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Том 3 №3 2001 год - Нефрология и диализ

Ишемическая болезнь сердца после трансплантации почки


Стюарт Г. Джардин А.Г. Бригс Дж.Д.

Аннотация: Вступление Ранние сердечно-сосудистые заболевания (ССЗ) в настоящее время являются ведущей причиной смерти больных с пересаженной почкой [1, 2] и, как следствие, одной из основных причин потерь почечных трансплантатов [3]. Из этого следует, что более эффективное лечение ССЗ должно улучшить как выживаемость реципиентов почечного трансплантата (ПТ), так и выживаемость трансплантатов. Однако проблема состоит в том, что существующие методы лечения ССЗ у «не почечных» больных не всегда подходят реципиентам ПТ. Как и в общей популяции, после трансплантации почки ССЗ имеют комплексную природу. Последняя обусловлена процессами ускоренного атеросклероза, ведущего к развитию коронарной болезни сердца, и патологией миокарда (особенно гипертрофией левого желудочка - ГЛЖ), которая, в свою очередь, может быть причиной хронической сердечной недостаточности и внезапной смерти от аритмии. Более того, ССЗ (коронарная болезнь сердца или кардиомиопатия), развиваясь уже на ранних стадиях прогрессирующего почечного заболевания, после трансплантации почки могут стать необратимыми. Вопрос о естественном течении ССЗ у реципиентов ПТ остается предметом изучения. ** Публикуется по согласованию с автором и с разрешения Oxford University Press ** Перевод И.Г. Ким

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