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Том 5 №2 2003 год - Нефрология и диализ

Вирусные инфекции и трансплантация почки (Обзор литературы, часть I)


Прокопенко Е.И.

Аннотация: Трансплантация почки (ТП) является методом выбора при лечении больных с терминальной хронической почечной недостаточностью (ХПН). Ежегодно в странах Европейского союза выполняется более 11 тысяч, а в США - более 12 тысяч трансплантаций почки [7]. При этом инфекционные, в том числе и вирусные, осложнения остаются серьезной проблемой посттрансплантационного периода. Установлено, что в течение первого года после ТП среди всех фатальных осложнений наиболее значимы инфекции, доля которых составляет 36% [44]. В последующем инфекционные осложнения отступают на второе место после сердечно-сосудистых, однако продолжают оставаться важнейшей причиной заболеваемости и летальности больных с трансплантированной почкой. Развитие инфекционных осложнений после трансплантации зависит от иммунологического статуса и эпидемиологического окружения. Иммунологический статус определяется типом применяемой иммуносупрессивной терапии, дозами и последовательностью применяемых препаратов, продолжительностью лечения. Важное влияние оказывают наличие уремии, нейтропении, анемии, гипопротеинемии, гипергликемии, повреждения кожных покровов [65].

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Ключевые слова: вирусы, трансплантация почки, иммуносупрессия

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