Современные взгляды на назначение витаминов пациентам, получающим лечение программным гемодиализом (Обзор литературы)

Глубокое нарушение функций почек, неадекватное питание и/или нарушение всасывания в желудочно-кишечном тракте, потери во время процедуры гемодиализа, особенно при использовании высокопоточных высокоэффективных диализных мембран определяют необходимость назначения водорастворимых витаминов пациентам, получающим программный гемодиализ (ПГД) для предотвращения развития гиповитаминозов. Другим направлением витаминотерапии у пациентов, получающих ПГД, является использование физиологических эффектов определенных витаминов в коррекции некоторых патологических состояний, характерных для данной категории пациентов. В данном обзоре рассмотрены физиологические эффекты витаминов, причины их возможной недостаточности у диализных пациентов, объем потерь в ходе процедуры гемодиализа, существующие на сегодняшний день рекомендации по приему каждого конкретного витамина для пациентов, получающих ПГД. В обзоре рассмотрены следующие витамины: тиамин, рибофлавин, никотинамид, пантотеновая кислота, пиридоксин, биотин, фолиевая кислота, цианокобаламин, аскорбиновая кислота, ретинол, токоферол и витамин К. Хотя в настоящее время крупные рандомизированные контролируемые исследования по вопросам назначения витаминов пациентам, получающим ПГД, немногочисленны, представленные в данном обзоре результаты рандомизированных контролируемых исследований по коррекции витаминами гипергомоцистеинемии, оксидативного стресса, повреждения клеточного генома, мышечных судорог, функционального дефицита железа, полинейропатии, гиперфосфатемии, дислипидемии и Европейские практические рекомендации по назначению витаминов диализным пациентам могут быть интересны и полезны нефрологам.

витамины, гемодиализ, никотинамид, пиридоксин, фолиевая кислота, цианкобаламин, аскорбиновая кислота, токоферол, vitamins, haemodialysis, nicotinamid, pyridoxine, folic acid, cobalamin, ascorbic acid, tocopherol

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