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Том 22 №1 2020 год - Нефрология и диализ

Здоровые почки всем и везде: от профилактики и выявления до равного доступа к медицинской помощи


Филипп Кам Тао Ли Гильермо Гарсия-Гарсия Сиу-Фай Луи Шэрон Андреоли Уинстон Винг-Шинг Фунг Анна Градски Латха Кумарасвами Василиос Лиакопулос Зиёда Рахимова Гамаль Саади Луиза Страни Ифеома Уласи Камьяр Калантар-Заде

DOI: 10.28996/2618-9801-2020-1-10-23

Аннотация: Перевод с английского Е.С. Камышовой под редакцией Е.В. Захаровой Перевод осуществлен по инициативе РДО, и одобрен Организационным комитетом Всемирного Дня Почки Глобальное бремя хронической болезни почек (ХБП) стремительно увеличивается: так, согласно прогнозам, к 2040 г. ХБП окажется на пятом месте среди наиболее частых причин сокращения продолжительности жизни во всем мире. Более того, ХБП является основной причиной катастрофических расходов на здравоохранение. В странах с высоким уровнем дохода расходы на диализ и трансплантацию составляют до 3% от ежегодного бюджета здравоохранения. В связи с этим особенно важно, что развитие и прогрессирование ХБП во многих случаях можно предотвратить. В 2020 году кампания «Всемирный День Почки» посвящена в первую очередь мероприятиям по первичной, вторичной и третичной профилактике ХБП. В данной статье представлены описание и анализ мер, которые могут быть внедрены в каждой стране с целью пропаганды и дальнейшего развития профилактики ХБП. Первичная профилактика заболеваний почек должна быть направлена на модификацию факторов риска и устранение структурных повреждений почек и мочевыводящих путей, а также ограничение воздействия факторов риска окружающей среды и нефротоксических веществ. У лиц, уже страдающих заболеваниями почек, вторичная профилактика (включая оптимизацию артериального давления и контроль гликемии) должна быть основной целью как обучения, так и клинических вмешательств. У пациентов с далеко зашедшими стадиями ХБП настоятельно рекомендуются превентивные меры, позволяющие предотвратить или отсрочить потребность в диализе или трансплантации почки, а именно - лечение уремии и сопутствующих состояний, таких как сердечно-сосудистые заболевания. Для реализации профилактического подхода необходимо принятие мер на государственном уровне. Несмотря на то, что в той или иной стране может существовать национальная политика и стратегия по профилактике неинфекционных заболеваний в целом, конкретные меры, направленные на повышение осведомленности и настороженности в отношении диагностики, ведения и лечения ХБП, часто отсутствуют. В связи с этим необходимо повышение информированности населения, медицинских работников и политиков о важной роли профилактических мероприятий.

Весь текст

Ключевые слова: заболевания почек, профилактика, выявление, осведомленность, Kidney diseases, prevention, detection, awareness

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