nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-552Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESСклеростин в контексте хронической болезни почек (Обзор литературы)Sclerostin in a context of chronic kidney disease (Review)ГуревичЕ. А.GurevichE. A.ekaterina.a.gurevich@gmail.comУниверситетская клиника, г. Цюрих, ШвейцарияРоссияUniversity Hospital, Zurich, SwitzerlandRussian Federation201413092024163339349Copyright © Гуревич Е.А., 20242024Гуревич Е.А.Gurevich E.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/552

Расстройство костного метаболизма и сосудистая кальцификация в значительной степени способствуют развитию сердечно-сосудистых осложнений у пациентов со сниженной функцией почек и являются предикторами худшей выживаемости этой группы больных. В последнее время все больше внимания уделяется поиску и исследованию маркеров костного повреждения, которые ассоциируются с развитием ряда системных осложнений у больных с хронической болезнью почек (ХБП), включая пациентов, находящихся на заместительной почечной терапии. Wnt-сигнальный путь состоит из ряда сложных белков, постоянно взаимодействующих между собой и определяющих не только нормальный эмбриогенез, но и метаболизм костной ткани. Склеростин, ингибируя Wnt-сигнальный путь, нарушает образование костной ткани путем подавления пролиферации и дифференциации остеобластов. У пациентов с нарушением функции почек уровень склеростина в крови повышен за счет усиленного образования. Однако до сих пор неизвестно, является ли склеростин предиктором неблагоприятного прогноза у больных с ХБП, либо он выступает в роли своеобразного защитника сосудистой стенки от кальцификации, тем самым обеспечивая лучшую выживаемость как сосудистого доступа, так и пациентов в целом. В обзоре представлены современные данные о роли склеростина в метаболизме костной ткани, его участии в процессах ремоделирования кости у больных с почечной недостаточностью, а также о потенциальных терапевтических стратегиях, направленных на изменение концентрации этого белка.

Disarrangement of bone metabolism and vascular calcification significantly contribute to the development of cardiovascular complications in patients with reduced kidney function, thereby determining the worst survival in this group of patients. In recent years, more attention has been paid to search and research of markers of bone damage that are associated with the development of a number of systemic complications in patients with chronic kidney disease, including patients on renal replacement therapy. Wnt-signaling pathway consists of a number of complex proteins, constantly interacting with each other and determining not only normal embryogenesis, but also bone metabolism. Sclerostin by inhibiting Wnt-signaling pathway alters bone formation by suppressing the proliferation and differentiation of osteoblasts. Patients with impaired renal function have elevated serum levels of sclerostin due to its enhanced synthesis. However, until now it is not known whether sclerostin is a predictor of poor prognosis in patients with CKD, or it acts as a kind of protector of vascular wall from calcification, thus ensuring a better survival of both vascular access and patients in general. The review presents recent data on a role of sclerostin in bone metabolism, its participation in the processes of bone remodeling in patients with renal insufficiency, as well as potential therapeutic strategies aimed at changing the concentration of the protein.

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