nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-464Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESЛекарственное острое повреждение почек у больных хронической болезнью почекDrug-induced acute kidney injury in patients with chronic kidney diseaseНиколаевА. Ю.NikolaevA. Yu.nephrology@mail.ruЕрмоленкоВ. М.ErmolenkoV. M.noemail@neicon.ruГБОУ ДПО РМАПО Минздрава РФРоссияRussian Medical Academy of postgraduate education, Russiаn Ministry of healthRussian Federation2015190820241712933Copyright © Николаев А.Ю., Ермоленко В.М., 20242024Николаев А.Ю., Ермоленко В.М.Nikolaev A.Y., Ermolenko V.M.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/464

В обзоре литературы приведены последние эпидемиологические и клинические данные о взаимосвязи между острым повреждением почек (ОПП) и хронической болезнью почек (ХБП). Наряду с многочисленными факторами риска ОПП (преренальной, постренальной, ренальной), включающей старческий возраст, сахарный диабет, гипертензию, афро-американскую расу, наличие предшествующей ХБП рассматривается как ведущий фактор риска лекарственного ОПП, увеличивающий риск развития ОПП в 10 раз по сравнению с лицами без ХБП. ОПП увеличивает риск прогрессирования ХБП в её терминальную стадию и приводит к ХБП независимо от причины ОПП. Установлено прогностическое значение преходящего острого снижения функции почек. Обсуждается связь между острым канальцевым некрозом и отдаленными почечными и сердечно-сосудистыми осложнениями. Увеличение отдалённой сердечно-сосудистой заболеваемости наблюдается как при ХБП, так после перенесённого ОПП.

Recent epidemiological and clinical studies suggest that drug-induced acute and chronic kidney diseases are closely connected. Multiple risk factors for acute kidney injury are AKI (prerenal kidney injury, postrenal urinary tract obstruction, and intrinsic renal diseases) including advanced age, diabetes mellitus, hypertension and afro-american race. However, the most important risk factor for acute kidney injury is preexisting chronic kidney disease, which increases the risk of AKI in 10 folds compared to case of the absence of chronic kidney disease. AKI increases the risk of progression CKD to terminal uremia аnd may lead to chronic kidney disease regardless the cause of the acute injury. The prognostic importance of a small acute decrement in kidney function is discovered. Association between the acute tubular necrosis and long-term renal and cardiovascular outcomes is discussed. Both AKI and CKD are the risk factors for cardiovascular disease.

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