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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 pub-id-type="doi">10.28996/2618-9801-2024-4-487-497</article-id><article-id custom-type="elpub" pub-id-type="custom">nid-742</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>НАБЛЮДЕНИЯ ИЗ ПРАКТИКИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CASE REPORTS</subject></subj-group></article-categories><title-group><article-title>Спонтанный тромбоз брюшной аорты – редкая причина острого повреждения почек у новорожденного</article-title><trans-title-group xml:lang="en"><trans-title>Spontaneous abdominal aortic thrombosis, a rare cause of acute kidney injury in a newborn</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7175-5633</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абасеева</surname><given-names>Т. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Abaseeva</surname><given-names>T. Y.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Абасеева Татьяна Юрьевна – канд. мед. наук, доцент кафедры педиатрии;</p><p>Врач-нефролог Центра гравитационной хирургии крови и гемодиализа;</p><p>Врач-нефролог Центра неонатальной нефрологии и диализа</p><p>127006, Москва, ул. Долгоруковская, д. 4;</p><p>123317, Москва, Шмитовский проезд, д. 29;</p><p>107014, Москва, ул. Рубцовско-Дворцовая, д. 1/3</p></bio><bio xml:lang="en"><p>4, Dolgorukovskaya str., Moscow, 127006;</p><p>29, Shmitovsky dr., Moscow, 123317;</p><p>3/1, Rubtsovsko-Dvortsovaya str., Moscow, 107014</p></bio><email xlink:type="simple">tatyanaab@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9952-3159</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макулова</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Makulova</surname><given-names>A. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Макулова Анастасия Ивановна – канд. мед. наук, руководитель Центра неонатальной нефрологии и диализа;</p><p>доцент кафедры педиатрии им. академика М.Я. Студеникина;</p><p>врач анестезиолог-реаниматолог Центра гравитационной хирургии крови и гемодиализа</p><p>117997, Москва, ул. Островитянова, д. 1;</p><p>123317, Москва, Шмитовский проезд, д. 29;</p><p>107014, Москва, ул. Рубцовско-Дворцовая, д. 1/3</p></bio><bio xml:lang="en"><p>1, Ostrovityanova str., Moscow, 117997;</p><p>29, Shmitovsky dr., Moscow, 123317;</p><p>3/1, Rubtsovsko-Dvortsovaya str., Moscow, 107014</p></bio><email xlink:type="simple">makulova@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7305-9036</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Саркисян</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Sarkisyan</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Саркисян Егине Альбертовна – канд. мед. наук, доцент кафедры госпитальной педиатрии им. В.А. Таболина;</p><p>Врач-неонатолог</p><p>117997, Москва, ул. Островитянова, д. 1;</p><p>123317, Москва, Шмитовский проезд, д. 29</p></bio><bio xml:lang="en"><p>1, Ostrovityanova str., Moscow, 117997;</p><p>29, Shmitovsky dr., Moscow, 123317</p></bio><email xlink:type="simple">heghinesarg@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6435-7437</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абретенёва</surname><given-names>Д. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Abreteneva</surname><given-names>D. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Абретенёва Диана Дмитриевна – клинический ординатор кафедры госпитальной педиатрии им. академика В.А. Таболина педиатрического факультета</p><p>117997, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>1, Ostrovityanova str., Moscow, 117997</p></bio><email xlink:type="simple">diana.abreteneva@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3091-6170</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Журавлева</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhuravleva</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Журавлева Ирина Витальевна – клинический ординатор кафедры госпитальной педиатрии им. академика В.А. Таболина педиатрического факультета</p><p>117997, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>1, Ostrovityanova str., Moscow, 117997</p></bio><email xlink:type="simple">ira.sindyankina@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0419-5410</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Холоднова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kholodnova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Холоднова Наталья Витальевна – врач-неонатолог, врач-педиатр инфекционного отделения №8 (для новорожденных)</p><p>123317, Москва, Шмитовский проезд, д. 29</p></bio><bio xml:lang="en"><p>29, Shmitovsky dr., Moscow, 123317</p></bio><email xlink:type="simple">kholodnova.natalia@gmail.com</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макарова</surname><given-names>Л. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Makarova</surname><given-names>L. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Макарова Людмила Михайловна – заведующая инфекционным отделением №8 (для новорожденных)</p><p>123317, Москва, Шмитовский проезд, д. 29</p></bio><bio xml:lang="en"><p>29, Shmitovsky dr., Moscow, 123317</p></bio><email xlink:type="simple">makarova.inf8@yandex.ru</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шабельникова</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Shabelnikova</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шабельникова Екатерина Игоревна – канд. мед. наук, ассистент кафедры госпитальной педиатрии им. академика В.А. Таболина</p><p>117997, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>1, Ostrovityanova str., Moscow, 117997</p></bio><email xlink:type="simple">eishabelnikova@rambler.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9567-6761</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шумилов</surname><given-names>П. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Shumilov</surname><given-names>P. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шумилов Петр Валентинович – доктор мед. наук, заведующий кафедрой госпитальной педиатрии им. академика В.А. Таболина педиатрического факультета</p><p>117997, Москва, ул. Островитянова, д. 1</p></bio><bio xml:lang="en"><p>1, Ostrovityanova str., Moscow, 117997</p></bio><email xlink:type="simple">peter_shumilov@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Российский университет медицины» Министерства здравоохранения Российской Федерации;&#13;
ГБУЗ "Детская городская клиническая больница №9 им. Г.Н. Сперанского Департамента здравоохранения города Москвы";&#13;
ГБУЗ "Детская городская клиническая больница святого Владимира Департамента здравоохранения города Москвы"</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian University of medicine, Ministry of Health of the Russian Federation;&#13;
G.N. Speransky Children’s City Clinical Hospital No.9;&#13;
Children’s State Hospital of St. Vladimir, Moscow Healthcare Department</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГАОУ ВО "Российский национальный исследовательский медицинский университет имени Н.И. Пирогова" Министерства здравоохранения Российской Федерации;&#13;
ГБУЗ "Детская городская клиническая больница №9 им. Г.Н. Сперанского Департамента здравоохранения города Москвы";&#13;
ГБУЗ "Детская городская клиническая больница святого Владимира Департамента здравоохранения города Москвы"</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation;&#13;
G.N. Speransky Children’s City Clinical Hospital No.9;&#13;
Children’s State Hospital of St. Vladimir, Moscow Healthcare Department</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГАОУ ВО "Российский национальный исследовательский медицинский университет имени Н.И. Пирогова" Министерства здравоохранения Российской Федерации;&#13;
ГБУЗ "Детская городская клиническая больница №9 им. Г.Н. Сперанского Департамента здравоохранения города Москвы"</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation;&#13;
G.N. Speransky Children’s City Clinical Hospital No.9</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ФГАОУ ВО "Российский национальный исследовательский медицинский университет имени Н.И. Пирогова" Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ГБУЗ "Детская городская клиническая больница №9 им. Г.Н. Сперанского Департамента здравоохранения города Москвы"</institution><country>Россия</country></aff><aff xml:lang="en"><institution>G.N. Speransky Children’s City Clinical Hospital No.9</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>29</day><month>12</month><year>2024</year></pub-date><volume>26</volume><issue>4</issue><fpage>487</fpage><lpage>497</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Абасеева Т.Ю., Макулова А.И., Саркисян Е.А., Абретенёва Д.Д., Журавлева И.В., Холоднова Н.В., Макарова Л.М., Шабельникова Е.И., Шумилов П.В., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Абасеева Т.Ю., Макулова А.И., Саркисян Е.А., Абретенёва Д.Д., Журавлева И.В., Холоднова Н.В., Макарова Л.М., Шабельникова Е.И., Шумилов П.В.</copyright-holder><copyright-holder xml:lang="en">Abaseeva T.Y., Makulova A.I., Sarkisyan E.A., Abreteneva D.D., Zhuravleva I.V., Kholodnova N.V., Makarova L.M., Shabelnikova E.I., Shumilov P.V.</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/742">https://journal.nephro.ru/jour/article/view/742</self-uri><abstract><p>Вступление. Тромбоз аорты – редкое состояние у новорожденных, ассоциированное с неблагоприятными исходами. Около 80% всех случаев неонатального тромбоза аорты связаны с катетеризацией пупочной артерии. Спонтанным считается тромбоз, не ассоциированный с катетеризацией. Клиническая картина зависит от локализации и степени тромбоза аорты. Неонатальный тромбоз аорты может протекать бессимптомно, приводить к органной дисфункции или представлять собой чрезвычайную ситуацию, угрожающую жизни. Заболевание может манифестировать как сердечная или дыхательная недостаточность, некротизирующий энтероколит вследствие ишемии кишечника, гангрена конечностей или с появлением макрогематурии/анурии в случае тромбоза на уровне почечных артерий, приводя к развитию острого повреждения почек.Материалы и методы: в статье представлено описание клинического случая спонтанного тромбоза брюшного отдела аорты у новорожденной девочки, приведшего к развитию острого повреждения почек с потребностью в заместительной почечной терапии.Результаты: у доношенной новорожденной девочки на грудном вскармливании на 11-е сутки жизни отмечалось ухудшение состояния, стала вялой, отказалась от еды, отмечалось появление макрогематурии, а на 12-е сутки развилась анурия. При госпитализации ультразвуковое допплеровское исследование выявило двусторонний тромбоз почечных артерий, по лабораторным данным выявлена гиперазотемия, гипернатриемия, гемоконцентрация, клинически отмечалась потеря в массе тела 18%. После восстановления волемического статуса и коррекции уровня электролитов, сохранялась анурия, что потребовало старта заместительной почечной терапии (перитонеальный диализ). Для уточнения диагноза выполнена КТ-ангиография аорты, где выявлен тромбоз аорты от уровня дистальнее отхождения верхней брыжеечной артерии до общих бедренных артерий. Тактика лечения тромбоза включала антикоагулятную (нефракционированный гепарин) и тромболитическую терапию (тканевой активатор плазминогена Алтеплаза), однако функция почек не восстановилась, и ребенок остался диализ-зависимым.Выводы: представленный клинический случай демонстрирует редкое состояние в неонатальном периоде – тромбоз брюшной аорты, осложнившийся острым повреждением почек, с последующим формированием хронической болезни почек 5Д в результате перенесенного кортикального некроза почек. Неонатальный период является наиболее опасным в плане развития тромботических осложнений, учитывая наличие ряда факторов риска (дегидратация, гипернатриемия, полицитемия).</p></abstract><trans-abstract xml:lang="en"><p>Introduction: Neonatal aortic thrombosis is a rare but serious condition with potentially severe outcomes. Approximately 80% of cases are linked to umbilical catheterization, while not non-catheter-related cases are classified as spontaneous. Clinical presentation varies with the location and severity of thrombosis, ranging from asymptomatic cases to life-threatening emergency such as cardiac or respiratory failure, necrotizing enterocolitis, limb gangrene, or acute kidney injury (AKI) renal artery involvement.Materials and methods: This report describes a case of spontaneous abdominal aortic thrombosis in a newborn girl, resulting in AKI necessitating renal replacement therapy.Results: A full-term newborn breastfed girl experiences clinical deterioration on day 11, presenting with lethargy, feeding refusal, macrohematuria, anuria on day 12. Ultrasound Doppler revealed bilateral renal artery thrombosis, with laboratory findings of hyperazotemia, hypernatremia, hemoconcentration, and 18% weight loss. Despite fluid replacement, electrolyte correction, anuria persisted, requiring peritoneal dialysis. CT angiography confirmed abdominal aortic thrombosis extending from the superior mesenteric artery to the common femoral arteries. Treatment included unfractionated heparin and tissue plasminogen activator (Alteplase), but kidney function did not recover, leaving the child dialysis-dependent.Conclusions: This case highlights the rare occurrence of abdominal aortic thrombosis in the neonatal period, leading to AKI and chronic kidney disease (CKD) 5D due to cortical necrosis. Neonates are particularly vulnerable to thrombotic complications due to factors such a dehydration, hypernatremia, and polycythemia.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>новорожденный</kwd><kwd>тромбоз аорты</kwd><kwd>гипернатриемическая дегидратация</kwd><kwd>острое повреждение почек</kwd><kwd>перитонеальный диализ</kwd></kwd-group><kwd-group xml:lang="en"><kwd>newborn</kwd><kwd>aortic thrombosis</kwd><kwd>hypernatremic dehydration</kwd><kwd>acute kidney injury</kwd><kwd>peritoneal dialysis</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">Monagle P, Chan AKC, Goldenberg NA et al. American College of Chest Physicians. Antithrombotic Therapy in Neonates and Children: Antithrombotic Therapy and Prevention of Thrombosis. 9th ed: American College of Chest Physician Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2Suppl):e737S–e801S. 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