References

avk

Архивъ внутренней медицины

The Russian Archives of Internal Medicine

2226-67042411-6564

“SINAPS” LLC

10.20514/2226-6704-2018-8-4-260-265

avk-804

Research Article

ОБЗОРНЫЕ СТАТЬИ

REVIEW ARTICLES

ВЛИЯНИЕ ПОЧЕЧНОЙ ДИСФУНКЦИИ НА СЕРДЕЧНО-СОСУДИСТУЮ СИСТЕМУ. ВОЗМОЖНОСТИ РАННЕЙ ДИАГНОСТИКИ ПОЧЕЧНОЙ ДИСФУНКЦИИ

EFFECT OF RENAL DYSFUNCTION ON THE CARDIACVASCULAR SYSTEM. THE POSSIBILI TIES OF EARLY DIAGNOSIS OF THE RENAL DYSFUNCTION

Иманов

Б. Ж.

Imanov

B. Zh.

Бишкек

Bishkek

Муркамилов

И. Т.

Murkamilov

I. T.

Бишкек

Bishkek

murkamilov.i@mail.ru

Сабиров

И. С.

Sabirov

I. S.

Бишкек

Bishkek

Сарыбаев

А. Ш.

Sarybaev

A. Sh.

Бишкек

Bishkek

Национальный Центр кардиологии и терапии имени академика Мирсаида МиррахимоваКыргызстанNational Cardiology and Therapy Center named after academician Mirsaid MirrahimovKyrgyzstan

Кыргызская государственная медицинская академия имени И.К. Ахунбаева; Кыргызско-Российский Славянский университет имени первого Президента России Б.Н. ЕльцинаКыргызстанKyrgyz State Medical Academy named after I.K. Akhunbaev; Kyrgyz Russian Slavic University named after the First President of Russia B.N. YeltsinKyrgyzstan

Кыргызско-Российский Славянский университет имени первого Президента России Б.Н. ЕльцинаКыргызстанKyrgyz State Medical Academy named after I.K. AkhunbaevKyrgyzstan

2018

11082018

84260265

2018

Иманов Б.Ж., Муркамилов И.Т., Сабиров И.С., Сарыбаев А.Ш.

Imanov B.Z., Murkamilov I.T., Sabirov I.S., Sarybaev A.S.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.medarhive.ru/jour/article/view/804

Обзор посвящен обсуждению современных представлений о роли почечной дисфункции в развитии хронической миокардиальной дисфункции в контексте кардиоренального синдрома (КРС) тип 4. В начале обзора приводится определение КРС, затрагиваются общие вопросы патогенеза и диагностики заболевания. Указывается, что у пациентов с начальной стадией хронической болезни почек (ХБП) уже регистрируются сердечно-сосудистые нарушения, которые на отдаленных этапах развития почечной дисфункции выступают в качестве ведущих причин смерти и истинная тяжесть болезни у пациентов с почечной дисфункцией связана, скорее, с повышенным риском сердечно-сосудистых событий, нежели достижением терминальной почечной недостаточности, требующей заместительной почечной терапии. Прогрессирование патологии почек приводит к повреждению сердца через различные механизмы и факторы, как традиционные, так и нетрадиционные, некоторые из которых в кульминации почечного континуума являются результатом самой процедуры диализа у пациентов с терминальной почечной дисфункцией. Механизмы развития застойной сердечной недостаточности при КРС тип 4 включают в себя перегрузку давлением (артериальная гипертензия) и объемом (анемия, отечный синдром), которые увеличиваются пропорционально снижению функции почек. Прирост артериального давления, изменения интракардиальной гемодинамики, ухудшение податливости артерий способствуют ускорению сердечно-сосудистых событий. Обсуждается роль лабораторных предикторов почечной дисфункции в прогрессировании сердечно-сосудистых нарушений. Освещаются общие подходы эхокардиографической визуализации полостей сердца и ее значение в диагностике сердечно-сосудистых заболеваний. Отдельное внимание уделено развитию легочной артериальной гипертензии, изменениям левого и правого желудочка миокарда при почечной дисфункции.

The review is devoted to the discussion of modern concepts of the role of renal dysfunction in the development of chronic myocardial dysfunction in the context of cardio-renal syndrome (RVC) type 4. At the beginning of the review, the definition of cattle is given, general questions of pathogenesis and diagnosis of the disease are addressed. It is indicated that in patients with the initial stage of CKD, cardiovascular disorders are already registered which in the late stages of development of renal dysfunction are the leading causes of death and the true severity of the disease in patients with renal dysfunction is associated with an increased risk of cardiovascular events, rather than an achievement terminal renal failure and requiring renal replacement therapy. The progression of renal pathology leads to damage to the heart through various mechanisms and factors, both traditional and non-traditional, some of which, at the culmination of the renal continuum, are the result of the dialysis procedure itself in patients with terminal renal dysfunction. Mechanisms for the development of congestive heart failure in type 4 cattle include pressure overload (arterial hypertension) and volume (anemia, edematous syndrome), which increase in proportion to the decrease in renal function. Increase in blood pressure, changes in intracardial hemodynamics, deterioration of arterial compliance contribute to the acceleration of cardiovascular events. The role of laboratory predictors of renal dysfunction in the progression of cardiovascular disorders is discussed. The general approaches of echocardiographic visualization of the heart cavities and its importance in the diagnosis of cardiovascular diseases are discussed. Special attention is paid to the development of pulmonary arterial hypertension, changes in the left and right ventricle of the myocardium with renal dysfunction.

почечная дисфункциякардио-ренальный синдромдиагностикавыживаемость

renal dysfunctioncardio-renal syndromediagnosissurvival

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