nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2017-21-5-9-13nefr-291Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESФЕРТИЛЬНОСТЬ У ЖЕНЩИН С ТЕРМИНАЛЬНОЙ ПОЧЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ (ОБЗОР ЛИТЕРАТУРЫ)WOMEN FERTILITY ASSOCIATED WITH END-STAGE CHRONIC RENAL FAILURE (LITERATURE REVIEW)ЛитвиновА. С.LitvinovA. S.

канд. мед. наук, директор,

344022, Ростовская область, г. Ростов-на-Дону, ул. М. Горького, д. 130, этаж 7

MD, PhD, director,

344022 Rostov-on-Don, M. Gorkogo st., build. 130, floor 7

sknefc@yandex.ruБисультановаЗ. А.BisultanovaZ. A.

отделение гинекологии, врач,

364000, Чеченская Республика, г. Грозный, ул. Социалистическая, д. 4

Department of gynecology, physician,

364000 Grozniy, Socialist st., build. 4

4gkb@bk.ruСеверо-Кавказский нефрологический центрРоссияNorth-Caucasian Nephrology CenterRussian FederationКлиническая больница № 4РоссияClinical hospital № 4Russian Federation201705092017215913Copyright © Литвинов А.С., Бисультанова З.А., 20172017Литвинов А.С., Бисультанова З.А.Litvinov A.S., Bisultanova Z.A.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/291

В обзоре представлены современные данные о причинах снижения репродуктивной функции у женщин, получающих заместительную почечную терапию. Был проведен анализ доступных информационных источников и установлена общая характеристика изменений репродуктивной функции женского организма и ассоциация с течением хронической почечной недостаточности. Выявлена прямая зависимость снижения репродуктивной функции женщин в зависимости от вида, длительности и модальности проводимой заместительной почечной терапии. Определены возможные пути повышения фертильности путем выбора альтернативных гемодиализу и гемодиафильтрации методов заместительной почечной терапии. Выявлены этиологические факторы и патогенетические механизмы развития инволютивных изменений в женской репродуктивной системе с указанием влияния на эти изменения нарушенных функций почек, повышенной лекарственной нагрузки и самих параметров процедур заместительной почечной терапии. Установлено, что применение метода трансплантации почки вне зависимости от ее вида (трупная или близкородственная от живого донора) является наиболее оптимальной формой заместительной почечной терапии поддержания и восстановления женской фертильности. Проведены аналогии с развитием гормональных нарушений у женщин без хронической почечной недостаточности и у женщин с терминальной стадией хронической болезни почек. Выделены перспективные направления в изучении женской фертильности при достижении конечной стадии болезни почек и начале диализной терапии.

The review presents modern data on the causes of reduced reproductive function in females receiving renal replacement therapy. We conducted an analysis of available information sources and determined the common features of female reproductive function changes and association with chronic renal failure. We revealed direct dependence of women reproductive function decrease from type, duration and modalities of ongoing renal replacement therapy. We identified possible ways to improve fertility through selection of alternative to hemodialysis and hemodiafiltration methods of renal replacement therapy. Revealed etiological factors and pathogenic mechanisms of involutive changes development in the female reproductive system detailing influence on these changes of kidney failure, increased drug loading and the parameters of renal replacement therapy procedures. It is established that the application of the method of renal transplantation, regardless of its type (cadaveric or closely related from a living donor) is the most optimal form of renal replacement therapy to maintain and restore female fertility. We made a comparison of the development of hormonal imbalance in women without chronic renal failure and women with endstage chronic kidney disease. We revealed promising directions in the study of female fertility when reaching end-stage kidney disease and the beginning of dialysis therapy.

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