nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1007Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESСовременные взгляды на назначение витаминов пациентам, получающим лечение программным гемодиализом (Обзор литературы)Modern Views on Vitamins Administration in Haemodialysis Patients ReviewКаратаеваН. В.KarataevaN. V.nvkarataeva@mail.ruГосударственное бюджетное учреждение здравоохранения «Государственная Новосибирская областная клиническая больница», г. НовосибирскРоссияState organisation of public health “Novosibirsk State regional hospital”, NovosibirskRussian Federation201017062025124242249Copyright © Каратаева Н.В., 20252025Каратаева Н.В.Karataeva N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/1007

Глубокое нарушение функций почек, неадекватное питание и/или нарушение всасывания в желудочно-кишечном тракте, потери во время процедуры гемодиализа, особенно при использовании высокопоточных высокоэффективных диализных мембран определяют необходимость назначения водорастворимых витаминов пациентам, получающим программный гемодиализ (ПГД) для предотвращения развития гиповитаминозов. Другим направлением витаминотерапии у пациентов, получающих ПГД, является использование физиологических эффектов определенных витаминов в коррекции некоторых патологических состояний, характерных для данной категории пациентов. В данном обзоре рассмотрены физиологические эффекты витаминов, причины их возможной недостаточности у диализных пациентов, объем потерь в ходе процедуры гемодиализа, существующие на сегодняшний день рекомендации по приему каждого конкретного витамина для пациентов, получающих ПГД. В обзоре рассмотрены следующие витамины: тиамин, рибофлавин, никотинамид, пантотеновая кислота, пиридоксин, биотин, фолиевая кислота, цианокобаламин, аскорбиновая кислота, ретинол, токоферол и витамин К. Хотя в настоящее время крупные рандомизированные контролируемые исследования по вопросам назначения витаминов пациентам, получающим ПГД, немногочисленны, представленные в данном обзоре результаты рандомизированных контролируемых исследований по коррекции витаминами гипергомоцистеинемии, оксидативного стресса, повреждения клеточного генома, мышечных судорог, функционального дефицита железа, полинейропатии, гиперфосфатемии, дислипидемии и Европейские практические рекомендации по назначению витаминов диализным пациентам могут быть интересны и полезны нефрологам.

Deep impairment of kidney function, inadequate intake and/or gastrointestine absorption, dialysis losses, especially during high-flux, high-effective dialysis, require administration of water-soluble vitamins in maintenance haemodialysis (MHD) patients in order to prevent hypovitaminosis. Another reason of vitamin use in MHD patients is based on physiological effects of some vitamins useful for correction of some pathological conditions typical for these patients. In this review we consider physiological effects of vitamins, causes of vitamin insufficiency in MHD patients, dialysis losses, and last recommendation for vitamin supplementation for MHD patients. The review includes information on thiamin, riboflavin, nicotinamid, pantothenic acid, pyridoxin, biotin, folic acid, cobalamin, ascorbic acid, retinol, tocopherol and vitamin K. Although there is a lack of well-design randomized placebo-controlled trials on vitamin usage in MHD patients, the results of some randomized controlled studies of vitamin use in correction of hyperhomocysteinemia, oxidative stress, genomic damage level, muscle cramps, functional iron deficiency, polyneuropathy, hyperphosphatemia, dyslipidemia in MHD patients and European recommendations on vitamins administration in MHD patients reviewed may be interesting and helpful for nephrologists.

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