Мелатонин в патогенезе и лечении хронической болезни почек

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.

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