nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2025-29-4-91-99XUYNJDnefr-2500Research ArticleНАБЛЮДЕНИЯ ИЗ ПРАКТИКИPRACTICAL NOTESВлияние низкоуглеводной диеты на экскреторную функцию почек у пациентов с метаболическими нарушениями. Описание клинических случаевThe effect of a low-carbohydrate diet on renal dysfunction in patients with metabolic disorders. Description of clinical caseshttps://orcid.org/0000-0003-0187-0457ХудяковаН. В.KhudyakovaN. V.

Проф. Худякова Наталья Валерьевна, канд. мед. наук

11070, г. Белград, ул. Парижской Коммуны, д. 24

Тел.: (+381) 011 2623 475

Prof. Khudiakova Natalia Valerevna, MD, PhD

11070, Beograd, Pariske komune 24

tel. (+381) 011 2623 475

natalia_temnaja@mail.ruhttps://orcid.org/0009-0002-6326-6458СтояновичС.StojanovichS.

Проф. Срджан Стоянович, д-р мед. наук

11070, г. Белград, ул. Парижской Коммуны, д. 24

Тел.: (+381) 011 2623 475

Prof. Srdjan Stojanovich, PhD, Dr. Sci. (Chem.)

11070, Srbia, Beograd, Pariske komune 24

tel. (+381) 011 2623 475

srdjan.stojanovic@iceps.edu.rshttps://orcid.org/0009-0008-2123-3045РадоичичД.RadoichichD.

Даниела Радоичич

11070, г. Белград, ул. Парижской Коммуны, д. 24

Тел.: (+381) 011 2623 475)

Lecturer Daniela Radoichich

11070, Srbia, Beograd, Pariske komune 24

tel. (+381) 011 2623 475

daca.radoicic@gmail.comhttps://orcid.org/0009-0008-4994-0913ХудяковЮ. С.KhudyakovYu. S.

Проф., Худяков Юрий Сергеевич, канд. мед. наук

36210, Врнячка Баня, Липовачка 9Г; директор PR

Тел.: (+381) 062 649 858

Prof. Yurij Sergeevich Khudyakov, PhD, Dr. Sci. (Chem.)

36210, Serbia, Vrnjaсhka Banja, Lipovacka 9G

tel. (+381) 062 649 858

uhs83@mail.ruhttps://orcid.org/0000-0001-8529-3890ПчелинИ. Ю.PchelinI. Yu.

Доц. Пчелин Иван Юрьевич, канд. мед. наук

199106, Cанкт-Петербург, 21-я линия ВО 8а

Тел.: +7 (812) 326-03-26

Pchelin Ivan Yurevich, MD, PhD

199106, St-Peterburg, 21 line VO 8a

Phone: +7 (812) 326-03-26

ewan2008@bk.ruhttps://orcid.org/0000-0002-1915-2237МазуренкоС. О.MazurenkoS. O.

Проф. Мазуренко Сергей Олегович, д-р мед. наук

199106, Cанкт-Петербург, 21-я линия ВО 8а,

Тел.: +7 (812) 326-03-26

Prof. Mazurenko Sergey Olegovich, MD, PhD, DMedSci

199106, Russia, St-Peterburg, 21 line VO 8a

Phone: +7 (812) 326-03-26

dr_mazurenko@mail.ruhttps://orcid.org/0000-0002-0253-4132СмирновВ. В.SmirnovV. V.

Доц. Смирнов Виктор Владимирович, канд. мед. наук

194 100 Санкт- Петербург, ул. Литовская, д. 2

Тел.: +79210958072

Smirnov Victor Vladimirovich, MD

194100 St-Peterburg, Litovskaya street 2

Phone: +7 9210958072

vs@tdom.bizhttps://orcid.org/0000-0002-9430-6339КотроваА. Д.KotrovaA. D.

Анна Дмитриевна Котрова, канд. мед. наук

199106, Cанкт-Петербург, 21-я линия ВО 8а

Тел.: +7 (812) 326-03-26

Kotrova Anna Dmitrievna MD

199106, St-Peterburg, 21 line VO 8a

Phone: +7 (812) 326-03-26

anna_hoh@mail.ruhttps://orcid.org/0000-0002-6956-9014ВасильковаО. Н.VasilkovaV. N.

Доц. Ольга Николаевна Василькова, канд. мед. наук

246000, г. Гомель, Ланге, д. 5

Тел.: +37529 730-10-27

Vasilkova Volha Nikolaevna, PhD

246000, Belarus, Gomel, Lange 5

Phone: +37829 730-10-27

olga.n.vasilkova@gmail.coCollege of Professional StudiesСербияCollege of Professional StudiesSerbiaPR Natural IntelligenceСербияPR Natural IntelligenceSerbiaСанкт-Петербургский государственный университетРоссияSt. Petersburg State UniversityRussian FederationСанкт-Петербургский государственный педиатрический медицинский университетРоссияSt. Petersburg State Pediatric Medical UniversityRussian FederationГородская поликлиника № 32РоссияMunicipal Polyclinic № 32Russian FederationГомельский государственный медицинский университетБеларусьGomel State Medical UniversityBelarus2025260120262949199Copyright © Худякова Н.В., Стоянович С., Радоичич Д., Худяков Ю.С., Пчелин И.Ю., Мазуренко С.О., Смирнов В.В., Котрова А.Д., Василькова О.Н., 20262026Худякова Н.В., Стоянович С., Радоичич Д., Худяков Ю.С., Пчелин И.Ю., Мазуренко С.О., Смирнов В.В., Котрова А.Д., Василькова О.Н.Khudyakova N.V., Stojanovich S., Radoichich D., Khudyakov Y.S., Pchelin I.Y., Mazurenko S.O., Smirnov V.V., Kotrova A.D., Vasilkova V.N.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/2500

Нездоровое и неполноценное питание входит в число основных факторов риска развития большинства заболеваний. Многочисленные метаболические нарушения, возникающие из-за грубых нарушений диеты, запускают каскад патологических процессов, вовлекающие абсолютно все органы и системы. Так, например, на сегодняшний день лидирующими факторами развития и прогрессирования хронической болезни почек (ХБП) являются не первичная почечная патология, а сахарный диабет 2 типа (СД2) и артериальная гипертензия (АГ), в основе которых часто лежит избыточная масса тела, развившийся вследствие нерационального питания. Данные литературы однозначно говорят о том, что правильно подобранная диета благоприятно влияет не только на уровень артериального давления и показатели углеводного обмена, но и на состояние почек. Наличие ХБП в большинстве случаев предполагает коморбидность, в связи с чем требует подбора оптимальной схемы питания, включающей коррекцию всех имеющихся многочисленных метаболических нарушений. Сегодня насчитываются более 100 разработанных диет, но какая из них будет наилучшей для такого пациента остается неясным. Более того, влияние основных макронутриентов на почечную функцию остается противоречивым и до конца не изученным. В статье описаны три клинических случая применения низкоуглеводной диеты (НУД) со средним потреблением углеводов и ее влияние на почечную функцию и метаболические параметры. Данный вариант питания у пациентов с метаболическими нарушениями при высокой приверженности пациентов к диете привел к улучшению работы почек и показателей углеводного, липидного и пуринового обменов, уменьшению массы тела, снижению доз и количества применяемых препаратов, и в ряде случаев помог нормализовать артериальное давление.

Currently, the leading factors in the development and progression of chronic kidney disease (CKD) are type 2 diabetes mellitus and arterial hypertension, which are often caused by obesity resulting from overeating. The literature clearly shows that a properly selected diet has a beneficial effect not only on blood pressure and carbohydrate metabolism, but also on kidney function. The presence of CKD in most cases assumes comorbidity, and therefore requires the selection of an optimal diet that includes correction of all existing metabolic disorders. Today, there are more than 100 diets known, but it remains unclear which one is best for these patients. Moreover, the effect of major macronutrients on renal function remains controversial and has not been fully studied. The article describes three clinical cases of a low-carbohydrate diet (LCD) with moderate carbohydrate intake and its effect on renal function and metabolic parameters. This dietary option in patients with metabolic disorders, combined with high patient adherence to the diet, led to improved kidney function and carbohydrate, lipid and purine metabolism indicators, weight loss, a reduction in the doses and number of medications used, and in some cases helped to normalise blood pressure.

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