nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2025-29-4-22-36MUTQZVnefr-2492Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESМелатонин в патогенезе и лечении хронической болезни почекMelatonin in the pathogenesis and treatment of chronic kidney diseasehttps://orcid.org/0000-0001-7325-8027ОванесовК. Б.OvanesovK. B.

Проф. Ованесов Карэн Борисович, д-р мед. наук

195067, Санкт-Петербург, Пискаревский пр., д. 47

Тел.: +7(962)-454-91-88

Prof. Karen B. Ovanesov, MD, PhD, DMedSci

195067, St. Petersburg, Piskarevsky pr., 47

ovanesov2007@mail.ruhttps://orcid.org/0000-0002-1745-6982КолмаковаЕ. В.KolmakovaE. V.

Доц. Колмакова Елена Валерьевна, канд. мед. наук

195067, Санкт-Петербург, Пискаревский пр., д. 47

Тел.: +7(981)-120-13-10

Associate prof. Elena V. Kolmakova, MD, PhD

195067, St. Petersburg, Piskarevsky pr., 47

Phone: +7(962)-454-91-88

Elena.Kolmakova@szgmu.ruhttps://orcid.org/0000-0003-4075-4096БакулинаН. В.BakulinaN. V.

Проф. Бакулина Наталья Валерьевна, д-р мед. наук

195067, Санкт-Петербург, Пискаревский пр., д. 47

Тел.: +7(906)-240-55-55

Prof. Natalia V. Bakulina, MD, PhD, DMedSci

195067, St. Petersburg, Piskarevsky pr., 47

Phone: +7(906)-240-55-55

Bakulina@szgmu.ruСеверо-Западный государственный медицинский университет им. И.И. МечниковаРоссияNorth-Western State Medical University named after I.I. MechnikovRussian Federation2025260120262942236Copyright © Ованесов К.Б., Колмакова Е.В., Бакулина Н.В., 20262026Ованесов К.Б., Колмакова Е.В., Бакулина Н.В.Ovanesov K.B., Kolmakova E.V., Bakulina N.V.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/2492

Хроническая болезнь почек (ХБП) широко распространена и встречается у 10–13 % населения планеты. К примеру, только в США, по последним данным, заболевание диагностировано у 37 миллионов взрослых пациентов. При такой патологии страдают физиологические и биологические механизмы гомеостаза (баланс электролитов и pH, регуляция артериального давления и эндокринной сферы, выведение токсинов, метаболические нарушения). Заболевание необратимо, на начальных этапах протекает бессимптомно, постепенно прогрессирует, и нарушения гомеостаза становятся клинически значимыми. На начальных этапах проводится консервативная нефропротективная терапия. На поздних этапах появляется потребность в заместительной терапии (гемодиализ, перитонеальный диализ и трансплантация почки). Целью консервативного лечения ХБП является замедление прогрессирования почечной патологии, а также коррекция возникающих осложнений со стороны других органов и систем организма (метаболические состояния, сердечно-сосудистые нарушения, анемии и др.). Разработанные сегодня алгоритмы лечения ХБП, к сожалению, не решают всех вопросов и заставляют искать новые, дополнительные подходы к коррекции определенных патологических процессов при ХБП. Именно с фармакотерапевтических позиций в последние годы привлекает к себе внимание мелатонин (МТ), у которого показана способность ограничивать большинство проявлений ХБП. Цель данного обзора – обобщить информацию о потенциальных возможностях применения МТ при ХБП, учитывая его позитивное влияние на сердечно-сосудистую систему, диабет, гомеостаз и ряд других состояний, сопутствующих почечной патологии.

Chronic kidney disease (CKD) is widespread and occurs in 10-13 % of the world's population. For example, in the United States alone, according to the latest data, 37 million adult patients have been diagnosed with the disease. With this pathology, the physiological and biological mechanisms of homeostasis are affected (electrolyte and pH balance, regulation of blood pressure and the endocrine system, elimination of toxins, and metabolic disorders). The disease is irreversible, asymptomatic at the initial stages, gradually progresses and homeostasis disorders become clinically significant. Conservative nephroprotective therapy is performed at the initial stages. In the later stages, there is a need for replacement therapy (hemodialysis, peritoneal dialysis and kidney transplantation). The goal of conservative treatment of CKD is to slow the progression of renal pathology, as well as to correct complications from other organs and body systems (metabolic conditions, cardiovascular disorders, anemia, etc.). Unfortunately, the algorithms developed today for the treatment of CKD do not solve all the issues and force us to look for new, additional approaches to correcting certain pathological processes in CKD. It is from a pharmacotherapeutic perspective that melatonin (MT) has attracted attention in recent years, showing its ability to limit most manifestations of CKD. The purpose of this review is to summarize information about the potential use of MT in CKD, taking into account its positive effect on the cardiovascular system, diabetes, homeostasis, and a number of other conditions associated with renal pathology.

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