nakhichevansky Ln

ul.kuznetsova04@mail.ruhttps://orcid.org/0000-0002-8217-0091ХатламаджиянВ. В.KhatlamadzhiyanV. V.

Хатламаджиян Вячеслав Владимирович, студент, кафедра внутренних болезней №1,

344022, г. Ростов-на-Дону, пер. Нахичеванский, д. 29

Vyacheslav V. Khatlamadzhiyan, student, Department of Internal Medicine №1,

344022, Rostov-on-Don, 29 Nakhichevansky Ln

vyachik77777@yandex.ruhttps://orcid.org/0000-0001-6850-5118РябоконеваТ. Ю.RyabokonevaT. Yu.

Рябоконева Татьяна Юрьевна, студентка, кафедра внутренних болезней №1,

344022, г. Ростов-на-Дону, пер. Нахичеванский, д. 29

Tatyana Yu. Ryabokoneva, student, Department of Internal Medicine №1,

344022, Rostov-on-Don, 29 Nakhichevansky Ln

tanya.ryabokoneva13@gmail.comООО «Балтийская Медицинская Компания»; Партнерство с ограниченной ответственностью «Metaco LLP»РоссияLimited liability Company “Baltic Medical Company”; Limited liability Partnership “Metaco LLP”Russian FederationГородская клиническая больница имени С.С. ЮдинаРоссияCity clinical hospital named after S.S. YudinRussian FederationРостовский государственный медицинский университетРоссияRostov state medical UniversityRussian Federation2023110920232731122Copyright © Литвинов А.С., Кухтина А.А., Кузнецова Ю.В., Хатламаджиян В.В., Рябоконева Т.Ю., 20232023Литвинов А.С., Кухтина А.А., Кузнецова Ю.В., Хатламаджиян В.В., Рябоконева Т.Ю.Litvinov A.S., Kukhtina A.A., Kuznetsova Y.V., Khatlamadzhiyan V.V., Ryabokoneva T.Y.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/2236

В мире наблюдается увеличение распространенности хронической болезни почек. Это связано, прежде всего, с ростом заболеваемости сахарным диабетом и артериальной гипертензией, как основных этиологических факторов. Прогрессирующее снижение экскреторной функции почек ассоциировано с такими метаболическими нарушениями, как метаболический ацидоз, гиперурикемия, гиперпаратиреоз, оксидативный и воспалительный стресс и др. Это приводит, в свою очередь, к снижению массы тела пациентов, прежде всего, за счет потери мышечной массы. Подобные изменения оказывают неблагоприятное влияние, в том числе, на синтез половых гормонов, в частности, на уровень тестостерона, продукция которого снижается в обсуждаемой когорте больных. Гормональный дисбаланс в виде гипогонадизма может играть существенную роль в повышении сердечно-сосудистого риска. Самостоятельным фактором риска развития и прогрессирования гипогонадизма может быть заместительная почечная терапия. Вместе с тем, проблемы нарушения регуляции, синтеза и баланса половых гормонов, а также вопросы коррекции вторичного гипогонадизма у пациентов с хронической болезнью почек остаются малоизученными и представляют научный интерес.

There is an increase in the prevalence of chronic kidney disease in the world. This is primarily due to the increase in the incidence of diabetes mellitus and arterial hypertension as the main etiological factors. A progressive decline in the excretory function of the kidneys is associated with metabolic disorders such as metabolic acidosis, hyperuricemia, hyperparathyroidism, oxidative and inflammatory stress, etc. This leads, in turn, to a decrease in the body weight of patients, primarily due to the loss of muscle mass. Such changes have an adverse effect, including on the synthesis of sex hormones, in particular, on the level of testosterone, the production of which decreases in the cohort of patients under discussion. Hormonal imbalance in the form of hypogonadism can play a significant role in increasing cardiovascular risk. Renal replacement therapy may be an independent risk factor for the development and progression of hypogonadism. At the same time, the problems of impaired regulation, synthesis and balance of sex hormones, as well as the issues of correction of secondary hypogonadism in patients with chronic kidney disease remain poorly understood and are of scientific interest.

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