Клинические практические рекомендации KDIGO 2026 по лечению анемии при хронической болезни почек (ХБП). Перевод на русский язык К.А. Вишневского, В.Ю. Ряснянского и А.Ю. Земченкова под общей редакцией К.А. Вишневского

Клинические практические рекомендации Kidney Disease: Improving Global Outcomes (KDIGO) 2026 по лечению анемии при хронической болезни почек (ХБП) представляют собой обновление рекомендаций KDIGO 2012 года по данной теме. Рекомендации определяют помощь взрослым и детям с анемией и ХБП, получающим и не получающим заместительную почечную терапию. Рекомендации содержат главы, посвящённые диагностике и оценке анемии при ХБП, применению железа для лечения дефицита железа и анемии у пациентов с ХБП, применению эритропоэз-стимулирующих препаратов, ингибиторов пролилгидроксилазы гипоксией индуцируемого фактора и других препаратов для лечения анемии у пациентов с ХБП, а также использование гемотрансфузий для лечения анемии у пациентов с ХБП. Предложена новая номенклатура для обозначения различных состояний дефицита железа: термин «абсолютный дефицит железа» заменён на «системный дефицит железа», а «функциональный дефицит железа» – на «железо-ограниченный эритропоэз», чтобы точнее отразить патофизиологическое состояние. Обновление учитывает доказательства из рандомизированных контролируемых исследований, опубликованных по октябрь 2024 года включительно. Рекомендации содержат практически применимые положения, основанные на строгом формальном обзоре доказательств, с практическими советами и вспомогательной инфографикой для содействия применению рекомендаций. Целевая аудитория рекомендаций включает медицинских работников, участвующих в оказании помощи пациентам с анемией и ХБП, а также самих пациентов с анемией и ХБП. Разработка настоящих рекомендаций осуществлялась в рамках чётко определённого процесса обзора и оценки доказательств. Рекомендации основаны на систематических обзорах соответствующих исследований и оценке достоверности доказательств и силы рекомендаций в соответствии с подходом GRADE («Оценка, разработка и экспертиза рекомендаций»). Обсуждаются ограничения доказательной базы, а также представлены предлагаемые направления будущих исследований.

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