nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2011-15-2-11-19nefr-454Research ArticleПЕРЕДОВАЯ СТАТЬЯLEADING ARTICLEСИСТЕМНЫЙ ПОДХОД К АНАЛИЗУ КАРДИОРЕНАЛЬНЫХ ВЗАИМООТНОШЕНИЙ КАК ПЕРВЫЙ ШАГ НА ПУТИ К НЕФРОЛОГИИ ФОРМАТА П4SYSTEMATIC APPROACH TO THE ANALYSIS OF CARDIO-RENAL RELATIONS AS A FIRST STEP TOWARDS NEPHROLOGY P4 FORMATСМИРНОВА. В.SMIRNOVA. V.

Кафедра пропедевтики внутренних болезней

Научно-исследовательский институт нефрологии Санкт-Петербургского государственного медицинского университета им. акад. И.П.ПавловаRussian Federation2011100220111521119Copyright © СМИРНОВ А.В., 20112011СМИРНОВ А.В.SMIRNOV A.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/454

С позиций системного подхода рассмотрена проблема кардиоренальных взаимоотношений. Предполагается, что в течение ближайших 5–20 лет успехи компьютерных технологий и приближение их к анализу сложных биологических систем в медицине достигнут такого уровня, который позволит существенным образом изменить традиционные подходы. Медицина в целом, и надо думать нефрология как ее часть, станет: персонализированной (personalized), предсказательной (predictive), превентивной (preventive) и партнерской (participatory), т.е. приобретет формат П4.

From the view of system approach a problem of cardiorenal relations is considered. It is assumed that within the next 5 20 years the progress of computer technologies and its advance toward the analysis of complex biological systems in medicine will reach a level that will significantly change the traditional approaches. Medicine in general, and probable to think nephrology as part of it, will become: personalized, predictive, preventive and participatory, and so will acquire the P4 format.

нефрологиякардиоренальные взаимоотношениясистемный подходnephrologycardiorenal relationssystem approachReferencesVenter JC, Adams MD, Myers EW et al. The seguence of the human genome. Science 2001; 291 (5507): 1304–1351Venter JC, Adams MD, Myers EW et al. The seguence of the human genome. Science 2001; 291 (5507): 1304–1351Ng A, Bursteinas B, Gao Q et al. Resources for integrative systems biology: from data through data bases to networks and dynamic system models. Briefings in Bioinformatics 2006; 7 (4): 318–330Ng A, Bursteinas B, Gao Q et al. Resources for integrative systems biology: from data through data bases to networks and dynamic system models. Briefings in Bioinformatics 2006; 7 (4): 318–330Hood L, Rowen L, Galas DJ, Aitchison JD. Systems biology at the Institute for Systems Biology. Brief Funct Genomic Proteomic 2008; 7 (4): 239–248Hood L, Rowen L, Galas DJ, Aitchison JD. Systems biology at the Institute for Systems Biology. Brief Funct Genomic Proteomic 2008; 7 (4): 239–248Sobradillo P, Pozo F, Agusti A. P4 Medicine: the future around the corner. Arch Bronconeumol 2011; 47 (1): 35–40Sobradillo P, Pozo F, Agusti A. P4 Medicine: the future around the corner. Arch Bronconeumol 2011; 47 (1): 35–40Goh KI, Cusick ME, Valle D. et al. The human disease network. PNAS 2007; 104 (21): 8685–8690Goh KI, Cusick ME, Valle D. et al. The human disease network. PNAS 2007; 104 (21): 8685–8690Lee DS, Park J, Kay KA et al. The implications of human metabolic network topology for disease comorbidity. PNAS 2008; 105 (29): 9880–9885Lee DS, Park J, Kay KA et al. The implications of human metabolic network topology for disease comorbidity. PNAS 2008; 105 (29): 9880–9885Hidalgo CA, Blumm N, Barabasi AL, Christakis NA. A dynamic network approach for the study of human phenotypes. PLoS Computational Biology 2009; 5 (4): e1000353Hidalgo CA, Blumm N, Barabasi AL, Christakis NA. A dynamic network approach for the study of human phenotypes. PLoS Computational Biology 2009; 5 (4): e1000353Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med 2007; 357 (4): 370–379Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med 2007; 357 (4): 370–379Tegner J, Skogsberg J, Bjцrkegren J. Multiorgan wholegenome measurements and reverse engineering to uncover gene networks underlying complex traits. J Lipid Res 2007; 48 (2): 267–277Tegner J, Skogsberg J, Bjцrkegren J. Multiorgan wholegenome measurements and reverse engineering to uncover gene networks underlying complex traits. J Lipid Res 2007; 48 (2): 267–277Barabasi AL Network medicine – from obersity to the «diseasome». N Engl J Med 2007; 357 (4): 404–407Barabasi AL Network medicine – from obersity to the «diseasome». N Engl J Med 2007; 357 (4): 404–407Loscalzo J, Kohane I, Barabasi AL. Human disease classification in postgenomic era; a complex systems approach to human pathobiology. Molecular System Biology 2007; 3: 124Loscalzo J, Kohane I, Barabasi AL. Human disease classification in postgenomic era; a complex systems approach to human pathobiology. Molecular System Biology 2007; 3: 124Sarraf M, Masoumi A, Schrier RW. Cardiorenal syndrome in acute decompensated heart failure. Clin J Am Soc Nephrol 2009; 4 (12): 2013–2026Sarraf M, Masoumi A, Schrier RW. Cardiorenal syndrome in acute decompensated heart failure. Clin J Am Soc Nephrol 2009; 4 (12): 2013–2026Damman K, Navis G, Voors AA et al. Worsening renal function and prognosis in heart failure: systematic review and metaanalysis. J Card Fail 2007; 13 (8): 599–608Damman K, Navis G, Voors AA et al. Worsening renal function and prognosis in heart failure: systematic review and metaanalysis. J Card Fail 2007; 13 (8): 599–608Damman K, Navis G, Smilde TD et al. Decreased cardiac output, venous congestion and the association with renal impairment in patients. Eur J Heart Fail 2007; 9 (9): 872–878Damman K, Navis G, Smilde TD et al. Decreased cardiac output, venous congestion and the association with renal impairment in patients. Eur J Heart Fail 2007; 9 (9): 872–878Khavandi A, Greenstein AS, Sonoyama K et al. Myogenic tone and small artery remodeling: insight into diabetic nephropathy. Nephrol Dial Transplant 2009: 24 (2)): 361–369Khavandi A, Greenstein AS, Sonoyama K et al. Myogenic tone and small artery remodeling: insight into diabetic nephropathy. Nephrol Dial Transplant 2009: 24 (2)): 361–369D’Agati VD. Podocyte injury in focal segmental glomerulosclerosis: lessons from animal models (a play in five acts). Kidney Int 2008; 73 (4): 300–406D’Agati VD. Podocyte injury in focal segmental glomerulosclerosis: lessons from animal models (a play in five acts). Kidney Int 2008; 73 (4): 300–406Yoshida H, Yashiro M, Liang P et al. Mesangiolytic glomerulopathy in severe congestive heart failure. Kidney Int 1998; 53 (4): 880–891Yoshida H, Yashiro M, Liang P et al. Mesangiolytic glomerulopathy in severe congestive heart failure. Kidney Int 1998; 53 (4): 880–891Кузьмин ОБ. Механизмы развития и прогрессирования нефропатии у больных сердечной недостаточностью с хроническим кардиоренальным синдромом. Нефрология 2011; 15(2): 20–37Кузьмин ОБ. Механизмы развития и прогрессирования нефропатии у больных сердечной недостаточностью с хроническим кардиоренальным синдромом. Нефрология 2011; 15(2): 20–37Ronco C, McCullough P, Anker SD et al. Acute dialysis Quality Initiative (ADQI) consensus group. Cardiorenal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J 2010; 31 (6): 703–711Ronco C, McCullough P, Anker SD et al. Acute dialysis Quality Initiative (ADQI) consensus group. Cardiorenal syndromes: report from the consensus conference of the acute dialysis quality initiative. Eur Heart J 2010; 31 (6): 703–711McCullough PA. Cardiorenal syndromes: pathophysiology to prevention. Int J Nephrol 2010; 2011: 7622590McCullough PA. Cardiorenal syndromes: pathophysiology to prevention. Int J Nephrol 2010; 2011: 7622590Мухин НА, Моисеев ВС, Кобалава ЖД и др. Кардиоренальные взаимодействия: клиническое значение и роль в патогенезе заболеваний сердечно-сосудистой системы и почек. Тер арх 2004; 6: 39–46Мухин НА, Моисеев ВС, Кобалава ЖД и др. Кардиоренальные взаимодействия: клиническое значение и роль в патогенезе заболеваний сердечно-сосудистой системы и почек. Тер арх 2004; 6: 39–46Смирнов АВ, Добронравов ВА, Каюков ИГ. Кардиоренальный континуум: патогенетические основы превентивной нефрологии. Нефрология 2005; 9 (3): 7–15Смирнов АВ, Добронравов ВА, Каюков ИГ. Кардиоренальный континуум: патогенетические основы превентивной нефрологии. Нефрология 2005; 9 (3): 7–15Levey AS, de Jong PE, Coresh J et al. The definition, classification and prognosis of chronic Kidney disease: a KDIGO Controversies Conference report. Kidney Int 2010; (Epub ahead of print)Levey AS, de Jong PE, Coresh J et al. The definition, classification and prognosis of chronic Kidney disease: a KDIGO Controversies Conference report. Kidney Int 2010; (Epub ahead of print)Van der Velde M, Matsushita K, Coresh J. et al. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative metaanalysis of high-risk populations cohorts. Kidney Int 2011; (Epub ahead of print)Van der Velde M, Matsushita K, Coresh J. et al. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative metaanalysis of high-risk populations cohorts. Kidney Int 2011; (Epub ahead of print)Смирнов АВ, Седов ВМ, Лхаахуу Од-Эрдэне и др. Снижение скорости клубочковой фильтрации как независимый фактор риска сердечно-сосудистой болезни. Нефрология 2006; 10 (4): 7–17Смирнов АВ, Седов ВМ, Лхаахуу Од-Эрдэне и др. Снижение скорости клубочковой фильтрации как независимый фактор риска сердечно-сосудистой болезни. Нефрология 2006; 10 (4): 7–17Nakano T, Ninomiya T, Sumiyoshi S et al. Association of kidney function with coronary atherosclerosis and calcification in autopsy samples from Japanese elders: the Hisayama study. Am J Kidney Dis 2010; 55 (1): 21–30Nakano T, Ninomiya T, Sumiyoshi S et al. Association of kidney function with coronary atherosclerosis and calcification in autopsy samples from Japanese elders: the Hisayama study. Am J Kidney Dis 2010; 55 (1): 21–30Смирнов АВ, Добронравов ВА, Голубев РВ и др. Распространенность гипергомоцистеинемии в зависимости от стадии хронической болезни почек. Нефрология 2005; 9 (2): 48–52Смирнов АВ, Добронравов ВА, Голубев РВ и др. Распространенность гипергомоцистеинемии в зависимости от стадии хронической болезни почек. Нефрология 2005; 9 (2): 48–52Schwedhelm E, Bцger RH. The role of asymmetric and symmetric dimethylarginines in renal disease. Nat Rev Nephrol 2011; 7 (5): 275–285Schwedhelm E, Bцger RH. The role of asymmetric and symmetric dimethylarginines in renal disease. Nat Rev Nephrol 2011; 7 (5): 275–285Barreto FC, Barreto DV, Liabenf S et al. Serum indoxyl-sulfate is associated with vascular disease and mortality in chronic kidney disease patients. Clin J Am Soc Nephrol 2009; 4 (10): 1551–1558Barreto FC, Barreto DV, Liabenf S et al. Serum indoxyl-sulfate is associated with vascular disease and mortality in chronic kidney disease patients. Clin J Am Soc Nephrol 2009; 4 (10): 1551–1558de Borst MH, de Boer RA, Stolk RP et al. Vitamin D deficiency: universal risk factor for multifactorial disease? Curr Drug Targets 2011: 12 (1): 97–106de Borst MH, de Boer RA, Stolk RP et al. Vitamin D deficiency: universal risk factor for multifactorial disease? Curr Drug Targets 2011: 12 (1): 97–106Saito A, Kaseda R, Hosojima M, Sato H. Proximal tubule cell hypothesis for cardiorenal syndrome in diabetes. Int J Nephrol 2011; ID 957164Saito A, Kaseda R, Hosojima M, Sato H. Proximal tubule cell hypothesis for cardiorenal syndrome in diabetes. Int J Nephrol 2011; ID 957164Vallon V. The proximal tubule in the pathophysiology of the diabetic kidney. Am J Physiol Regul Integr Comp Physiol 2011; 12 (Epub ahead of print)Vallon V. The proximal tubule in the pathophysiology of the diabetic kidney. Am J Physiol Regul Integr Comp Physiol 2011; 12 (Epub ahead of print)Turkmen K, Oflaz H, Uslu B et al. Coronary flow velocity reserve and carotid intima media thickness in patients with autosomal dominant polycystic kidney disease: from impaired tubules to impaired carotid and coronary arteries. Clin J Am Soc Nephrol 2008: 3 (4): 986–991Turkmen K, Oflaz H, Uslu B et al. Coronary flow velocity reserve and carotid intima media thickness in patients with autosomal dominant polycystic kidney disease: from impaired tubules to impaired carotid and coronary arteries. Clin J Am Soc Nephrol 2008: 3 (4): 986–991Virsi GM, Corradi V, Panagioton A et al. ADPKD: Prototype of cardiorenal syndrome type 4. Int J Nephrol 2011: ID 490795Virsi GM, Corradi V, Panagioton A et al. ADPKD: Prototype of cardiorenal syndrome type 4. Int J Nephrol 2011: ID 490795Haraldsson B, Nystrцm J, Deen WM. Properties of the glomerular barrier and mechanisms of proteinuria. Physiol Rev 2008; 88 (2): 451–487Haraldsson B, Nystrцm J, Deen WM. Properties of the glomerular barrier and mechanisms of proteinuria. Physiol Rev 2008; 88 (2): 451–487Russo LM, Sandoval RM, Campos SB et al. Impaired tubular uptake explains albuminuria in early diabetic nephropathy. J Am Soc Nephrol 2009; 20 (3): 489–494Russo LM, Sandoval RM, Campos SB et al. Impaired tubular uptake explains albuminuria in early diabetic nephropathy. J Am Soc Nephrol 2009; 20 (3): 489–494Chade AR, Lerman A, Lerman LO. Kidney in early atherosclerosis. Hypertension 2005; 45 (6): 1042–1049Chade AR, Lerman A, Lerman LO. Kidney in early atherosclerosis. Hypertension 2005; 45 (6): 1042–1049Bax L, van der Graaf Y, Rabelink AJ et al. Influence of atherosclerosis on age-related changes in renal size and function. Eur J Clin Invest 2003; 33 (1): 34–40Bax L, van der Graaf Y, Rabelink AJ et al. Influence of atherosclerosis on age-related changes in renal size and function. Eur J Clin Invest 2003; 33 (1): 34–40Vassalotti JA, Stevens LA, Levey AS. Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 2007; 50 (2): 169–180Vassalotti JA, Stevens LA, Levey AS. Testing for chronic kidney disease: a position statement from the National Kidney Foundation. Am J Kidney Dis 2007; 50 (2): 169–180Muhlberger I, Moensk K, Bernthaler A. et al. Integrative bioinformatics analysis of proteins associated with the cardiorenal syndrome. Int J Nephrol 2011; ID809378Muhlberger I, Moensk K, Bernthaler A. et al. Integrative bioinformatics analysis of proteins associated with the cardiorenal syndrome. Int J Nephrol 2011; ID809378Galas DJ, Hood L. Systems biology and emerging technologies will catalyze the transition from reactive medicine to Predictive, Personalized, Preventive and Participatory (P4) Medicine. IBC 2009; 1: 1–4Galas DJ, Hood L. Systems biology and emerging technologies will catalyze the transition from reactive medicine to Predictive, Personalized, Preventive and Participatory (P4) Medicine. IBC 2009; 1: 1–4Шутов АМ, Серов ВА. Кадиоренальный континуум или кардиоренальный синдром? Клиническая нефрология 2010; 1: 44–48Шутов АМ, Серов ВА. Кадиоренальный континуум или кардиоренальный синдром? Клиническая нефрология 2010; 1: 44–48

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