References

nid

Нефрология и диализ

Nephrology and Dialysis

1680-44222618-9801

Российское диализное общество

nid-3763

Research Article

ОБЗОРЫ И ЛЕКЦИИ

REVIEWS AND LECTURES

Ремоделирование артерий и артериальное давление у больных с уремией (Лекция)

Arterial remodeling and blood pressure in uremic patients

Жерар

Лондон

Gerard

M. London

noemail@neicon.ru

Госпиталь Манс, Флери-Мерожи, ФранцияRussian Federation

2000

28062025

23124130

2025

Жерар Л.

Gerard M.L.

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/3763

Артериальная гипертензия (АГ), как следует из проспективных исследований, выполненных в общей популяции, является главным фактором риска ишемической болезни сердца (ИБС), застойной сердечной недостаточности и инсульта. Кроме того, она также повышает вероятность формирования гипертрофии левого желудочка (ЛЖ), которая сама по себе является независимым кардиоваскулярным фактором риска. Наконец, АГ представляет собой фактор риска развития почечной недостаточности. У гемодиализных больных влияние артериального давления (АД) на исход заболевания менее ясно. Результаты проспективных исследований по этому поводу противоречивы. В частности, было показано, что повышение смертности диализных больных ассоциируется с низким АД [1-3]. Одним из объяснений такого противоречия может быть упрощенный подход к пониманию патогенеза различных форм АГ. Роль АД состоит в поддержании адекватного тканевого перфузионного давления, так называемого среднего АД (СрАД). Последнее является производной сердечного выброса (СВ) и общего периферического сопротивления (ОПС) и считается постоянным в течение сердечного цикла. Поэтому в артериях, в которых измеряется АД, СрАД является «виртуальным». Реально оно существует только в прекапиллярных артериолах, где колебания давления в значительной степени сглаживаются [4]. На этом уровне СрАД - это давление, ответственное за стабильное распределение кровотока по тканям и органам. Для данного СВ оно определяется площадью поперечного сечения и числом артериол и мелких артерий, от общего поперечного сечения которых зависит ОПС. ** Редколлегия журнала благодарит автора за предоставленные материалы лекции. ** Перевод Е.В. Захаровой

артериальная гипертонияремоделирование артерийдемпфирующая и проводящая функцииподатливостьатеросклерозартериосклерозуремия

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