nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2011-15-1-nefr-400Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESВКЛАД ГАСТРОИНТЕСТИНАЛЬНЫХ ГОРМОНАЛЬНЫХ ФАКТОРОВ В ПАТОГЕНЕЗ НЕДОСТАТОЧНОСТИ ПИТАНИЯ У ПАЦИЕНТОВ С ТЕРМИНАЛЬНОЙ ПОЧЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ, ПОЛУЧАЮЩИХ ЛЕЧЕНИЕ ХРОНИЧЕСКИМ ГЕМОДИАЛИЗОМTHE SIGNIFICANCE OF GASTROINTESTINAL HORMONE IN PATHOGENESIS OF MALNUTRITION IN PATIENTS WITH HEND STAGE RENAL DISEASE ON REGULAR HAEMODIALYSISАСАНИНАЮ. Ю.ASANINAY. Y.

Кафедра факультетской терапии медицинского факультета

ШИШКИНА. Н.SHISHKINA. N.

Кафедра факультетской терапии медицинского факультета

Санкт-Петербургский государственный университетRussian Federation2011100120111513236Copyright © АСАНИНА Ю.Ю., ШИШКИН А.Н., 20112011АСАНИНА Ю.Ю., ШИШКИН А.Н.ASANINA Y.Y., SHISHKIN A.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/400

Проблемы питания, анорексия и поражения верхних отделов желудочнокишечного тракта (ЖКТ) часто встречаются у пациентов с хронической болезнью почек (ХБП). Однако при лечении таких больных мало внимания уделяют аспектам гастроэнтерологии и питания, вследствие чего терапия носит эмпирический характер и часто неэффективна. У пациентов с ХБП, получающих хронический гемодиализ, часто наблюдаются гастрит, дуоденит, язвенная болезнь. Патологические изменения верхних отделов ЖКТ у пациентов с ХБП часто возникают изза изменений метаболизма гастроинтестинальных гормонов.

Feeding problems, anorexia and upper gastrointestinal lesions are common patients with chronic kidney disease (CKD). However, the gastroenterological and nutritional aspects of CKD have received little attention, therapeutic interventions are usually empirical and often ineffective. Gastritis, duodenitis and peptic ulcer are often found in adults with CKD on regular hemodialysis. Patients with CKD have significant upper gastrointestinal tract abnormalities which mainly occur due to changes in metabolism of gastrointestinal hormones.

недостаточность питаниягрелингемодиализmalnutritionghrelinhemodialysisReferencesCooper L. USRDS: 2001 Annual Data Report. Nephrol News Issues 2001; 15 (31): 34-35Cooper L. USRDS: 2001 Annual Data Report. Nephrol News Issues 2001; 15 (31): 34-35Pupim LB, Ikizler TA. Uremic malnutrition: new insights into an old problem: Review. Semin Dial (Cambridge, Ma) 2003; 16 (3): 224-232Pupim LB, Ikizler TA. Uremic malnutrition: new insights into an old problem: Review. Semin Dial (Cambridge, Ma) 2003; 16 (3): 224-232Carvalho KT, Silva MI, Bregman R. Nutritional profile of patients with chronic renal failure. J Ren Nutr 2004; 14 (2): 97-100Carvalho KT, Silva MI, Bregman R. Nutritional profile of patients with chronic renal failure. J Ren Nutr 2004; 14 (2): 97-100Кучер АГ, Румянцев АШ, Асанина ЮЮ, Яковенко АА. Современные представления о недостаточности питания у больных с хронической почечной недостаточностью, получающих лечение хроническим гемодиализом. Нефрология 2006; 10 (4): 23-30Кучер АГ, Румянцев АШ, Асанина ЮЮ, Яковенко АА. Современные представления о недостаточности питания у больных с хронической почечной недостаточностью, получающих лечение хроническим гемодиализом. Нефрология 2006; 10 (4): 23-30Кучер АГ, Румянцев АШ, Яковенко АА. и др. Особенности патогенеза недостаточности питания у больных с хронической почечной недостаточностью, получающих лечение хроническим гемодиализом. Нефрология 2008; 12 (3): 56-65Кучер АГ, Румянцев АШ, Яковенко АА. и др. Особенности патогенеза недостаточности питания у больных с хронической почечной недостаточностью, получающих лечение хроническим гемодиализом. Нефрология 2008; 12 (3): 56-65Walser M. Dialysis and protein malnutrition. Kidney Int 1999; 56 (1): 353Walser M. Dialysis and protein malnutrition. Kidney Int 1999; 56 (1): 353Cooper BA, Penne EL, Bartlett LH, Pollock CA. Protein malnutrition and hypoalbuminemia as predictors of vascular events and mortality in ESRD. Am J Kidney Dis 2004; 43: 61-66Cooper BA, Penne EL, Bartlett LH, Pollock CA. Protein malnutrition and hypoalbuminemia as predictors of vascular events and mortality in ESRD. Am J Kidney Dis 2004; 43: 61-66Yao Q, Lindholm B, Stenvinkel P. Inflammation as a cause of malnutrition, atherosclerotic cardiovascular disease, and poor outcome in hemodialysis patients. Hemodial Int 2004; 8 (2): 118-129Yao Q, Lindholm B, Stenvinkel P. Inflammation as a cause of malnutrition, atherosclerotic cardiovascular disease, and poor outcome in hemodialysis patients. Hemodial Int 2004; 8 (2): 118-129Stenvinkel P, Heimburger O, Lindholm B. et al. Are there two types of malnutrition in chronic renal failure. Evidence for relationships between malnutrition, inflammation, and atherosclerosis (MIA syndrome). Nephrol Dial Transplant 2000; 15 (7): 953-960Stenvinkel P, Heimburger O, Lindholm B. et al. Are there two types of malnutrition in chronic renal failure. Evidence for relationships between malnutrition, inflammation, and atherosclerosis (MIA syndrome). Nephrol Dial Transplant 2000; 15 (7): 953-960Рысс ЕС, Рябов СИ, Лутошкин МБ, Панина ИЮ. Пищеварительная система. Рябов С.И., ред. Лечение хрони ческой почечной недостаточности. Фолиант, СПб, 1997;11-25Рысс ЕС, Рябов СИ, Лутошкин МБ, Панина ИЮ. Пищеварительная система. Рябов С.И., ред. Лечение хрони ческой почечной недостаточности. Фолиант, СПб, 1997;11-25Матюшечкин ЕВ, Шишкин АН, Серебряная НБ, Кареев ВЕ, Тимоховская ГЮ. Цитокиновый статус и клинико-морфологические особенности гастродуоденальной зоны у больных, получающих заместительную почечную терапию. Нефрология 2007; 11 (4): 64-69Матюшечкин ЕВ, Шишкин АН, Серебряная НБ, Кареев ВЕ, Тимоховская ГЮ. Цитокиновый статус и клинико-морфологические особенности гастродуоденальной зоны у больных, получающих заместительную почечную терапию. Нефрология 2007; 11 (4): 64-69Misra V, Misra SP, Shukla SK. Endoscopic and histological changes in upper gastrointestinal tract of patients with chronic renal failure. Indian J Pathol Microbiol 2004; 47 (2): 170-173Misra V, Misra SP, Shukla SK. Endoscopic and histological changes in upper gastrointestinal tract of patients with chronic renal failure. Indian J Pathol Microbiol 2004; 47 (2): 170-173Кasacka I. Review article – involvement of gastric APUD cells in chronic renal failure. Acta Histochem 2003; 105 (4): 319-327Кasacka I. Review article – involvement of gastric APUD cells in chronic renal failure. Acta Histochem 2003; 105 (4): 319-327Meier U, Gressner A. Endocrine regulation of Energy Metabolism: Review of Pathobiochemical and Clinical Chemical Aspects of Leptin, Ghrelin, Adiponectin and Resistin. Clinical Chemistry 2004; 50 (9): 1511-1525Meier U, Gressner A. Endocrine regulation of Energy Metabolism: Review of Pathobiochemical and Clinical Chemical Aspects of Leptin, Ghrelin, Adiponectin and Resistin. Clinical Chemistry 2004; 50 (9): 1511-1525Kojima M, Kangawa K. Drug Insight the function of ghrelin and its potential as a multitherapeutic hormone. Nature clinical practice Endocrinology and Metabolism 2006; 2 (2): 234-237Kojima M, Kangawa K. Drug Insight the function of ghrelin and its potential as a multitherapeutic hormone. Nature clinical practice Endocrinology and Metabolism 2006; 2 (2): 234-237Vera Popovic. Ghrelin. Current Opinion in Endocrinology @ diabetes 2006; 13: 70-75Vera Popovic. Ghrelin. Current Opinion in Endocrinology @ diabetes 2006; 13: 70-75van der Lely AJ, Tschop M, Heiman M, Ghigo E. Biologycal, physiological, pathophysiological and pharmacological aspects of ghrelin. Endocr Rev 2004; 25: 426-457van der Lely AJ, Tschop M, Heiman M, Ghigo E. Biologycal, physiological, pathophysiological and pharmacological aspects of ghrelin. Endocr Rev 2004; 25: 426-457Simonian HP, Kresge KM, Boden GH, Parkman HP. Differential effects of sham feeding and meal ingestion on ghrelin and pancreatic polypeptide levels: evidence for vagal efferents stimulation mediating ghrelin release. Neorogastroenterol Motil 2005; 17: 348-354Simonian HP, Kresge KM, Boden GH, Parkman HP. Differential effects of sham feeding and meal ingestion on ghrelin and pancreatic polypeptide levels: evidence for vagal efferents stimulation mediating ghrelin release. Neorogastroenterol Motil 2005; 17: 348-354Jobst E, Enriori P, Cowley M. The electrophysiology of feeding circuits. Trends. Endocrinology Metab 2004; 15: 488-499Jobst E, Enriori P, Cowley M. The electrophysiology of feeding circuits. Trends. Endocrinology Metab 2004; 15: 488-499Zizzari P, Halem H, Taylor J et al. Endogenous ghrelin regulates episodic GH secretion by amplifying GH pulse amplitude evidence from antagonism of the GHS-R1a receptor. Endocrinology 2005; 146: 3836-3842Zizzari P, Halem H, Taylor J et al. Endogenous ghrelin regulates episodic GH secretion by amplifying GH pulse amplitude evidence from antagonism of the GHS-R1a receptor. Endocrinology 2005; 146: 3836-3842Broglio F, Gottero C, Arvat E, Ghigo E. Hormone Research, Endocrine and Non-Endocrine Actions of Ghrelin. Hormone Research 2003; 59 (3): 109-117Broglio F, Gottero C, Arvat E, Ghigo E. Hormone Research, Endocrine and Non-Endocrine Actions of Ghrelin. Hormone Research 2003; 59 (3): 109-117Wittert G, Chapman I. Physiology of gut hormones an overview. Current Opinion in Endocrinology and Diabetes (Hagerstown, Md) 2006; 13 (1): 36-41Wittert G, Chapman I. Physiology of gut hormones an overview. Current Opinion in Endocrinology and Diabetes (Hagerstown, Md) 2006; 13 (1): 36-41Matsuda K, Nishi Y, Okamatsu Y, Kojima M et al. Ghrelin and leptin: a link between obesity and allergy. Journal of allergy and clinical Immunology (St Louis MO) 2006; 117 (3): 705-706Matsuda K, Nishi Y, Okamatsu Y, Kojima M et al. Ghrelin and leptin: a link between obesity and allergy. Journal of allergy and clinical Immunology (St Louis MO) 2006; 117 (3): 705-706Korbonits M, Goldstone A, Gueorguiev M, Grossman A. Ghrelin – a gormone with multiple functions. Front Neuroend crinol 2004; 25: 27-68Korbonits M, Goldstone A, Gueorguiev M, Grossman A. Ghrelin – a gormone with multiple functions. Front Neuroend crinol 2004; 25: 27-68Osawa H. Ghrelin and Helicobacter pylori infection. World J Gastroenterol 2008; 14 (41): 6327-6333Osawa H. Ghrelin and Helicobacter pylori infection. World J Gastroenterol 2008; 14 (41): 6327-6333Mendez-Sanchez N. Effect of Helicobacter pylori infection in gastric ghrelin expression and body weight. Gastroenterol 2007; 72 (4): 359-364Mendez-Sanchez N. Effect of Helicobacter pylori infection in gastric ghrelin expression and body weight. Gastroenterol 2007; 72 (4): 359-364Pacifico L. Long-term effects of Helicobacter pylori eradication on circulating ghrelin and leptin concentrations and body composition in prepubertal children. Eur J Endocrinol 2008; 158 (3): 323-332Pacifico L. Long-term effects of Helicobacter pylori eradication on circulating ghrelin and leptin concentrations and body composition in prepubertal children. Eur J Endocrinol 2008; 158 (3): 323-332Deboer MD, Zhu X, Levasseur PR, Inui A et al. Ghrelin treatment of chronic kidney disease: improvements in lean body mass and cytokine profile. Endocrinology 2008; 149 (2): 827-835Deboer MD, Zhu X, Levasseur PR, Inui A et al. Ghrelin treatment of chronic kidney disease: improvements in lean body mass and cytokine profile. Endocrinology 2008; 149 (2): 827-835Barazzoni R, Zhu X, Deboer M, Datta R et al. Combined effects of ghrelin and higher food intake enhance skeletal muscle mitochondrial oxidative capacity and AKT phosphorylation in rats with chronic kidney disease // Clinica MedicaDepartment of Clinical, Morphological and Technological Sciences, University of Trieste, Trieste, Italy 2009. Kidney Int 2010; 77(1): 23-28Barazzoni R, Zhu X, Deboer M, Datta R et al. Combined effects of ghrelin and higher food intake enhance skeletal muscle mitochondrial oxidative capacity and AKT phosphorylation in rats with chronic kidney disease // Clinica MedicaDepartment of Clinical, Morphological and Technological Sciences, University of Trieste, Trieste, Italy 2009. Kidney Int 2010; 77(1): 23-28Jarkovska Z, Rosicka M, Krsek M, Sulkova S et al. Plasma ghrelin levels in patiens with EndStage Renal Disease. Phisiological Research 2005; 54: 403-408Jarkovska Z, Rosicka M, Krsek M, Sulkova S et al. Plasma ghrelin levels in patiens with EndStage Renal Disease. Phisiological Research 2005; 54: 403-408Guebre-Egziabher F, Bernhard J, Geelen G. Leptin, Adiponectin, and Ghrelin Dysregulation in Chronic Kidney Disease. J Renal Nutrition 2005; 15 (1): 116-120Guebre-Egziabher F, Bernhard J, Geelen G. Leptin, Adiponectin, and Ghrelin Dysregulation in Chronic Kidney Disease. J Renal Nutrition 2005; 15 (1): 116-120Mafra D. Endocrine role of stomach in appetite regulation in chronic kidney disease about ghrelin and obestatin. J Renal Nutritoin 2010; 20(2): 68-73Mafra D. Endocrine role of stomach in appetite regulation in chronic kidney disease about ghrelin and obestatin. J Renal Nutritoin 2010; 20(2): 68-73

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