ЭТИОПАТОЛОГИЯ ХРОНИЧЕСКОЙ ТУБУЛЯРНОЙ, ГЛОМЕРУЛЯРНОЙ И РЕНОВАСКУЛЯРНОЙ НЕФРОПАТИЙ: КЛИНИЧЕСКИЕ АСПЕКТЫ
https://doi.org/10.24884/1561-6274-2013-17-2-9-38
Аннотация
Хроническая болезнь почек (ХБП) включает в себя группу патологичеcких состояний, при которых стойко снижена экскреторная функция почек. Большинство из них, хотя и не все формы ХБП, представляют собой прогрессирующие и необратимые патологические процессы, которые начинаются незаметно (без явного снижения функции), протекают с развитием нарушения функции почек и завершаются терминальной почечной недостаточностью. На последнем этапе появляется необходимость выполнения трансплантации почки или проведения диализа (т.е. заместительной почечной терапии, ЗПТ) для предотвращения летального исхода, обусловленного неспособностью почек обеспечить очищение крови и поддержание водно-электролитного баланса. Во всем мире около 1,5 млн человек нуждаются в ЗПТ, причем число новых случаев ХБП значительно возросло за последние десятилетия. Ведущими причинами терминальной почечной недостаточности являются сахарный диабет и артериальная гипертензия, хотя аутоиммунные заболевания, атеросклеротическое поражение почек, ряд инфекционных заболеваний, медикаменты, токсины, обструкция мочевыводящих путей, генетические нарушения и другие повреждающие факторы могут инициировать развитие ХБП, вызывая повреждение гломерул, канальцев, сосудов и интерстиция почки. Во всех случаях при ХБП, в конечном итоге, поражаются все указанные выше структуры, что приводит к появлению одинаковых изменений вне зависимости от этиологии основного заболевания. В этом обзоре с помощью комплексного подхода описывается патофизиологический процесс тубулоинтерстициальных, гломерулярных и реноваскулярных заболеваний, акцентируется внимание на ключевых клеточных и молекулярных процессах. Далее проводится анализ основных механизмов формирования сходных изменений, исследуется патофизиологический сценарий прогрессирования разных по этиологии заболеваний. В завершении обсуждаются клинические проявления, перспективы экспериментальных исследований и терапии.
Об авторах
Дж. М. Лопес-НовойяИспания
López-Novoa JM
А. Б. Родригес-Пена
Соединённые Штаты Америки
А. Ортис
Испания
К. Мартинес-Салдаго
Испания
Ф. Дж. Лопес Эрнандес
Испания
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Рецензия
Для цитирования:
Лопес-Новойя Д., Родригес-Пена А., Ортис А., Мартинес-Салдаго К., Лопес Эрнандес Ф. ЭТИОПАТОЛОГИЯ ХРОНИЧЕСКОЙ ТУБУЛЯРНОЙ, ГЛОМЕРУЛЯРНОЙ И РЕНОВАСКУЛЯРНОЙ НЕФРОПАТИЙ: КЛИНИЧЕСКИЕ АСПЕКТЫ. Нефрология. 2013;17(2):9-38. https://doi.org/10.24884/1561-6274-2013-17-2-9-38
For citation:
López-Novoa J., Rodríguez-Peña A., Ortiz A., Martínez-Salgado C., López Hernández F. ETIOPATHOLOGY OF CHRONIC TUBULAR, GLOMERULAR AND RENOVASCULAR NEPHROPATHIES: CLINICAL IMPLICATIONS. Nephrology (Saint-Petersburg). 2013;17(2):9-38. (In Russ.) https://doi.org/10.24884/1561-6274-2013-17-2-9-38