nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1313Research ArticleШКОЛА НЕФРОЛОГАEDUCATIONAL MATERIALSПрименение сандиммуна-неорала в лечении нефротического синдрома при болезни минимальных изменений в сочетании с сахарным диабетом I типа (Обзор литературы и собственное наблюдение)Sandimmun-neoral in treatment of nephrotic syndrome in minimal change disease with type I diabetes mellitus Review and case reportЗахароваЕ. В.ZakharovaE. V.zakharoval@mtu-net.ruИпатьеваЕ. И.IpatjevaE. I.noemail@neicon.ruСтоляревичЕ. С.StoljarevichE. S.noemail@neicon.ruМосковская городская клиническая больница имени С.П. БоткинаRussian FederationКафедра нефрологии ФПДО МГСМУ; г. МоскваRussian Federation2008190620251016266Copyright © Захарова Е.В., Ипатьева Е.И., Столяревич Е.С., 20252025Захарова Е.В., Ипатьева Е.И., Столяревич Е.С.Zakharova E.V., Ipatjeva E.I., Stoljarevich E.S.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/1313

Наличие протеинурии, изолированной или в сочетании с артериальной гипертензией и почечной недостаточностью, у больного с сахарным диабетом (СД) в анамнезе, следует расценивать как проявление диабетической нефропатии, если не доказано обратное [29]. Сочетание протеинурии с диабетической ретинопатией, которая наблюдается более чем у 90% пациентов с поражением почек диабетической природы, делает диагноз еще более вероятным. При отсутствии диабетической ретинопатии и полинейропатии необходимо учитывать возможность иных причин появления протеинурии [2, 29]. Внезапное развитие нефротического синдрома (НС), особенно при небольшой длительности СД, может указывать на наличие первичной гломерулярной патологии, в том числе болезни минимальных изменений (БМИ), фокально-сегментарного гломерулосклероза (ФСГС) или мембранозной нефропатии. В таких случаях для установления диагноза, определения прогноза и тактики лечения показано выполнение биопсии почки [2, 29]. У больных СД описаны случаи развития НС, обусловленного БМИ, с хорошим эффектом от лечения кортикостероидами (КС) [30]. Имеется также описание случая успешного лечения НС сандиммуном-неоралом при гистологически доказанной БМИ у больного СД 2 типа [16].

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