nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное общество10.28996/2618-9801-2023-2-222-231nid-110Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESВторичный гиперпаратиреоз. Специфика, сложности, особенности лечения. Обзор литературы. Часть ISecondary hyperparathyroidism. Specific features, complexity, features of treatment. Literature review. Part IШабунинА. В.ShabuninA. V.glavbotk@yandex.ruШутовЕ. В.ShutovE. V.shutov_e_v@mail.ruДолидзеД. Д.DolidzeD. D.ddolidzed@mail.ruЗахароваЕ. В.ZakharovaE. V.helena.zakharova@gmail.comСлепуховаД. В.SlepukhovaD. V.dia.slepuhova@yandex.ruКованцевС. Д.CovantsevS. D.kovantsev.s.d@gmail.comБольшаковС. А.BolshakovS. A.bolshakoff123@yandex.ruГБУЗ “Городская клиническая больница имени С.П. Боткина” Департамента здравоохранения города Москвы; ФГБОУ ДПО “Российская медицинская академия непрерывного профессионального образования” Министерства здравоохранения Российской ФедерацииРоссияS.P. Botkin City Clinical Hospital Department of Health of the City of Moscow; FGBOU DPO Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian FederationRussian FederationГБУЗ “Городская клиническая больница имени С.П. Боткина” Департамента здравоохранения города Москвы; ФГБОУ ДПО “Российская медицинская академия непрерывного профессионального образования” Министерства здравоохранения Российской Федерации; ФПДО ФГБУ ФГОУ «Московский государственный медико-стоматологический университет им. А.И. Евдокимова»РоссияS.P. Botkin City Clinical Hospital Department of Health of the City of Moscow; FGBOU DPO Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation; A. I. Evdokimov Moscow State University of Medicine and DentistryRussian FederationГБУЗ “Городская клиническая больница имени С.П. Боткина” Департамента здравоохранения города МосквыРоссияS.P. Botkin City Clinical Hospital Department of Health of the City of MoscowRussian Federation202321062024252222231Copyright © Шабунин А.В., Шутов Е.В., Долидзе Д.Д., Захарова Е.В., Слепухова Д.В., Кованцев С.Д., Большаков С.А., 20242024Шабунин А.В., Шутов Е.В., Долидзе Д.Д., Захарова Е.В., Слепухова Д.В., Кованцев С.Д., Большаков С.А.Shabunin A.V., Shutov E.V., Dolidze D.D., Zakharova E.V., Slepukhova D.V., Covantsev S.D., Bolshakov S.A.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/110

В представленном обзоре литературы освещены современные представления о патогенезе и актуальные вопросы медикаментозного лечения вторичного гиперпаратиреоза у больных с хронической болезнью почек. Факторами развития и прогрессирования вторичного гиперпаратиреоза считают наличие гипокальциемии, гиперфосфатемии и низкий уровень кальцитриола. На первых этапах лечения вторичного гиперпаратиреоза используется консервативный подход, который направлен на коррекцию каждого из этих факторов. В обзоре обобщен опыт использования фосфат-связывающих препаратов, витамина Д и его аналогов и кальцимиметиков у данной категории больных. Рассмотрены механизмы действия этих препаратов и представлены схемы лечения для достижения удовлетворительного контроля минерально-костного обмена и снижения рисков развития и прогрессирования тяжелого гиперпаратиреоза.

This review summarizes the current understanding of pathogenesis and the most important issues of pharmacological therapy of secondary hyperparathyroidism in patients with chronic kidney disease. Key factors of secondary hyperparathyroidism progression include hypocalcemia, hyperphosphatemia, and low levels of calcitriol. The first line treatment of secondary hyperparathyroidism is the use of a conservative approach, aimed at the correction of each of these factors. The review summarizes the experience of phosphate binders, vitamin D analogs, and calcimimetics usage in this category of patients. The mechanisms of action of these drugs are discussed, as well as treatment regimens aimed at achieving satisfactory control of mineral and bone metabolism and the risk of progression of severe hyperparathyroidism reduction.

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