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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nid</journal-id><journal-title-group><journal-title xml:lang="ru">Нефрология и диализ</journal-title><trans-title-group xml:lang="en"><trans-title>Nephrology and Dialysis</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1680-4422</issn><issn pub-type="epub">2618-9801</issn><publisher><publisher-name>Российское диализное общество</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">nid-1541</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>Распространенность вторичного гиперпаратиреоза (ВГПТ) до и на фоне лечения активными метаболитами витамина Д3 в популяции больных амбулаторного диализного центра</article-title><trans-title-group xml:lang="en"><trans-title>Prevalence of secondary hyperparathyroidism (SHPT) before and under treatment with 1 alpha-hydroxylated derivatives of vitamin D3 in hemodialysis patients of ambulatory hemodialysis centre</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Борисов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Borisov</surname><given-names>A. V.</given-names></name></name-alternatives><email xlink:type="simple">avborisov@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мордик</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Mordik</surname><given-names>A. I.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Борисова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Borisova</surname><given-names>E. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ермакова</surname><given-names>И. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Ermakova</surname><given-names>I. P.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff xml:lang="ru" id="aff-1"><institution>Центр экстракорпоральной терапии «Фесфарм»</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-2"><institution>НИИТиИО МЗ РФ; г. Москва</institution><country>Russian Federation</country></aff><pub-date pub-type="collection"><year>2006</year></pub-date><pub-date pub-type="epub"><day>23</day><month>06</month><year>2025</year></pub-date><volume>8</volume><issue>2</issue><fpage>147</fpage><lpage>151</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Борисов А.В., Мордик А.И., Борисова Е.В., Ермакова И.П., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Борисов А.В., Мордик А.И., Борисова Е.В., Ермакова И.П.</copyright-holder><copyright-holder xml:lang="en">Borisov A.V., Mordik A.I., Borisova E.V., Ermakova I.P.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.nephro.ru/jour/article/view/1541">https://journal.nephro.ru/jour/article/view/1541</self-uri><abstract><p>Исследованы распространенность ВГПТ и нарушения фосфорно-кальциевого обмена у 450 пациентов находящихся на лечении программным ГД в Центре экстракорпоральной терапии «Фесфарм». ВГПТ диагностировали согласно рекомендациям K/DOQI Clinical Practice Guidelines при уровне иПТГ более 300 пг/мл. При поступлении в центр ВГПТ различной степени выраженности обнаружен у 180 пациентов (40%). Легкий (иПТГ от 300 до 450 пг/мл) у 13%. Средней степени (иПТГ от 450 до 800 пг/мл) - 16%. Тяжелый (иПТГ&gt;800 пг/мл) у 11%. Приблизительно у трети больных (131 чел.) уровень иПТГ находился в оптимальном диапазоне (150-300 пг/мл). У 144 больных уровень иПТГ был ниже 150 пг/мл и у них имелись признаки адинамического поражения кости. У пациентов диабетической нефропатией, частота ВГПТ была достоверно ниже, а степень выраженности гиперпаратиреоза была меньше по сравнению с другими нозологиями. Выявлена обратная корреляционная зависимость между уровнем иПТГ и возрастом (кроме пациентов сахарным диабетом). Частота гиперкальциемии составляла около 15% и была меньше чем в аналогичных исследованиях, а уровень фосфора и частота гиперфосфатемии (около 50%) существенно не отличались. В группе пациентов с четырехлетним периодом наблюдения (n-152) частота ВГПТ уменьшалась на фоне лечения с 46% до 27%. Среди 70 пациентов с ВГПТ, на фоне проводимого лечения активными метаболитами витамина Д3 компенсация достигнута в 60% случаев. У 82 пациентов с нормальным уровнем иПТГ, развитие ВГПТ составило около 10% в год, а частота развития ВГПТ нарастала с увеличением срока диализного лечения.</p></abstract><trans-abstract xml:lang="en"><p>The prevalence of SHPT and disorders of calcium-phosphorus metabolism were studied in 450 hemodialysis patients of Hemodialysis Centre “FESPHARM” (Moscow). SHPT were diagnosed in accordance with K/DOQI Clinical Practice Guidelines in patients with iPTH levels &gt;300 pg/ml. On admission to the Centre, SHPT was found in 180 patients (40%): mild SHPT (iPTH 300-450 pg/ml) in 13% cases, moderate (iPTH 450-800 pg/ml) SHPT in 16% cases, a severe one (iPTH&gt;800 pg/ml) in 11% of the patients. About one third (131) of centre patients had optimal iPTH levels of 150-300 pg/ml; 144 patients had iPTH levels of less than 150 pg/ml and had signs of adynamic bone disease. The prevalence of SHPT and severity of hyperparathyroidism were significantly lower in patients with diabetic nephropathy in comparison with other diseases. A reciprocal correlation was found between the iPTH level and age of (except diabetic patients). The prevalence of hypercalcemia was about 15% lower than in similar studies described in literature, whereas phosphorus level and prevalence of hyperphosphatemia (about 50%) did not differ significantly from data of other studies. In 152 patients treated the fraction of patients with SHPT was found to decrease from 46% to 27% over 4 years of treatment. Among 70 patients with SHPT treated with 1 alpha-hydroxylated derivatives of vitamin D3 a remission was achieved in 60% cases. In 82 patients with normal iPTH levels the SHPT incidence rate was 10% per year. It increased with duration dialysis treatment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>вторичный гиперпаратиреоз</kwd><kwd>гемодиализ</kwd><kwd>витамин Д3.</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Волгина Г.В., Перепеченых Ю.В. Паратиреоидный гормон - универсальный уремический токсин. Нефрология и диализ 2000; 2: 1-2.</mixed-citation><mixed-citation xml:lang="en">Волгина Г.В., Перепеченых Ю.В. Паратиреоидный гормон - универсальный уремический токсин. Нефрология и диализ 2000; 2: 1-2.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Ермоленко В.М. Фосфорно-кальциевый обмен и почки. Руководство для врачей. Под ред. И.Е. Тареевой, 2-е изд., перераб. и доп. М.: Медицина 2000: 62-75.</mixed-citation><mixed-citation xml:lang="en">Ермоленко В.М. Фосфорно-кальциевый обмен и почки. Руководство для врачей. Под ред. И.Е. Тареевой, 2-е изд., перераб. и доп. М.: Медицина 2000: 62-75.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Aterini S., Salvadori M., Ippolito E. et al. The role of vitamin D receptor alleles in the secondary hyperparathyroidism of hemodialysis patients. J Nephrol 1996; 9: 201-206.</mixed-citation><mixed-citation xml:lang="en">Aterini S., Salvadori M., Ippolito E. et al. The role of vitamin D receptor alleles in the secondary hyperparathyroidism of hemodialysis patients. J Nephrol 1996; 9: 201-206.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Dusso A.S., Pavlopoulos T., Naumovich L. et al. P21(WAF1) and transforming growth factor-alpha mediate dietary phosphate regulation of parathyroid cell growth. Kidney Int 2001; 59: 855-865.</mixed-citation><mixed-citation xml:lang="en">Dusso A.S., Pavlopoulos T., Naumovich L. et al. P21(WAF1) and transforming growth factor-alpha mediate dietary phosphate regulation of parathyroid cell growth. Kidney Int 2001; 59: 855-865.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Falchetti A., Bale A.E., Amorosi A. et al. Progression of uremic hyperparathyroidism involves allelic loss on chromosome 11 J Clin Endocrinol Metab 1993; 76: 139-144.</mixed-citation><mixed-citation xml:lang="en">Falchetti A., Bale A.E., Amorosi A. et al. Progression of uremic hyperparathyroidism involves allelic loss on chromosome 11 J Clin Endocrinol Metab 1993; 76: 139-144.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Fernandez A., Fibla J., Betriu A., Piulats J.M., Almirall J., Montoliu J. Association between vitamin D receptor gene polymorphism and relative hypoparathyroidism in patients with chronic renal failure. J Am Soc Nephrol 1997; 8: 1546-1552.</mixed-citation><mixed-citation xml:lang="en">Fernandez A., Fibla J., Betriu A., Piulats J.M., Almirall J., Montoliu J. Association between vitamin D receptor gene polymorphism and relative hypoparathyroidism in patients with chronic renal failure. J Am Soc Nephrol 1997; 8: 1546-1552.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Fukagawa M., Kitaoka M., Yi H., Fukuda N., Matsumoto T., Ogata E. Serial evaluation of parathyroid size by ultrasonography is another useful marker for the long-term prognosis of calcitriol pulse therapy in chronic dialysis patients. Nephron 1994; 68: 221-228.</mixed-citation><mixed-citation xml:lang="en">Fukagawa M., Kitaoka M., Yi H., Fukuda N., Matsumoto T., Ogata E. Serial evaluation of parathyroid size by ultrasonography is another useful marker for the long-term prognosis of calcitriol pulse therapy in chronic dialysis patients. Nephron 1994; 68: 221-228.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Fukuda N., Tanaka H., Tominaga Y., Fukagawa M., Kurokawa K., Seino Y. Decreased 1,25-dihydroxyvitamin D3 receptor density is associated with a more severe form of parathyroid hyperplasia in chronic uremic patients. J Clin Invest 1993; 92: 1436-1442.</mixed-citation><mixed-citation xml:lang="en">Fukuda N., Tanaka H., Tominaga Y., Fukagawa M., Kurokawa K., Seino Y. Decreased 1,25-dihydroxyvitamin D3 receptor density is associated with a more severe form of parathyroid hyperplasia in chronic uremic patients. J Clin Invest 1993; 92: 1436-1442.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Gogusev J., Duchambon P., Hory B., Giovannini M., Sarfati E., Druke T.B. Depressed expression of calcium receptor in parathyroid gland tissue of patients with primary or secondary uremic hyperparathyroidism. Kidney Int 1997; 51: 328-336.</mixed-citation><mixed-citation xml:lang="en">Gogusev J., Duchambon P., Hory B., Giovannini M., Sarfati E., Druke T.B. Depressed expression of calcium receptor in parathyroid gland tissue of patients with primary or secondary uremic hyperparathyroidism. Kidney Int 1997; 51: 328-336.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Gogusev J., Duchambon P., Stoermann-Chopard C., Giovannini M., Sarfati E. in parathyroidaDrьeke TB. De novo expression of transforming growth factor- gland tissue of patients with primary or secondary uraemic hyperparathyroidism. Nephrol Dial Transplant 1996; 11: 2155-2162.</mixed-citation><mixed-citation xml:lang="en">Gogusev J., Duchambon P., Stoermann-Chopard C., Giovannini M., Sarfati E. in parathyroidaDrьeke TB. De novo expression of transforming growth factor- gland tissue of patients with primary or secondary uraemic hyperparathyroidism. Nephrol Dial Transplant 1996; 11: 2155-2162.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Magnitude and impact of abnormal mineral metabolism in hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS) A. J of Kidney Diseases November 2004, Suppl. 44 Number 5.</mixed-citation><mixed-citation xml:lang="en">Magnitude and impact of abnormal mineral metabolism in hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS) A. J of Kidney Diseases November 2004, Suppl. 44 Number 5.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Matsushita H., Hara M., Endo Y. et al. Proliferation of parathyroid cells negatively correlates with expression of parathyroid hormone-related protein in secondary parathyroid hyperplasia. Kidney Int 1999; 55: 130-138.</mixed-citation><mixed-citation xml:lang="en">Matsushita H., Hara M., Endo Y. et al. Proliferation of parathyroid cells negatively correlates with expression of parathyroid hormone-related protein in secondary parathyroid hyperplasia. Kidney Int 1999; 55: 130-138.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Naveh-Many T., Rahamimov R., Livni N., Silver J. Parathyroid cell proliferation in normal and chronic renal failure rats. The effects of calcium, phosphate, and vitamin D. J Clin Invest 1995; 96: 1786-1793.</mixed-citation><mixed-citation xml:lang="en">Naveh-Many T., Rahamimov R., Livni N., Silver J. Parathyroid cell proliferation in normal and chronic renal failure rats. The effects of calcium, phosphate, and vitamin D. J Clin Invest 1995; 96: 1786-1793.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Roussanne M.C., Lieberherr M., Souberbielle J.C., Sarfati E., Drueke T., Bourdeau A. Human parathyroid cell proliferation in response to calcium, NPS R-467, calcitriol and phosphate. Eur J Clin Invest 2001; 31: 610-616.</mixed-citation><mixed-citation xml:lang="en">Roussanne M.C., Lieberherr M., Souberbielle J.C., Sarfati E., Drueke T., Bourdeau A. Human parathyroid cell proliferation in response to calcium, NPS R-467, calcitriol and phosphate. Eur J Clin Invest 2001; 31: 610-616.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Slatopolsky E., Finch J., Denda M. et al. Phosphorus restriction prevents parathyroid gland growth: high phosphorus directly stimulates PTH secretion in vitro. J Clin Invest 1996; 97: 2534-2540.</mixed-citation><mixed-citation xml:lang="en">Slatopolsky E., Finch J., Denda M. et al. Phosphorus restriction prevents parathyroid gland growth: high phosphorus directly stimulates PTH secretion in vitro. J Clin Invest 1996; 97: 2534-2540.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Tahara H., Yasuo Y., Yamada T., Tsujimoto Y. et al. Rare Somatic Inactivation of the Multiple Endocrine Neoplasia Type 1 Gene in Secondary Hyperparathyroidism of Uremia J Clin Endocrinol Metab 2000; 85: 4113-4117.</mixed-citation><mixed-citation xml:lang="en">Tahara H., Yasuo Y., Yamada T., Tsujimoto Y. et al. Rare Somatic Inactivation of the Multiple Endocrine Neoplasia Type 1 Gene in Secondary Hyperparathyroidism of Uremia J Clin Endocrinol Metab 2000; 85: 4113-4117.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Yokoyama K., Shigematsu T., Tsukada T. et al. Apa I polymorphism in the vitamin D receptor gene may affect the parathyroid response in Japanese with end-stage renal disease. Kidney Int 1998; 53: 454-458.</mixed-citation><mixed-citation xml:lang="en">Yokoyama K., Shigematsu T., Tsukada T. et al. Apa I polymorphism in the vitamin D receptor gene may affect the parathyroid response in Japanese with end-stage renal disease. Kidney Int 1998; 53: 454-458.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
