The 53 references with contexts in paper O. KUZMIN V., О. КУЗЬМИН Б. (2011) “МЕХАНИЗМЫ РАЗВИТИЯ И ПРОГРЕССИРОВАНИЯ НЕФРОПАТИИ У БОЛЬНЫХ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ С ХРОНИЧЕСКИМ КАРДИОРЕНАЛЬНЫМ СИНДРОМОМ // MECHANISMS OF NEPHROPATHY DEVELOPMENT AND PROGRESSION IN HEART FAILURE PATIENTS WITH CHRONIC CARDIORENAL SYNDROME” / spz:neicon:nefr:y:2011:i:2:p:20-29

1
Ronco C, McCullough P, Anker SD et al. Cardio-renal syndromes: report from the consensus conference of the Acute Dialysis Quality Initiative. Eur Heart J 2010; 31 (6): 703-711
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    .: (3532) 77-49-66; E-mail: o.kuzmin.orgma@yandex.ru Õðîíè÷åñêàÿ áîëåçíü ïî÷åê (ÕÁÏ), ôîðìèðóþùàÿñÿ ó áîëüøèíñòâà ïàöèåíòîâ ñ õðîíè÷åñêîé ñåðäå÷íîé íåäîñòàòî÷íîñòüþ (ÕÑÍ) III–IV ÔÊ NYHA, ïðåäñòàâëÿåò ñîáîé êëèíè÷åñêîå ïðîÿâëåíèå õðîíè÷åñêîãî êàðäèîðåíàëüíîãî ñèíäðîìà (ÊÐÑ), êîòîðûé ðàçâèâàåòñÿ â îòâåò íà ñíèæåíèå ñîêðàòèòåëüíîé ñïîñîáíîñòè ìèîêàðäà è íàðàñòàþùåå íàðóøåíèå ñèñòåìíîé ãåìîäèíàìèêè
    Exact
    [1]
    Suffix
    . Ðåçóëüòàòû ìíîãî÷èñëåííûõ ïðîñïåêòèâíûõ èññëåäîâàíèé, âûïîëíåííûõ íà áîëüøèõ ãðóïïàõ áîëüíûõ ÕÑÍ II–IV ÔÊ NYHA, ïîêàçûâàþò, ÷òî êëèíè÷åñêè âûðàæåííàÿ äèñôóíêöèÿ ïî÷åê ÿâëÿåòñÿ êðàéíå íåáëàãîïðèÿòíûì ôàêòîðîì ðèñêà, êîòîðûé âåäåò ê áûñòðîìó ïðîãðåññèðîâàíèþ ïîâðåæäåíèÿ ñåðäöà, ñîñóäèñòîé ñèñòåìû è ñóùåñòâåííîìó ðîñòó îáùåé è ñåðäå÷íî-ñîñóäèñòîé ñìåðòíîñòè [2– 4].

2
Smith GL, Lichtman JH, Bracken MG et al. Renal impairment and outcomes in heart failure. Systemic review and meta-analysis. J Am Coll Cardiol 2006; 47 (10): 1987-1996
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    Ðåçóëüòàòû ìíîãî÷èñëåííûõ ïðîñïåêòèâíûõ èññëåäîâàíèé, âûïîëíåííûõ íà áîëüøèõ ãðóïïàõ áîëüíûõ ÕÑÍ II–IV ÔÊ NYHA, ïîêàçûâàþò, ÷òî êëèíè÷åñêè âûðàæåííàÿ äèñôóíêöèÿ ïî÷åê ÿâëÿåòñÿ êðàéíå íåáëàãîïðèÿòíûì ôàêòîðîì ðèñêà, êîòîðûé âåäåò ê áûñòðîìó ïðîãðåññèðîâàíèþ ïîâðåæäåíèÿ ñåðäöà, ñîñóäèñòîé ñèñòåìû è ñóùåñòâåííîìó ðîñòó îáùåé è ñåðäå÷íî-ñîñóäèñòîé ñìåðòíîñòè
    Exact
    [2– 4]
    Suffix
    . Çíà÷èòåëüíûé ðîñò ñìåðòíîñòè òàêèõ ïàöèåíòîâ ïðåäïîëàãàåò ïðîâåäåíèå ó íèõ ñîâìåñòíî ñ êàðäèîïðîòåêòèâíîé àäåêâàòíîé íåôðîïðîòåêòèâíîé òåðàïèè, íàïðàâëåííîé íå òîëüêî íà ñîõðàíåíèå èëè çàìåäëåíèå ïîòåðè ïî÷å÷íîé ôóíêöèè, íî è íà óëó÷øåíèå ïðîãíîçà èõ æèçíè.

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    Âìåñòå ñ òåì, ýôôåêòèâíîñòü êàðäèîïðîòåêòèâíîé òåðàïèè òàêèõ ïàöèåíòîâ ìîæåò áûòü ïîâûøåíà áëàãîäàðÿ îñëàáëåíèþ èëè ïðåäîòâðàùåíèþ ðàçâèòèÿ è ïðîãðåññèðîâàíèÿ íåôðîïàòèè, êîòîðàÿ óñêîðÿåò ïîâðåæäåíèå ñåðäå÷íî-ñîñóäèñòîé ñèñòåìû è óâåëè÷èâàåò ðèñê ïîâòîðíîé ãîñïèòàëèçàöèè, ñåðäå÷íî-ñîñóäèñòûõ è äðóãèõ îñëîæíåíèé
    Exact
    [2–4]
    Suffix
    . Ïðåäîòâðàùåíèå íàðóøåíèé âíóòðèïî÷å÷íîé ãåìîäèíàìèêè. Êàê ïîêàçûâàþò êëèíè÷åñêèå è ýêñïåðèìåíòàëüíûå äàííûå, ãëàâíûì çâåíîì â ôîðìèðîâàíèè «ñåðäå÷íîé» íåôðîïàòèè ÿâëÿåòñÿ ïîÿâëåíèå ñòîéêîé ãëîìåðóëÿðíîé ãèïåðòåíçèè, âûçûâàþùåé ìåõàíè÷åñêîå ïîâðåæäåíèå êëóáî÷êîâ è íàðàñòàþùåå ñíèæåíèå ïîñòãëîìåðóëÿðíîãî êðîâîòîêà, âåäóùåå ê ãèïîêñè÷åñêîìó ïîâðåæäåíèþ ïî÷å÷íîé òêàíè.

3
Masson S, Latini R, Milani V et al. Prevalence and prognostic value of elevated urinary albumin excretion in patients with chronic heart failure: data from GISSI-Heart Failure trial. Circ Heart Fail 2010; 3 (1): 65-72
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    Ðåçóëüòàòû ìíîãî÷èñëåííûõ ïðîñïåêòèâíûõ èññëåäîâàíèé, âûïîëíåííûõ íà áîëüøèõ ãðóïïàõ áîëüíûõ ÕÑÍ II–IV ÔÊ NYHA, ïîêàçûâàþò, ÷òî êëèíè÷åñêè âûðàæåííàÿ äèñôóíêöèÿ ïî÷åê ÿâëÿåòñÿ êðàéíå íåáëàãîïðèÿòíûì ôàêòîðîì ðèñêà, êîòîðûé âåäåò ê áûñòðîìó ïðîãðåññèðîâàíèþ ïîâðåæäåíèÿ ñåðäöà, ñîñóäèñòîé ñèñòåìû è ñóùåñòâåííîìó ðîñòó îáùåé è ñåðäå÷íî-ñîñóäèñòîé ñìåðòíîñòè
    Exact
    [2– 4]
    Suffix
    . Çíà÷èòåëüíûé ðîñò ñìåðòíîñòè òàêèõ ïàöèåíòîâ ïðåäïîëàãàåò ïðîâåäåíèå ó íèõ ñîâìåñòíî ñ êàðäèîïðîòåêòèâíîé àäåêâàòíîé íåôðîïðîòåêòèâíîé òåðàïèè, íàïðàâëåííîé íå òîëüêî íà ñîõðàíåíèå èëè çàìåäëåíèå ïîòåðè ïî÷å÷íîé ôóíêöèè, íî è íà óëó÷øåíèå ïðîãíîçà èõ æèçíè.

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    Âìåñòå ñ òåì, ýôôåêòèâíîñòü êàðäèîïðîòåêòèâíîé òåðàïèè òàêèõ ïàöèåíòîâ ìîæåò áûòü ïîâûøåíà áëàãîäàðÿ îñëàáëåíèþ èëè ïðåäîòâðàùåíèþ ðàçâèòèÿ è ïðîãðåññèðîâàíèÿ íåôðîïàòèè, êîòîðàÿ óñêîðÿåò ïîâðåæäåíèå ñåðäå÷íî-ñîñóäèñòîé ñèñòåìû è óâåëè÷èâàåò ðèñê ïîâòîðíîé ãîñïèòàëèçàöèè, ñåðäå÷íî-ñîñóäèñòûõ è äðóãèõ îñëîæíåíèé
    Exact
    [2–4]
    Suffix
    . Ïðåäîòâðàùåíèå íàðóøåíèé âíóòðèïî÷å÷íîé ãåìîäèíàìèêè. Êàê ïîêàçûâàþò êëèíè÷åñêèå è ýêñïåðèìåíòàëüíûå äàííûå, ãëàâíûì çâåíîì â ôîðìèðîâàíèè «ñåðäå÷íîé» íåôðîïàòèè ÿâëÿåòñÿ ïîÿâëåíèå ñòîéêîé ãëîìåðóëÿðíîé ãèïåðòåíçèè, âûçûâàþùåé ìåõàíè÷åñêîå ïîâðåæäåíèå êëóáî÷êîâ è íàðàñòàþùåå ñíèæåíèå ïîñòãëîìåðóëÿðíîãî êðîâîòîêà, âåäóùåå ê ãèïîêñè÷åñêîìó ïîâðåæäåíèþ ïî÷å÷íîé òêàíè.

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Jackson CE, Solomon SD, Gerstein HC et al. Albuminuria in chronic heart failure: prevalence and prognostic importance. Lancet 2009; 374 (9689): 543-550
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    Ðåçóëüòàòû ìíîãî÷èñëåííûõ ïðîñïåêòèâíûõ èññëåäîâàíèé, âûïîëíåííûõ íà áîëüøèõ ãðóïïàõ áîëüíûõ ÕÑÍ II–IV ÔÊ NYHA, ïîêàçûâàþò, ÷òî êëèíè÷åñêè âûðàæåííàÿ äèñôóíêöèÿ ïî÷åê ÿâëÿåòñÿ êðàéíå íåáëàãîïðèÿòíûì ôàêòîðîì ðèñêà, êîòîðûé âåäåò ê áûñòðîìó ïðîãðåññèðîâàíèþ ïîâðåæäåíèÿ ñåðäöà, ñîñóäèñòîé ñèñòåìû è ñóùåñòâåííîìó ðîñòó îáùåé è ñåðäå÷íî-ñîñóäèñòîé ñìåðòíîñòè
    Exact
    [2– 4]
    Suffix
    . Çíà÷èòåëüíûé ðîñò ñìåðòíîñòè òàêèõ ïàöèåíòîâ ïðåäïîëàãàåò ïðîâåäåíèå ó íèõ ñîâìåñòíî ñ êàðäèîïðîòåêòèâíîé àäåêâàòíîé íåôðîïðîòåêòèâíîé òåðàïèè, íàïðàâëåííîé íå òîëüêî íà ñîõðàíåíèå èëè çàìåäëåíèå ïîòåðè ïî÷å÷íîé ôóíêöèè, íî è íà óëó÷øåíèå ïðîãíîçà èõ æèçíè.

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    Âìåñòå ñ òåì, ýôôåêòèâíîñòü êàðäèîïðîòåêòèâíîé òåðàïèè òàêèõ ïàöèåíòîâ ìîæåò áûòü ïîâûøåíà áëàãîäàðÿ îñëàáëåíèþ èëè ïðåäîòâðàùåíèþ ðàçâèòèÿ è ïðîãðåññèðîâàíèÿ íåôðîïàòèè, êîòîðàÿ óñêîðÿåò ïîâðåæäåíèå ñåðäå÷íî-ñîñóäèñòîé ñèñòåìû è óâåëè÷èâàåò ðèñê ïîâòîðíîé ãîñïèòàëèçàöèè, ñåðäå÷íî-ñîñóäèñòûõ è äðóãèõ îñëîæíåíèé
    Exact
    [2–4]
    Suffix
    . Ïðåäîòâðàùåíèå íàðóøåíèé âíóòðèïî÷å÷íîé ãåìîäèíàìèêè. Êàê ïîêàçûâàþò êëèíè÷åñêèå è ýêñïåðèìåíòàëüíûå äàííûå, ãëàâíûì çâåíîì â ôîðìèðîâàíèè «ñåðäå÷íîé» íåôðîïàòèè ÿâëÿåòñÿ ïîÿâëåíèå ñòîéêîé ãëîìåðóëÿðíîé ãèïåðòåíçèè, âûçûâàþùåé ìåõàíè÷åñêîå ïîâðåæäåíèå êëóáî÷êîâ è íàðàñòàþùåå ñíèæåíèå ïîñòãëîìåðóëÿðíîãî êðîâîòîêà, âåäóùåå ê ãèïîêñè÷åñêîìó ïîâðåæäåíèþ ïî÷å÷íîé òêàíè.

5
Yoshida H, Yashiro M, Ping Liang et al. Mesangiolytic glomerulopathy in severe congestive heart failure. Kidney Int 1998; 53 (4): 880-891
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    Îäíîâðåìåííî íàáëþäàåòñÿ ýíäîêàïèëëÿðíàÿ èíôèëüòðàöèÿ êëóáî÷êîâ ìîíîíóêëåàðíûìè ëåéêîöèòàìè è ìàêðîôàãàìè (70%), óêàçûâàþùàÿ íà ôîðìèðîâàíèå âîñïàëèòåëüíîãî ïðîöåññà â ïåðèâàñêóëÿðíîé òêàíè. Ðàçìåð êëóáî÷êîâ òåñíî êîððåëèðóåò ñ âûðàæåííîñòüþ ãèïîêñåìèè è íàõîäèòñÿ â îáðàòíîé çàâèñèìîñòè îò âåëè÷èíû íàïðÿæåíèè êèñëîðîäà â àðòåðèàëüíîé êðîâè
    Exact
    [5]
    Suffix
    . Ðåçóëüòàòû ýòîãî èññëåäîâàíèÿ ïîêàçûâàþò, ÷òî ìîðôîëîãè÷åñêàÿ êàðòèíà ãëîìåðóëîïàòèè, âîçíèêàþùåé ó ëèö ñ òÿæåëîé ÕÑÍ, ñóùåñòâåííî îòëè÷àåòñÿ îò ãèñòîëîãè÷åñêèõ ïðîÿâëåíèé ïîâðåæäåíèÿ êëóáî÷êîâ ïðè èøåìè÷åñêîé èëè ãèïåðòîíè÷åñêîé íåôðîïàòèè.

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Kjaer A, Hesse B. Heart failure and neuroendocrine activation: diagnostic, prognostic and therapeutic perspective. Clin Physiol 2001; 21 (6): 661-672
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    Ïóñêîâûì çâåíîì ýòîãî ìåõàíèçìà ÿâëÿåòñÿ âîçáóæäåíèå áàðîðåöåïòîðîâ äóãè àîðòû è êàðîòèäíîãî ñèíóñà, êîòîðîå âûçûâàåò ðåôëåêòîðíóþ ñòèìóëÿöèþ ñèìïàòè÷åñêîé íåðâíîé ñèñòåìû (ÑÍÑ), àêòèâàöèþ öèðêóëèðóþùåé ÐÀÀÑ è íå ñâÿçàííîå ñ îñìîòè÷åñêèìè ñòèìóëàìè óâåëè÷åíèå âûäåëåíèÿ àðãèíèí-âàçîïðåññèíà (ÀÄÃ) çàäíåé äîëåé ãèïîôèçà
    Exact
    [6]
    Suffix
    . Ñóùåñòâåííûé âêëàä â àäàïòàöèþ îðãàíèçìà ê íîâûì ãåìîäèíàìè÷åñêèì óñëîâèÿì âíîñèò òàêæå ïîâûøåíèå öåíòðàëüíîãî âåíîçíîãî äàâëåíèÿ (ÖÂÄ), êîòîðîå âîçáóæäàåò áàðîðåöåïòîðû çîíû íèçêîãî äàâëåíèÿ, ðàñïîëàãàþùèåñÿ â îñíîâíîì â ñòåíêå ïðåäñåðäèé.

7
Remes J, Tikkanen I, Fyhrqust F, Pyorala K. Neuroendocrine activity in untreated heart failure. Brit Heart J 1991; 65 (2): 249-255
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     ðåçóëüòàòå ó ëèö ñ òÿæåëîé íåëå÷åííîé ÕÑÍ îòìå÷àåòñÿ âåñüìà ñóùåñòâåííûé ïðèðîñò ñîäåðæàíèÿ â êðîâè íîðàäðåíàëèíà, ðåíèíà, àíãèîòåíçèíà (Àíã) II è àëüäîñòåðîíà, õîòÿ èìåþòñÿ çíà÷èòåëüíûå èíäèâèäóàëüíûå êîëåáàíèÿ âåëè÷èíû ýòèõ ïîêàçàòåëåé â çàâèñèìîñòè îò òÿæåñòè êëèíè÷åñêîé êàðòèíû è ïðîâîäèìîé ëåêàðñòâåííîé òåðàïèè
    Exact
    [7]
    Suffix
    . Íàðóøåíèå êðîâîñíàáæåíèÿ ïî÷åê ÿâëÿåòñÿ õàðàêòåðíîé ÷åðòîé ÕÑÍ. Ïåðâîíà÷àëüíîé åãî ïðè÷èíîé ÿâëÿåòñÿ íàðàñòàþùàÿ ãèïåðàêòèâíîñòü ÑÍÑ, öèðêóëèðóþùåé ÐÀÀÑ è äðóãèõ ñîñóäîñóæèâàþùèõ íåéðîãóìîðàëüíûõ ñèñòåì, à íà áîëåå ïîçäíèõ ýòàïàõ ñåðäå÷íîé äåêîìïåíñàöèè – âûðàæåííàÿ ãèïîïåðôóçèÿ ïî÷åê è ñèñòåìíûé âåíîçíûé çàñòîé.

8
Ситникова МЮ, Беляева ОД, Сычева ЮА и др. Гемодинамические и локальные натрийуретические системы почек при начальных стадиях сердечной недостаточности. Влияние длительной терапии периндоприлом. Кардиология 2000; 40 (9): 64-68
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    Íà ñóáêëèíè÷åñêîé ñòàäèè ñåðäå÷íîé íåäîñòàòî÷íîñòè ãåìîäèíàìè÷åñêèå íàðóøåíèÿ â ïî÷êàõ âûÿâëÿþòñÿ òîëüêî ïðè ôèçè÷åñêîé íàãðóçêå, â òî âðåìÿ êàê ó ïàöèåíòîâ ñ ÕÑÍ II ÔÊ NYHA óðîâåíü êðîâîñíàáæåíèÿ ïî÷åê ñíèæàåòñÿ óæå íà 40–50%
    Exact
    [8]
    Suffix
    , à ó áîëüíûõ ñ òÿæåëîé äåêîìïåíñàöèåé ñåðäöà ïî÷å÷íûé êðîâîòîê ìîæåò ïàäàòü íà 70– 75% îò ñâîåãî íîðìàëüíîãî óðîâíÿ [9]. Ïî ìåðå ñíèæåíèÿ êðîâîòîêà â ïî÷êàõ âêëþ÷àþòñÿ ðÿä êîìïåíñàòîðíûõ ñîñóäèñòûõ ðåàêöèé, êîòîðûå ñïîñîáñòâóþò ñîõðàíåíèþ èõ ôóíêöèîíàëüíîãî ñîñòîÿíèÿ, íî èìåþò íåæåëàòåëüíûå êëèíè÷åñêèå ïîñëåäñòâèÿ.

9
Ljungman S., Laragh J.H., Cody R.J. Role of the kidney in congestive heart failure. Relationship of cardiac index to kidney function. Drugs 1990; 39 [Suppl. 4]: 10-21
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    Íà ñóáêëèíè÷åñêîé ñòàäèè ñåðäå÷íîé íåäîñòàòî÷íîñòè ãåìîäèíàìè÷åñêèå íàðóøåíèÿ â ïî÷êàõ âûÿâëÿþòñÿ òîëüêî ïðè ôèçè÷åñêîé íàãðóçêå, â òî âðåìÿ êàê ó ïàöèåíòîâ ñ ÕÑÍ II ÔÊ NYHA óðîâåíü êðîâîñíàáæåíèÿ ïî÷åê ñíèæàåòñÿ óæå íà 40–50% [8], à ó áîëüíûõ ñ òÿæåëîé äåêîìïåíñàöèåé ñåðäöà ïî÷å÷íûé êðîâîòîê ìîæåò ïàäàòü íà 70– 75% îò ñâîåãî íîðìàëüíîãî óðîâíÿ
    Exact
    [9]
    Suffix
    . Ïî ìåðå ñíèæåíèÿ êðîâîòîêà â ïî÷êàõ âêëþ÷àþòñÿ ðÿä êîìïåíñàòîðíûõ ñîñóäèñòûõ ðåàêöèé, êîòîðûå ñïîñîáñòâóþò ñîõðàíåíèþ èõ ôóíêöèîíàëüíîãî ñîñòîÿíèÿ, íî èìåþò íåæåëàòåëüíûå êëèíè÷åñêèå ïîñëåäñòâèÿ.

10
Margi P, Rao A, Cangianiello S et al. Early impairment of renal hemodynamic reserve in patients with asymptomatic heart failure is restored by angiotensin II antagonism. Circulation 1998; 98 (25): 28-49-2854
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    Ïðÿìûì ïîäòâåðæäåíèåì ïîÿâëåíèÿ ãëîìåðóëÿðíîé ãèïåðòåíçèè óæå íà ðàííåé ñòàäèè äåêîìïåíñàöèè ñåðäöà ÿâëÿåòñÿ ïîëíîå îòñóòñòâèå ïî÷å÷íîãî ôóíêöèîíàëüíîãî ðåçåðâà ó ïàöèåíòîâ ñ ÕÑÍ I ÔÊ NYHA, âûÿâëÿåìîå ñ ïîìîùüþ áåëêîâîé íàãðóçêè
    Exact
    [10]
    Suffix
    . Îá ýòîì æå ãîâîðÿò ðåçóëüòàòû, ïîëó÷åííûå ïðè èçó÷åíèè ãåìîäèíàìè÷åñêîãî ñäâèãà, âîçíèêàþùåãî â ïî÷êàõ êðûñ ñ ìîäåëüþ òÿæåëîé ïîñòèíôàðêòíîé ÕÑÍ ñ íèçêèì ñåðäå÷íûì âûáðîñîì. Ó òàêèõ æèâîòíûõ, íåñìîòðÿ íà ñíèæåííûé óðîâåíü ÀÄ, ïî÷å÷íîãî êðîâîòîêà è ÑÊÔ, îòìå÷àåòñÿ ïîâûøåíèå ñîïðîòèâëåíèÿ ýôôåðåíòíûõ àðòåðèîë êëóáî÷êîâ, ôèëüòðàöèîííîé ôðàêöèè è ïðèðîñò äàâëåíèÿ â ãëîìåðóëÿðíûõ êàïèëëÿðàõ, ñâèäåòåë

11
Nishikimi T, Ochino K, Frohlich ED. Effects of alpha 1adrenergic blockade on intrarenal hemodynamics in heart failure rats. Am J Physiol 1992; 262 (2, Pt 2): R198-R203
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  1. In-text reference with the coordinate start=13494
    Prefix
    Ó òàêèõ æèâîòíûõ, íåñìîòðÿ íà ñíèæåííûé óðîâåíü ÀÄ, ïî÷å÷íîãî êðîâîòîêà è ÑÊÔ, îòìå÷àåòñÿ ïîâûøåíèå ñîïðîòèâëåíèÿ ýôôåðåíòíûõ àðòåðèîë êëóáî÷êîâ, ôèëüòðàöèîííîé ôðàêöèè è ïðèðîñò äàâëåíèÿ â ãëîìåðóëÿðíûõ êàïèëëÿðàõ, ñâèäåòåëüñòâóþùèé î ôîðìèðîâàíèè â ñîõðàíèâøèõñÿ íåôðîíàõ âíóòðèêëóáî÷êîâîé ãèïåðòåíçèè
    Exact
    [11, 12]
    Suffix
    . Ïåðâîíà÷àëüíî ñòîéêàÿ ãëîìåðóëÿðíàÿ ãèïåðòåíçèÿ, âîçíèêàþùàÿ ó áîëüíûõ ÕÑÍ, èìååò êîìïåíñàòîðíûé õàðàêòåð è ïîçâîëÿåò áëàãîäàðÿ ôåíîìåíó ãèïåðôèëüòðàöèè äëèòåëüíîå âðåìÿ ïîääåðæèâàòü äîñòàòî÷íî âûñîêèé óðîâåíü ÑÊÔ [13], êîòîðûé âïîñëåäñòâèè ñíèæàåòñÿ ïî ìåðå âîçðàñòíûõ èçìåíåíèé è/èëè ïðîãðåññèðîâàíèÿ õðîíè÷åñêîãî ÊÐÑ.

12
Numabe A, Komatsu K, Frohlich ED. Intrarenal hemodynamics in low- and high-output cardiac failure rats. Am J Med Sci 1994; 308 (6): 331-337
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  1. In-text reference with the coordinate start=13494
    Prefix
    Ó òàêèõ æèâîòíûõ, íåñìîòðÿ íà ñíèæåííûé óðîâåíü ÀÄ, ïî÷å÷íîãî êðîâîòîêà è ÑÊÔ, îòìå÷àåòñÿ ïîâûøåíèå ñîïðîòèâëåíèÿ ýôôåðåíòíûõ àðòåðèîë êëóáî÷êîâ, ôèëüòðàöèîííîé ôðàêöèè è ïðèðîñò äàâëåíèÿ â ãëîìåðóëÿðíûõ êàïèëëÿðàõ, ñâèäåòåëüñòâóþùèé î ôîðìèðîâàíèè â ñîõðàíèâøèõñÿ íåôðîíàõ âíóòðèêëóáî÷êîâîé ãèïåðòåíçèè
    Exact
    [11, 12]
    Suffix
    . Ïåðâîíà÷àëüíî ñòîéêàÿ ãëîìåðóëÿðíàÿ ãèïåðòåíçèÿ, âîçíèêàþùàÿ ó áîëüíûõ ÕÑÍ, èìååò êîìïåíñàòîðíûé õàðàêòåð è ïîçâîëÿåò áëàãîäàðÿ ôåíîìåíó ãèïåðôèëüòðàöèè äëèòåëüíîå âðåìÿ ïîääåðæèâàòü äîñòàòî÷íî âûñîêèé óðîâåíü ÑÊÔ [13], êîòîðûé âïîñëåäñòâèè ñíèæàåòñÿ ïî ìåðå âîçðàñòíûõ èçìåíåíèé è/èëè ïðîãðåññèðîâàíèÿ õðîíè÷åñêîãî ÊÐÑ.

13
Yoshida H, Matsushima H. Machiguchi T et al. Glomerular hyperfiltration and sclerosis in chronic heart failure. J Am Soc Nephrol 1995; 6 (3): 689 (Abstract)
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    Ïåðâîíà÷àëüíî ñòîéêàÿ ãëîìåðóëÿðíàÿ ãèïåðòåíçèÿ, âîçíèêàþùàÿ ó áîëüíûõ ÕÑÍ, èìååò êîìïåíñàòîðíûé õàðàêòåð è ïîçâîëÿåò áëàãîäàðÿ ôåíîìåíó ãèïåðôèëüòðàöèè äëèòåëüíîå âðåìÿ ïîääåðæèâàòü äîñòàòî÷íî âûñîêèé óðîâåíü ÑÊÔ
    Exact
    [13]
    Suffix
    , êîòîðûé âïîñëåäñòâèè ñíèæàåòñÿ ïî ìåðå âîçðàñòíûõ èçìåíåíèé è/èëè ïðîãðåññèðîâàíèÿ õðîíè÷åñêîãî ÊÐÑ. Îäíàêî îäíîâðåìåííî îíà ìåõàíè÷åñêè ïîâðåæäàåò ôåíåñòðèðîâàííûé ýíäîòåëèé ãëîìåðóëÿðíûõ êàïèëëÿðîâ, ïîäîöèòû, ìåçàíãèàëüíûå êëåòêè è çàïóñêàåò ïàòîëîãè÷åñêèå âíóòðèêëåòî÷íûå ñèãíàëüíûå ïóòè, êîòîðûå íåïîñðåäñòâåííî ó÷àñòâóþò â ñêëåðîòè÷åñêîì ðåìîäåëèðîâàíèè êëóáî÷êîâ [14].

14
Кузьмин ОБ, Бучнева НВ, Пугаева МО. Почечные гемодинамические механизмы формирования гипертонической нефропатии. Нефрология 2009; 13 (4): 28-36
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    Îäíàêî îäíîâðåìåííî îíà ìåõàíè÷åñêè ïîâðåæäàåò ôåíåñòðèðîâàííûé ýíäîòåëèé ãëîìåðóëÿðíûõ êàïèëëÿðîâ, ïîäîöèòû, ìåçàíãèàëüíûå êëåòêè è çàïóñêàåò ïàòîëîãè÷åñêèå âíóòðèêëåòî÷íûå ñèãíàëüíûå ïóòè, êîòîðûå íåïîñðåäñòâåííî ó÷àñòâóþò â ñêëåðîòè÷åñêîì ðåìîäåëèðîâàíèè êëóáî÷êîâ
    Exact
    [14]
    Suffix
    . Ñåé÷àñ ñòàíîâèòñÿ î÷åâèäíûì, ÷òî îäíèì èç ñèñòåìíûõ ãåìîäèíàìè÷åñêèõ ôàêòîðîâ, óõóäøàþùèõ ôóíêöèþ ïî÷åê ïðè òÿæåëîé ÕÑÍ, ÿâëÿåòñÿ âåíîçíûé çàñòîé, ñòåïåíü êîòîðîãî íàðàñòàåò ïî ìåðå ïðîãðåññèðîâàíèÿ ñåðäå÷íîé äåêîìïåíñàöèè.

15
Акаемова ОН, Коц ЯИ, Синицын ВЕ. Состояние периферической и внутрисердечной венозной системы сердца при хронической сердечной недостаточности. Тер архив 2009; 81 (12): 27-30
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    Àíàëîãè÷íûì îáðàçîì èçìåíÿåòñÿ è âåëè÷èíà ÖÂÄ, â ðåçóëüòàòå ÷åãî, êàê ïîêàçûâàþò äàííûå ìóëüòèñïèðàëüíîé êîìïüþòåðíîé òîìîãðàôèè, ó òàêèõ áîëüíûõ ñóùåñòâåííî âîçðàñòàþò äèàìåòðû íèæíåé ïîëîé âåíû, ïðàâîãî âåíå÷íîãî ñèíóñà è ðàçìåðû ïîëîñòåé ïðàâîãî ïðåäñåðäèÿ è ïðàâîãî æåëóäî÷êà ñåðäöà
    Exact
    [15]
    Suffix
    . Âûïîëíåííûå íåäàâíî êëèíè÷åñêèå èññëåäîâàíèÿ âûÿâèëè ñóùåñòâîâàíèå ñâÿçè ìåæäó âåëè÷èíîé ÖÂÄ è íàðóøåíèåì ôóíêöèè ïî÷åê.  îäíîì èç íèõ, âêëþ÷àâøåì 145 ëèö ñ òÿæåëîé ÕÑÍ, ãîñïèòàëèçèðîâàííûõ ïî ïîâîäó îñòðîé äåêîìïåíñàöèè ñåðäöà, áûëà óñòàíîâëåíà ïðÿìàÿ çàâèñèìîñòü óõóäøåíèÿ ôóíêöèè ïî÷åê îò âåëè÷èíû ÖÂÄ, êîòîðàÿ ñîõðàíÿëàñü ïðè ðàçíûõ çíà÷åíèÿõ âåëè÷èíû ÀÄ è ñåðäå÷íîãî èíäåêñà [16].

16
Mullens W, Abrahams Z, Francis GS et al. Importance of venous congestion for worsening of renal function in advanced decompensated renal failure. J Am Coll Cardiol 2009; 53 (7): 589-596
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     îäíîì èç íèõ, âêëþ÷àâøåì 145 ëèö ñ òÿæåëîé ÕÑÍ, ãîñïèòàëèçèðîâàííûõ ïî ïîâîäó îñòðîé äåêîìïåíñàöèè ñåðäöà, áûëà óñòàíîâëåíà ïðÿìàÿ çàâèñèìîñòü óõóäøåíèÿ ôóíêöèè ïî÷åê îò âåëè÷èíû ÖÂÄ, êîòîðàÿ ñîõðàíÿëàñü ïðè ðàçíûõ çíà÷åíèÿõ âåëè÷èíû ÀÄ è ñåðäå÷íîãî èíäåêñà
    Exact
    [16]
    Suffix
    .  äðóãîì èññëåäîâàíèè, ïðîäîëæàâøåìñÿ îêîëî 10 ëåò, èçó÷àëàñü ñâÿçü ìåæäó èçìåíåíèÿìè ÖÂÄ, óðîâíåì ÑÊÔ è îáùåé ñìåðòíîñòüþ â ãðóïïå èç 2557 áîëüíûõ ñ ðàçíûìè ñåðäå÷íî-ñîñóäèñòûìè çàáîëåâàíèÿìè, êîòîðûå ïåðèîäè÷åñêè ïîäâåðãàëèñü êàòåòåðèçàöèè ïðàâîãî ïðåäñåðäèÿ.

17
Damman K, Van Deursen VM, Navis G et al. Increased central venous pressure is associated with impaired renal function and mortality in a broad spectrum of patients with cardiovascular disease. J Am Coll Cardiol 2009; 53 (7): 582558
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    îêîëî 10 ëåò, èçó÷àëàñü ñâÿçü ìåæäó èçìåíåíèÿìè ÖÂÄ, óðîâíåì ÑÊÔ è îáùåé ñìåðòíîñòüþ â ãðóïïå èç 2557 áîëüíûõ ñ ðàçíûìè ñåðäå÷íî-ñîñóäèñòûìè çàáîëåâàíèÿìè, êîòîðûå ïåðèîäè÷åñêè ïîäâåðãàëèñü êàòåòåðèçàöèè ïðàâîãî ïðåäñåðäèÿ. Ïðîâåäåííûå ðàñ÷åòû ïîêàçàëè, ÷òî âåëè÷èíà ÖÂÄ òåñíî êîððåëèðóåò íå òîëüêî ñ óðîâíåì ÑÊÔ, íî è äèíàìèêîé ñìåðòíîñòè ïàöèåíòîâ â òå÷åíèå âñåãî ïåðèîäà íàáëþäåíèÿ
    Exact
    [17]
    Suffix
    . Êàêèì îáðàçîì ñèñòåìíûé âåíîçíûé çàñòîé, âîçíèêàþùèé ó ïàöèåíòîâ ñ ÕÑÍ III–IV ÔÊ NYHA, âûçûâàåò äèñôóíêöèþ è ïîâðåæäåíèå ïî÷åê, îñòàåòñÿ íåäîñòàòî÷íî ÿñíûì. Ñêîðåå âñåãî, ýòî ÿâëÿåòñÿ ñëåäñòâèåì ïåðåäà÷è ïîâûøåííîãî âåíîçíîãî äàâëåíèÿ íà ïî÷å÷íóþ ìèêðîöèðêóëÿöèþ, êîòîðàÿ ñïîñîáñòâóåò ïðîãðåññèðîâàíèþ ãëîìåðóëÿðíîé ãèïåðòåíçèè è óñèëåíèþ ãèïîêñè÷åñêîãî ïîâðåæäåíèÿ ïî÷å÷íîé òêàíè.

18
Abildgaard U. Hemodynamics and functional changes during renal venous stasis in dog kidney. Dan Med Bull 1989; 36 (3): 212-222
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  1. In-text reference with the coordinate start=16403
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    Êðàòêîâðåìåííîå ïîâûøåíèå ïî÷å÷íîãî âåíîçíîãî äàâëåíèÿ â óñëîâèÿõ ýêñïåðèìåíòà ñîïðîâîæäàåòñÿ áûñòðûì ðåôëåêòîðíûì óìåíüøåíèåì êðîâîñíàáæåíèÿ ïî÷åê, ñíèæåíèåì ÑÊÔ è çàäåðæêîé íàòðèÿ â îðãàíèçìå, îáóñëîâëåííîé óâåëè÷åíèåì åãî ðåàáñîðáöèè â ïðîêñèìàëüíûõ îòäåëàõ íåôðîíà
    Exact
    [18, 19]
    Suffix
    . Ãèïîêñè÷åñêîå ïîâðåæäåíèå ïî÷åê ïðè ñåðäå÷íîé íåäîñòàòî÷íîñòè Õðîíè÷åñêàÿ ãèïîêñèÿ ïî÷åê è äðóãèõ îðãàíîâ è òêàíåé ÿâëÿåòñÿ õàðàêòåðíîé ïàòîãåíåòè÷åñêîé îñîáåííîñòüþ ÕÑÍ. Ñòåïåíü ãèïîêñèè âîçðàñòàåò ïî ìåðå ïðîãðåññèðîâàíèÿ äåêîìïåíñàöèè ñåðäöà è íàèáîëåå âûðàæåíà ó áîëüíûõ ÕÑÍ III–IV ÔÊ NYHA, áîëüøèíñòâî èç êîòîðûõ èìåþò ñíèæåííûé óðîâåíü ÑÊÔ è/èëè äðóãèå êëèíè÷åñêèå ïðèçíàêè ÕÁÏ.

19
Doty JM, Saggi BH, Sugerman HJ et al. Effect of increased renal venous pressure on renal function. J Trauma 1999; 47 (6): 1000-1003
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    Êðàòêîâðåìåííîå ïîâûøåíèå ïî÷å÷íîãî âåíîçíîãî äàâëåíèÿ â óñëîâèÿõ ýêñïåðèìåíòà ñîïðîâîæäàåòñÿ áûñòðûì ðåôëåêòîðíûì óìåíüøåíèåì êðîâîñíàáæåíèÿ ïî÷åê, ñíèæåíèåì ÑÊÔ è çàäåðæêîé íàòðèÿ â îðãàíèçìå, îáóñëîâëåííîé óâåëè÷åíèåì åãî ðåàáñîðáöèè â ïðîêñèìàëüíûõ îòäåëàõ íåôðîíà
    Exact
    [18, 19]
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    . Ãèïîêñè÷åñêîå ïîâðåæäåíèå ïî÷åê ïðè ñåðäå÷íîé íåäîñòàòî÷íîñòè Õðîíè÷åñêàÿ ãèïîêñèÿ ïî÷åê è äðóãèõ îðãàíîâ è òêàíåé ÿâëÿåòñÿ õàðàêòåðíîé ïàòîãåíåòè÷åñêîé îñîáåííîñòüþ ÕÑÍ. Ñòåïåíü ãèïîêñèè âîçðàñòàåò ïî ìåðå ïðîãðåññèðîâàíèÿ äåêîìïåíñàöèè ñåðäöà è íàèáîëåå âûðàæåíà ó áîëüíûõ ÕÑÍ III–IV ÔÊ NYHA, áîëüøèíñòâî èç êîòîðûõ èìåþò ñíèæåííûé óðîâåíü ÑÊÔ è/èëè äðóãèå êëèíè÷åñêèå ïðèçíàêè ÕÁÏ.

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    Íà ïîçäíèõ ñòàäèÿõ ñåðäå÷íîé äåêîìïåíñàöèè â ìåõàíèçì íàðóøåíèÿ ïîñòãëîìåðóëÿðíîé ãåìîäèíàìèêè âêëþ÷àåòñÿ òàêæå ñèñòåìíûé âåíîçíûé çàñòîé, êîòîðûé, ïîâûøàÿ äàâëåíèå â ïî÷å÷íûõ âåíàõ, âûçûâàåò ðåôëåêòîðíîå óâåëè÷åíèå àêòèâíîñòè ÑÍÑ è ñíèæåíèå ïî÷å÷íîãî êðîâîòîêà
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    [19]
    Suffix
    . Ó áîëüøèíñòâà áîëüíûõ ñ âûðàæåííîé ÕÑÍ äîïîëíèòåëüíîé ïðè÷èíîé õðîíè÷åñêîé ïî÷å÷íîé ãèïîêñèè ìîæåò áûòü àíåìèÿ, êîòîðàÿ ñàìà ïî ñåáå óìåíüøàåò äîñòàâêó êèñëîðîäà ê ñòðóêòóðíûì ýëåìåíòàì êëóáî÷êîâ, êëåòêàì êàíàëüöåâ è îêîëîêàíàëüöåâîãî èíòåðñòèöèÿ.

20
Bresis M, Rosen S, Silva P, Epstein FH. Renal ischemia: A new perspective. Kidney Int 1984; 26 (4): 375-383
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    Prefix
     êîðêîâîì ñëîå ïî÷åê, ãäå óðîâåíü îêñèãåíàöèè î÷åíü âûñîêèé, à ïîòðåáëåíèå êèñëîðîäà ïî÷òè íå èçìåíÿåòñÿ â øèðîêîì äèàïàçîíå ôèçèîëîãè÷åñêèõ ðåàêöèé, ãëàâíûì ôàêòîðîì, ïîääåðæèâàþùèì íàïðÿæåíèå êèñëîðîäà, ÿâëÿåòñÿ êðîâîñíàáæåíèå ïî÷å÷íîé òêàíè
    Exact
    [20]
    Suffix
    .  ñâÿçè ñ ýòèì îñíîâíàÿ ïðè÷èíà õðîíè÷åñêîãî ãèïîêñè÷åñêîãî ïîâðåæäåíèÿ ïî÷åê ó áîëüíûõ ÕÑÍ III–IV ÔÊ NYHA – âåñüìà çíà÷èòåëüíîå óìåíüøåíèå ïîñòãëîìåðóëÿðíîãî è ïåðèòóáóëÿðíîãî êðîâîòîêîâ, êîòîðîå óñóãóáëÿåòñÿ ýíäîòåëèàëüíîé äèñôóíêöèåé è íàðàñòàþùåé ãèïîêñåìèåé àðòåðèàëüíîé êðîâè.

21
Higgins DF, Kimura K, Iwano M, Haase VH. Hypoxiainducible factor signaling in the development of tissue fibrosis. Cell Cycle 2008; 7 (9): 1128-1132
Total in-text references: 1
  1. In-text reference with the coordinate start=19626
    Prefix
    Ïîä åãî âëèÿíèåì â êëåòêàõ ïî÷å÷íîé òêàíè ïåðâîíà÷àëüíî âîçðàñòàåò àêòèâíîñòü àäàïòèâíûõ ãåíîâ è óâåëè÷èâàåòñÿ ïðîäóêöèÿ ýðèòðîïîýòèíà, ãåìîîêñèãåíàçû-1, VEGF (ñîñóäèñòîãî ýíäîòåëèàëüíîãî ôàêòîðà ðîñòà) è GLUT-1 (òðàíñïîðòåðà ãëþêîçû-1), ñòèìóëèðóþùèõ ïðîöåññû ýðèòðîïîýçà, àíãèîãåíåçà, àíàýðîáíîãî ãëèêîëèçà è çàùèùàþùèõ êëåòêè îò ïîâðåæäàþùåãî äåéñòâèÿ ãèïîêñèè
    Exact
    [21]
    Suffix
    . Îäíàêî öèòîïðîòåêòèâíûå âîçìîæíîñòè HIF-1 äîñòàòî÷íî îãðàíè÷åíû è, êàê ïîêàçûâàþò ðåçóëüòàòû ìîäåëüíûõ ýêñïåðèìåíòîâ, â íàèáîëüøåé ñòåïåíè ïðîÿâëÿþòñÿ ïðè îñòðûõ èëè êðàòêîñðî÷íûõ èøåìè÷åñêèõ èëè ãèïîêñè÷åñêèõ ïîâðåæäåíèÿõ ïî÷åê [22, 23].

22
Bemhardt WM, Campean V, Kany S et al. Preconditional activation of hypoxia-inducible factors ameliorates ischemic acute renal failure. J AM Soc Nephrol 2006; 17 (7): 1970-1980
Total in-text references: 1
  1. In-text reference with the coordinate start=19861
    Prefix
    Îäíàêî öèòîïðîòåêòèâíûå âîçìîæíîñòè HIF-1 äîñòàòî÷íî îãðàíè÷åíû è, êàê ïîêàçûâàþò ðåçóëüòàòû ìîäåëüíûõ ýêñïåðèìåíòîâ, â íàèáîëüøåé ñòåïåíè ïðîÿâëÿþòñÿ ïðè îñòðûõ èëè êðàòêîñðî÷íûõ èøåìè÷åñêèõ èëè ãèïîêñè÷åñêèõ ïîâðåæäåíèÿõ ïî÷åê
    Exact
    [22, 23]
    Suffix
    .  óñëîâèÿõ õðîíè÷åñêîé ãèïîêñèè â êëåòêàõ ïî÷å÷íîé òêàíè ñ ó÷àñòèåì ýòîãî òðàíñêðèïöèîííîãî ôàêòîðà íà÷èíàþò ýêñïðåññèðîâàòüñÿ ïðîôèáðîòè÷åñêèå è ïðîâîñïàëèòåëüíûå ãåíû, êîòîðûå íåïîñðåäñòâåííî âîâëåêàþòñÿ â ñêëåðîòè÷åñêîå è âîñïàëèòåëüíîå ïîâðåæäåíèå êëóáî÷êîâ, êëåòîê ïðîêñèìàëüíûõ êàíàëüöåâ è îêîëîêàíàëüöåâîãî èíòåðñòèöèÿ.

23
Song YR, You SJ, Lee YM et al. Activation of hypoxiainducible factor attenuates renal injury in rat remnant kidney. Nephrol Dial Transplant 2010; 25 (1): 77-85
Total in-text references: 1
  1. In-text reference with the coordinate start=19861
    Prefix
    Îäíàêî öèòîïðîòåêòèâíûå âîçìîæíîñòè HIF-1 äîñòàòî÷íî îãðàíè÷åíû è, êàê ïîêàçûâàþò ðåçóëüòàòû ìîäåëüíûõ ýêñïåðèìåíòîâ, â íàèáîëüøåé ñòåïåíè ïðîÿâëÿþòñÿ ïðè îñòðûõ èëè êðàòêîñðî÷íûõ èøåìè÷åñêèõ èëè ãèïîêñè÷åñêèõ ïîâðåæäåíèÿõ ïî÷åê
    Exact
    [22, 23]
    Suffix
    .  óñëîâèÿõ õðîíè÷åñêîé ãèïîêñèè â êëåòêàõ ïî÷å÷íîé òêàíè ñ ó÷àñòèåì ýòîãî òðàíñêðèïöèîííîãî ôàêòîðà íà÷èíàþò ýêñïðåññèðîâàòüñÿ ïðîôèáðîòè÷åñêèå è ïðîâîñïàëèòåëüíûå ãåíû, êîòîðûå íåïîñðåäñòâåííî âîâëåêàþòñÿ â ñêëåðîòè÷åñêîå è âîñïàëèòåëüíîå ïîâðåæäåíèå êëóáî÷êîâ, êëåòîê ïðîêñèìàëüíûõ êàíàëüöåâ è îêîëîêàíàëüöåâîãî èíòåðñòèöèÿ.

24
Orphanides C, Fine LG, Norman JT. Hypoxia stimulates proximal tubular cell matrix production via a TGF-β1independent mechanism. Kidney Int 1997; 52 (3): 637-647
Total in-text references: 1
  1. In-text reference with the coordinate start=20540
    Prefix
     ðåçóëüòàòå â òêàíè ïî÷åê ïîä âëèÿíèåì HIF-1 âîçðàñòàåò ïðîäóêöèÿ öèòîêèíà TGF-β1, CTGF (ôàêòîðà ðîñòà ñîåäèíèòåëüíîé òêàíè), PAI-1 (àêòèâàòîðà èíãèáèòîðà ïëàçìèíîãåíà-1), TIMP-1 (òêàíåâîãî èíãèáèòîðà ìåòàëëîïðîòåèíàçû-1) è íåêîòîðûõ ïðîâîñïàëèòåëüíûõ öèòîêèíîâ, óñêîðÿþùèõ ïðîöåññû ãëîìåðóëîñêëåðîçà è òóáóëîèíòåðñòèöèàëüíîãî ôèáðîçà
    Exact
    [24–26]
    Suffix
    . Ñâîé âêëàä â ïîâðåæäåíèå ïî÷åê ïðè õðîíè÷åñêîé ãèïîêñèè âíîñèò òàêæå ìåçàíãèàëüíîå è èíòåðñòèöèàëüíîå âîñïàëåíèå, îäíîé èç ïðè÷èí êîòîðîãî ÿâëÿåòñÿ íàðóøåíèå ïðîöåññîâ òêàíåâîãî äûõàíèÿ è ôîðìèðîâàíèå íèòðîçàòèâíîãî ñòðåññà.

25
Norman JT, Fine LG. Intrarenal oxygenation in chronic renal failure. Clin Exp Pharmacol Physiol 2006; 33 (10): 989-996
Total in-text references: 1
  1. In-text reference with the coordinate start=20540
    Prefix
     ðåçóëüòàòå â òêàíè ïî÷åê ïîä âëèÿíèåì HIF-1 âîçðàñòàåò ïðîäóêöèÿ öèòîêèíà TGF-β1, CTGF (ôàêòîðà ðîñòà ñîåäèíèòåëüíîé òêàíè), PAI-1 (àêòèâàòîðà èíãèáèòîðà ïëàçìèíîãåíà-1), TIMP-1 (òêàíåâîãî èíãèáèòîðà ìåòàëëîïðîòåèíàçû-1) è íåêîòîðûõ ïðîâîñïàëèòåëüíûõ öèòîêèíîâ, óñêîðÿþùèõ ïðîöåññû ãëîìåðóëîñêëåðîçà è òóáóëîèíòåðñòèöèàëüíîãî ôèáðîçà
    Exact
    [24–26]
    Suffix
    . Ñâîé âêëàä â ïîâðåæäåíèå ïî÷åê ïðè õðîíè÷åñêîé ãèïîêñèè âíîñèò òàêæå ìåçàíãèàëüíîå è èíòåðñòèöèàëüíîå âîñïàëåíèå, îäíîé èç ïðè÷èí êîòîðîãî ÿâëÿåòñÿ íàðóøåíèå ïðîöåññîâ òêàíåâîãî äûõàíèÿ è ôîðìèðîâàíèå íèòðîçàòèâíîãî ñòðåññà.

26
Neumann AK, Yang J, Biju MP et al. Hypoxia inducible factor 1б regulates T-cell receptor signal transduction. Proc Natl Acad Sci 2005; 102 (47): 17071-17076
Total in-text references: 1
  1. In-text reference with the coordinate start=20540
    Prefix
     ðåçóëüòàòå â òêàíè ïî÷åê ïîä âëèÿíèåì HIF-1 âîçðàñòàåò ïðîäóêöèÿ öèòîêèíà TGF-β1, CTGF (ôàêòîðà ðîñòà ñîåäèíèòåëüíîé òêàíè), PAI-1 (àêòèâàòîðà èíãèáèòîðà ïëàçìèíîãåíà-1), TIMP-1 (òêàíåâîãî èíãèáèòîðà ìåòàëëîïðîòåèíàçû-1) è íåêîòîðûõ ïðîâîñïàëèòåëüíûõ öèòîêèíîâ, óñêîðÿþùèõ ïðîöåññû ãëîìåðóëîñêëåðîçà è òóáóëîèíòåðñòèöèàëüíîãî ôèáðîçà
    Exact
    [24–26]
    Suffix
    . Ñâîé âêëàä â ïîâðåæäåíèå ïî÷åê ïðè õðîíè÷åñêîé ãèïîêñèè âíîñèò òàêæå ìåçàíãèàëüíîå è èíòåðñòèöèàëüíîå âîñïàëåíèå, îäíîé èç ïðè÷èí êîòîðîãî ÿâëÿåòñÿ íàðóøåíèå ïðîöåññîâ òêàíåâîãî äûõàíèÿ è ôîðìèðîâàíèå íèòðîçàòèâíîãî ñòðåññà.

27
Poyton RO, Ball KA, Castello PR. Mitochondrial generation of free radicals and hypoxic signaling. Trends Endocrinol Metab 2009; 20 (7): 332-340
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    Prefix
     óñëîâèÿõ íåäîñòàòêà êèñëîðîäà êëåòî÷íûå ìèòîõîíäðèè ãåíåðèðóþò èçáûòî÷íîå êîëè÷åñòâî àíèîíîâ NO–, êîòîðûå íå òîëüêî ñíèæàþò îáðàçîâàíèå è áèîäîñòóïíîñòü NO, ïðåâðàùàÿñü â âûñîêîòîêñè÷íûé ïåðîêñèíèòðèò ONOO–, íî è çàïóñêàþò ñèãíàëüíûå ïóòè, âûçûâàþùèå àêòèâàöèþ ÿäåðíûõ òðàíñêðèïöèîííûõ ôàêòîðîâ NF-kappa B, AP-1 è ïîâûøåííóþ ïðîäóêöèþ êëåòêàìè ïðîâîñïàëèòåëüíûõ öèòîêèíîâ
    Exact
    [27]
    Suffix
    . Ãèïîêñè÷åñêèé ãëîìåðóëîñêëåðîç. Äëèòåëüíàÿ ñèñòåìíàÿ ãèïîêñèÿ âûçûâàåò â êëóáî÷êàõ ïî÷åê ìûøåé ìîðôîëîãè÷åñêèå äåôåêòû â âèäå ãëîìåðóëîìåãàëèè, ãëîìåðóëîñêëåðîçà è óâåëè÷åíèÿ ðàçìåðîâ ñîñóäèñòîãî ïó÷êà, îòðàæàþùåãî ïîâûøåíèå äàâëåíèÿ â ãëîìåðóëÿðíûõ êàïèëëÿðàõ è èõ âòîðè÷íóþ ïðîëèôåðàöèþ, ñâÿçàííóþ ñ ïðîäóêöèåé VEGF ýíäîòåëèàëüíûìè êëåòêàìè [28, 29].

28
Subtirelu M, Gershin I, Teichman J, Tufro A. A novel model of chronic hypoxia-induced glomerulomegaly (Abstract). J Am Soc Nephrol 2005; 16: 668A
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  1. In-text reference with the coordinate start=21497
    Prefix
    Äëèòåëüíàÿ ñèñòåìíàÿ ãèïîêñèÿ âûçûâàåò â êëóáî÷êàõ ïî÷åê ìûøåé ìîðôîëîãè÷åñêèå äåôåêòû â âèäå ãëîìåðóëîìåãàëèè, ãëîìåðóëîñêëåðîçà è óâåëè÷åíèÿ ðàçìåðîâ ñîñóäèñòîãî ïó÷êà, îòðàæàþùåãî ïîâûøåíèå äàâëåíèÿ â ãëîìåðóëÿðíûõ êàïèëëÿðàõ è èõ âòîðè÷íóþ ïðîëèôåðàöèþ, ñâÿçàííóþ ñ ïðîäóêöèåé VEGF ýíäîòåëèàëüíûìè êëåòêàìè
    Exact
    [28, 29]
    Suffix
    . Îäíîâðåìåííî îãðàíè÷åíèå ïîñòóïëåíèÿ êèñëîðîäà â êëóáî÷êè ïîâðåæäàåò ãëîìåðóëÿðíûå ïîäîöèòû, êîòîðûå îêàçàëèñü âåñüìà ÷óâñòâèòåëüíûìè ê ãèïîêñè÷åñêîìó âîçäåéñòâèþ. Ïîä âëèÿíèåì õðîíè÷åñêîé ãèïîêñèè â íèõ èíäóöèðóåòñÿ òðàíñêðèïöèîííûé ôàêòîð HIF-1, èçáûòî÷íî àêòèâèðóåòñÿ ãåí VEGF, ñïîñîáñòâóþùèé ïðîôèáðîòè÷åñêîé ïåðåñòðîéêå ïîäîöèòîâ, è ïðîèñõîäèò âíóòðèÿäåðíàÿ òðàíñëîêàöèÿ AIF (ôàêòîðà, èíäóöèðó

  2. In-text reference with the coordinate start=22009
    Prefix
    Ïîä âëèÿíèåì õðîíè÷åñêîé ãèïîêñèè â íèõ èíäóöèðóåòñÿ òðàíñêðèïöèîííûé ôàêòîð HIF-1, èçáûòî÷íî àêòèâèðóåòñÿ ãåí VEGF, ñïîñîáñòâóþùèé ïðîôèáðîòè÷åñêîé ïåðåñòðîéêå ïîäîöèòîâ, è ïðîèñõîäèò âíóòðèÿäåðíàÿ òðàíñëîêàöèÿ AIF (ôàêòîðà, èíäóöèðóþùåãî àïîïòîç), êîòîðûé ñîêðàùàåò èõ æèçíåííûé öèêë, óñêîðÿÿ ïðîöåññû ïðåæäåâðåìåííîé ãèáåëè êëåòîê
    Exact
    [28]
    Suffix
    . Íåäàâíî óñòàíîâëåíî, ÷òî â ìåõàíèçì ãèïîêñè÷åñêîãî ïîâðåæäåíèÿ êëóáî÷êîâ ñ ó÷àñòèåì HIF-1 âêëþ÷àåòñÿ òàêæå ïðîäóöèðóåìûé ïîäîöèòàìè õåìîêèí CXCR 4, êîòîðûé ðàññìàòðèâàåòñÿ ñåé÷àñ â êà÷åñòâå åùå îäíîãî ïîòåíöèàëüíîãî ïðîôèáðîòè÷åñêîãî ôàêòîðà, âûçûâàþùåãî ðàçâèòèå ãëîìåðóëîñêëåðîçà [30].

29
Brukamp K, Jin B, Moeller M, Haase VH. Hypoxia and podocyte-specific Vhlh deletion confer risk of glomerular disease. Am J Physiol Renal 2007; 293 (4): F1397-F1407
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  1. In-text reference with the coordinate start=21497
    Prefix
    Äëèòåëüíàÿ ñèñòåìíàÿ ãèïîêñèÿ âûçûâàåò â êëóáî÷êàõ ïî÷åê ìûøåé ìîðôîëîãè÷åñêèå äåôåêòû â âèäå ãëîìåðóëîìåãàëèè, ãëîìåðóëîñêëåðîçà è óâåëè÷åíèÿ ðàçìåðîâ ñîñóäèñòîãî ïó÷êà, îòðàæàþùåãî ïîâûøåíèå äàâëåíèÿ â ãëîìåðóëÿðíûõ êàïèëëÿðàõ è èõ âòîðè÷íóþ ïðîëèôåðàöèþ, ñâÿçàííóþ ñ ïðîäóêöèåé VEGF ýíäîòåëèàëüíûìè êëåòêàìè
    Exact
    [28, 29]
    Suffix
    . Îäíîâðåìåííî îãðàíè÷åíèå ïîñòóïëåíèÿ êèñëîðîäà â êëóáî÷êè ïîâðåæäàåò ãëîìåðóëÿðíûå ïîäîöèòû, êîòîðûå îêàçàëèñü âåñüìà ÷óâñòâèòåëüíûìè ê ãèïîêñè÷åñêîìó âîçäåéñòâèþ. Ïîä âëèÿíèåì õðîíè÷åñêîé ãèïîêñèè â íèõ èíäóöèðóåòñÿ òðàíñêðèïöèîííûé ôàêòîð HIF-1, èçáûòî÷íî àêòèâèðóåòñÿ ãåí VEGF, ñïîñîáñòâóþùèé ïðîôèáðîòè÷åñêîé ïåðåñòðîéêå ïîäîöèòîâ, è ïðîèñõîäèò âíóòðèÿäåðíàÿ òðàíñëîêàöèÿ AIF (ôàêòîðà, èíäóöèðó

30
Neusser MA, Lindenmeyer MT, Moll AG et al. Human nephrosclerosis triggers a hypoxia-related glomerulopathy. Am J Pathol 2010; 176 (2): 594-607
Total in-text references: 1
  1. In-text reference with the coordinate start=22299
    Prefix
    Íåäàâíî óñòàíîâëåíî, ÷òî â ìåõàíèçì ãèïîêñè÷åñêîãî ïîâðåæäåíèÿ êëóáî÷êîâ ñ ó÷àñòèåì HIF-1 âêëþ÷àåòñÿ òàêæå ïðîäóöèðóåìûé ïîäîöèòàìè õåìîêèí CXCR 4, êîòîðûé ðàññìàòðèâàåòñÿ ñåé÷àñ â êà÷åñòâå åùå îäíîãî ïîòåíöèàëüíîãî ïðîôèáðîòè÷åñêîãî ôàêòîðà, âûçûâàþùåãî ðàçâèòèå ãëîìåðóëîñêëåðîçà
    Exact
    [30]
    Suffix
    . Ãèïîêñè÷åñêèé òóáóëîèíòåðñòèöèàëüíûé ôèáðîç. Ôèáðîòè÷åñêîå ïîâðåæäåíèå ïðîêñèìàëüíûõ êàíàëüöåâ (ÏÊ) è îêðóæàþùåé èíòåðñòèöèàëüíîé òêàíè èìååò êëþ÷åâîå çíà÷åíèå äëÿ ïðîãðåññèðîâàíèÿ äåñòðóêöèè ïî÷åê è íåîáðàòèìîé ïîòåðè èõ ôóíêöèè.

31
Rodriquez-Diez R, Carvajal-Gonzales G, Sancher-Lopes E et al. Pharmacological modulation of epithelial-mesenchymal transition caused by angiotensin II. Role of ROCK and MAPK pathways. Pharm Res 2008; 25 (10): 2447-2461
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  1. In-text reference with the coordinate start=23105
    Prefix
    Ïðåäïîëàãàåòñÿ, ÷òî ãëàâíóþ ðîëü â ýòîì ïðîöåññå èãðàåò TGF-β1, êîòîðûé ñàìîñòîÿòåëüíî èëè ñ ó÷àñòèåì CTGF àêòèâèðóåò âíóòðèêëåòî÷íûå ñèãíàëüíûå ïóòè, âûçûâàþùèå ïàòîëîãè÷åñêóþ ñòðóêòóðíî-ôóíêöèîíàëüíóþ ïåðåñòðîéêó ýïèòåëèàëüíûõ êàíàëüöåâûõ êëåòîê
    Exact
    [31]
    Suffix
    . Õðîíè÷åñêàÿ òêàíåâàÿ ãèïîêñèÿ ÿâëÿåòñÿ îäíèì èç îñíîâíûõ ôàêòîðîâ òóáóëîèíòåðñòèöèàëüíîãî ïîâðåæäåíèÿ è ðàññìàòðèâàåòñÿ ñåé÷àñ êàê îáùèé êîíå÷íûé ïàòîãåíåòè÷åñêèé ïóòü, êîòîðûé, óñêîðÿÿ ïðîöåññû òóáóëîèíòåðñòèöèàëüíîãî ôèáðîçà, âåäåò ê ïåðåõîäó ÕÁÏ â òåðìèíàëüíóþ ñòàäèþ çàáîëåâàíèÿ [32, 33].

32
Nangaki M. Chronic hypoxia and tubulointerstitial injury: a final common pathway to end-stage renal failure. J Am Soc Nephrol 2006; 17 (1): 17-25
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  1. In-text reference with the coordinate start=23395
    Prefix
    Õðîíè÷åñêàÿ òêàíåâàÿ ãèïîêñèÿ ÿâëÿåòñÿ îäíèì èç îñíîâíûõ ôàêòîðîâ òóáóëîèíòåðñòèöèàëüíîãî ïîâðåæäåíèÿ è ðàññìàòðèâàåòñÿ ñåé÷àñ êàê îáùèé êîíå÷íûé ïàòîãåíåòè÷åñêèé ïóòü, êîòîðûé, óñêîðÿÿ ïðîöåññû òóáóëîèíòåðñòèöèàëüíîãî ôèáðîçà, âåäåò ê ïåðåõîäó ÕÁÏ â òåðìèíàëüíóþ ñòàäèþ çàáîëåâàíèÿ
    Exact
    [32, 33]
    Suffix
    . Êëåòî÷íûå ìåõàíèçìû, ëåæàùèå â îñíîâå ãèïîêñè÷åñêîé ÝÌÒ êëåòîê ÏÊ, íåäîñòàòî÷íî èçó÷åíû, íî óñòàíîâëåíî, ÷òî èõ îñíîâíûì ïóñêîâûì çâåíîì òàêæå ÿâëÿåòñÿ àêòèâàöèÿ HIF-1, êîòîðûé èíäóöèðóåò ïðîäóêöèþ TGF-β1, çàïóñêàþùåãî Smad-ñèãíàëüíûé ïóòü ïðåâðàùåíèÿ ýïèòåëèàëüíûõ êëåòîê â êëåòêè ôèáðîòè÷åñêîãî ôåíîòèïà.

33
Fine LG, Norman JT. Chronic hypoxia as a mechanism of progression of chronic kidney diseases: from hypothesis to novel therapeutics. Kidney Int 2008; 74 (7): 867-872
Total in-text references: 1
  1. In-text reference with the coordinate start=23395
    Prefix
    Õðîíè÷åñêàÿ òêàíåâàÿ ãèïîêñèÿ ÿâëÿåòñÿ îäíèì èç îñíîâíûõ ôàêòîðîâ òóáóëîèíòåðñòèöèàëüíîãî ïîâðåæäåíèÿ è ðàññìàòðèâàåòñÿ ñåé÷àñ êàê îáùèé êîíå÷íûé ïàòîãåíåòè÷åñêèé ïóòü, êîòîðûé, óñêîðÿÿ ïðîöåññû òóáóëîèíòåðñòèöèàëüíîãî ôèáðîçà, âåäåò ê ïåðåõîäó ÕÁÏ â òåðìèíàëüíóþ ñòàäèþ çàáîëåâàíèÿ
    Exact
    [32, 33]
    Suffix
    . Êëåòî÷íûå ìåõàíèçìû, ëåæàùèå â îñíîâå ãèïîêñè÷åñêîé ÝÌÒ êëåòîê ÏÊ, íåäîñòàòî÷íî èçó÷åíû, íî óñòàíîâëåíî, ÷òî èõ îñíîâíûì ïóñêîâûì çâåíîì òàêæå ÿâëÿåòñÿ àêòèâàöèÿ HIF-1, êîòîðûé èíäóöèðóåò ïðîäóêöèþ TGF-β1, çàïóñêàþùåãî Smad-ñèãíàëüíûé ïóòü ïðåâðàùåíèÿ ýïèòåëèàëüíûõ êëåòîê â êëåòêè ôèáðîòè÷åñêîãî ôåíîòèïà.

34
Higgins DF, Kimura K, Bernhardt WM et al. Hypoxia promotes fibrogenesis in vivo via HIF-1 stimulation of epithelialto-mesenchymal transition. J Clin Invest 2007; 117 (12): 38103820
Total in-text references: 1
  1. In-text reference with the coordinate start=23993
    Prefix
    Íå èñêëþ÷åíî, ÷òî â ýòè ïðîöåññû âîâëåêàåòñÿ ÿäåðíûé òðàíñêðèïöèîííûé ôàêòîð Twist, êîòîðûé ýêñïðåññèðóåòñÿ â ãèïîêñè÷åñêèõ êëåòêàõ ÏÊ è âûçûâàåò àêòèâàöèþ ãåíîâ, ó÷àñòâóþùèõ â èõ ïðîôèáðîòè÷åñêîé ñòðóêòóðíî-ôóíêöèîíàëüíîé òðàíñôîðìàöèè
    Exact
    [34, 35]
    Suffix
    . Ïîìèìî ÝÌÒ ýïèòåëèàëüíûõ êàíàëüöåâûõ êëåòîê, õðîíè÷åñêàÿ ãèïîêñèÿ óñêîðÿåò ïðîöåññû ïî÷å÷íîãî èíòåðñòèöèàëüíîãî ôèáðîçà, ïîâûøàÿ ôèáðîãåííóþ àêòèâíîñòü ñàìèõ èíòåðñòèöèàëüíûõ ìèîôèáðîáëàñòîâ, ïðîäóöèðóþùèõ èçáûòî÷íîå êîëè÷åñòâî CTGF è áåëêîâ âíåêëåòî÷íîãî ìàòðèêñà [36].

35
Sun S, Ning X, Zhang Y et al. Hypoxia-inducible factor 1 alpha induces Twist expression in tubular epithelial cells subjected to hypoxia leading to epithelial-to-mesenchymal transition. Kidney Int 2009; 75 (12): 1278-1287
Total in-text references: 1
  1. In-text reference with the coordinate start=23993
    Prefix
    Íå èñêëþ÷åíî, ÷òî â ýòè ïðîöåññû âîâëåêàåòñÿ ÿäåðíûé òðàíñêðèïöèîííûé ôàêòîð Twist, êîòîðûé ýêñïðåññèðóåòñÿ â ãèïîêñè÷åñêèõ êëåòêàõ ÏÊ è âûçûâàåò àêòèâàöèþ ãåíîâ, ó÷àñòâóþùèõ â èõ ïðîôèáðîòè÷åñêîé ñòðóêòóðíî-ôóíêöèîíàëüíîé òðàíñôîðìàöèè
    Exact
    [34, 35]
    Suffix
    . Ïîìèìî ÝÌÒ ýïèòåëèàëüíûõ êàíàëüöåâûõ êëåòîê, õðîíè÷åñêàÿ ãèïîêñèÿ óñêîðÿåò ïðîöåññû ïî÷å÷íîãî èíòåðñòèöèàëüíîãî ôèáðîçà, ïîâûøàÿ ôèáðîãåííóþ àêòèâíîñòü ñàìèõ èíòåðñòèöèàëüíûõ ìèîôèáðîáëàñòîâ, ïðîäóöèðóþùèõ èçáûòî÷íîå êîëè÷åñòâî CTGF è áåëêîâ âíåêëåòî÷íîãî ìàòðèêñà [36].

36
Guo LP, Huang HC, Li JZ. Hypoxia induces the expression and secretion of connective tissue growth factor and fibronectin by cultured renal cortical myofibroblasts. Beijing Da Hue Bao 2007; 39 (1): 67-71
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  1. In-text reference with the coordinate start=24266
    Prefix
    Ïîìèìî ÝÌÒ ýïèòåëèàëüíûõ êàíàëüöåâûõ êëåòîê, õðîíè÷åñêàÿ ãèïîêñèÿ óñêîðÿåò ïðîöåññû ïî÷å÷íîãî èíòåðñòèöèàëüíîãî ôèáðîçà, ïîâûøàÿ ôèáðîãåííóþ àêòèâíîñòü ñàìèõ èíòåðñòèöèàëüíûõ ìèîôèáðîáëàñòîâ, ïðîäóöèðóþùèõ èçáûòî÷íîå êîëè÷åñòâî CTGF è áåëêîâ âíåêëåòî÷íîãî ìàòðèêñà
    Exact
    [36]
    Suffix
    . Âïîëíå î÷åâèäíî, ÷òî õðîíè÷åñêàÿ òêàíåâàÿ ãèïîêñèÿ, âîçíèêàþùàÿ â ïî÷êàõ â îòâåò íà íàðóøåíèå ïîñòãëîìåðóëÿðíîé ãåìîäèíàìèêè, ñèñòåìíóþ ãèïîêñåìèþ, àíåìèþ è ñíèæåíèå ýôôåêòèâíîñòè óòèëèçàöèè êèñëîðîäà êëåòêàìè ïî÷å÷íîé òêàíè, ìîæåò áûòü îäíîé èç ãëàâíûõ ïðè÷èí ïîÿâëåíèÿ íåôðîïàòèè ó ïàöèåíòîâ ñ ÕÑÍ è ôîðìèðîâàíèÿ ó íèõ õðîíè÷åñêîãî ÊÐÑ.

37
Namba S, Okuda Y, Morimoto A et al. Indoxyl sulfate is a useful predictor for progression of chronic kidney disease. Rinsho Byori 2010; 58 (5): 448-453
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  1. In-text reference with the coordinate start=25435
    Prefix
    Ïðîãðåññèðîâàíèå ÕÁÏ ñîïðîâîæäàåòñÿ íàðàñòàþùèì ñíèæåíèåì ïî÷å÷íîãî êëèðåíñà è íàêîïëåíèåì ýòîãî òîêñèíà â êðîâè, ñîäåðæàíèå êîòîðîãî ó óðåìè÷åñêèõ áîëüíûõ ìîæåò áîëåå ÷åì â 8 ðàç ïðåâûøàòü åãî íîðìàëüíûå çíà÷åíèÿ
    Exact
    [37]
    Suffix
    .  âûñîêèõ êîíöåíòðàöèÿõ èíäîêñèë ñóëüôàò îêàçûâàåò âûðàæåííîå êàðäèîòîêñè÷åñêîå, âàçîòîêñè÷åñêîå è íåôðîòîêñè÷åñêîå äåéñòâèå. Íåôðîòîêñè÷åñêèå ñâîéñòâà ýòîãî ñîåäèíåíèÿ îáóñëîâëåíû â îñíîâíîì åãî ñïîñîáíîñòüþ ñåêðåòèðîâàòüñÿ â èçáûòî÷íûõ êîëè÷åñòâàõ â ïðîêñèìàëüíûõ ñåãìåíòàõ íåôðîíà è óñêîðÿòü ïðîöåññû òóáóëîèíòåðñòèöèàëüíîãî ôèáðîçà, ÿâëÿþùåãîñÿ ãëàâíîé ïðè÷èíîé ïîòåðè ïî÷å÷íîé ôóíêöèè.

38
Miyazaki T, Ise M, Seo H et al. Indoxyl sulfate increases the gene expression of TGF-в1, TIMP-1 and proб(1) collagen in uremic rat kidney. Kidney Int 1997; 52 [Suppl]: S15-S22
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  1. In-text reference with the coordinate start=26179
    Prefix
     êëåòêàõ ÏÊ èíäîêñèë ñóëüôàò àêòèâèðóåò ÍÀÄÔ(Í)-îêñèäàçó è âûçûâàåò ëîêàëüíûé îêñèäàòèâíûé ñòðåññ, êîòîðûé ñ ó÷àñòèåì ÿäåðíîãî òðàíñêðèïöèîííîãî ôàêòîðà NF-kappa  èíäóöèðóåò ïðîäóêöèþ ïðîôèáðîòè÷åñêèõ öèòîêèíîâ TGF-β1, TIMP-1è PAI-1, âêëþ÷àþùèõñÿ â ïðîöåññû ñêëåðîòè÷åñêîãî ïîâðåæäåíèÿ ïî÷å÷íûõ êàíàëüöåâ è îêðóæàþùåé èõ èíòåðñòèöèàëüíîé òêàíè
    Exact
    [38, 39]
    Suffix
    . Âåñüìà ÷óâñòâèòåëüíûìè ê ýòîìó òîêñèíó îêàçàëèñü è ìåçàíãèàëüíûå êëåòêè êëóáî÷êîâ, â êîòîðûõ ïîä åãî âëèÿíèåì óâåëè÷èâàåòñÿ ãåíåðàöèÿ ñóïåðîêñèäíûõ àíèîíîâ Î2–, Í2Î2 è àíèîíîâ ÍΖ, âûçûâàþùèõ ïðîëèôåðàöèþ êëåòîê è èçáûòî÷íûé ñèíòåç áåëêîâ ìåçàíãèàëüíîãî ìàòðèêñà [40].

39
Motojima M, Hosokawa A, Yamamoto H et al. Uremic toxins of organic anions upregulate PAI-1 expression by induction of NF-kB and free radicals in proximal tubular cells. Kidney Int 2003; 63 (6): 1671-1680
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  1. In-text reference with the coordinate start=26179
    Prefix
     êëåòêàõ ÏÊ èíäîêñèë ñóëüôàò àêòèâèðóåò ÍÀÄÔ(Í)-îêñèäàçó è âûçûâàåò ëîêàëüíûé îêñèäàòèâíûé ñòðåññ, êîòîðûé ñ ó÷àñòèåì ÿäåðíîãî òðàíñêðèïöèîííîãî ôàêòîðà NF-kappa  èíäóöèðóåò ïðîäóêöèþ ïðîôèáðîòè÷åñêèõ öèòîêèíîâ TGF-β1, TIMP-1è PAI-1, âêëþ÷àþùèõñÿ â ïðîöåññû ñêëåðîòè÷åñêîãî ïîâðåæäåíèÿ ïî÷å÷íûõ êàíàëüöåâ è îêðóæàþùåé èõ èíòåðñòèöèàëüíîé òêàíè
    Exact
    [38, 39]
    Suffix
    . Âåñüìà ÷óâñòâèòåëüíûìè ê ýòîìó òîêñèíó îêàçàëèñü è ìåçàíãèàëüíûå êëåòêè êëóáî÷êîâ, â êîòîðûõ ïîä åãî âëèÿíèåì óâåëè÷èâàåòñÿ ãåíåðàöèÿ ñóïåðîêñèäíûõ àíèîíîâ Î2–, Í2Î2 è àíèîíîâ ÍΖ, âûçûâàþùèõ ïðîëèôåðàöèþ êëåòîê è èçáûòî÷íûé ñèíòåç áåëêîâ ìåçàíãèàëüíîãî ìàòðèêñà [40].

40
Gelasco AK, Raymond JR. Indoxyl sulfate induces complex redox alterations in mesangial cells. Am J Physiol Renal 2006; 290 (6): F1551-1558
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  1. In-text reference with the coordinate start=26456
    Prefix
    Âåñüìà ÷óâñòâèòåëüíûìè ê ýòîìó òîêñèíó îêàçàëèñü è ìåçàíãèàëüíûå êëåòêè êëóáî÷êîâ, â êîòîðûõ ïîä åãî âëèÿíèåì óâåëè÷èâàåòñÿ ãåíåðàöèÿ ñóïåðîêñèäíûõ àíèîíîâ Î2–, Í2Î2 è àíèîíîâ ÍΖ, âûçûâàþùèõ ïðîëèôåðàöèþ êëåòîê è èçáûòî÷íûé ñèíòåç áåëêîâ ìåçàíãèàëüíîãî ìàòðèêñà
    Exact
    [40]
    Suffix
    .  ñâÿçè ñ ýòèì ïîâûøåííûé óðîâåíü èíäîêñèë ñóëüôàòà â êðîâè ðàññìàòðèâàåòñÿ ñåé÷àñ íå òîëüêî êàê ïîêàçàòåëü, àäåêâàòíî îòðàæàþùèé ñòåïåíü ïîâðåæäåíèÿ ïî÷åê ïðè íåôðîïàòèÿõ ðàçëè÷íîãî ïðîèñõîæäåíèÿ, íî è êàê ôàêòîð, êîòîðûé ñïîñîáñòâóåò óñêîðåíèþ ïðîãðåññèðîâàíèÿ ÕÁÏ [41].

41
Namba S, Okuda Y, Morimoto A et al. A serum indoxyl sulfate is a useful predictor of chronic kidney disease. Rinsho Byori 2010; 58 (5): 448-453
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  1. In-text reference with the coordinate start=26725
    Prefix
     ñâÿçè ñ ýòèì ïîâûøåííûé óðîâåíü èíäîêñèë ñóëüôàòà â êðîâè ðàññìàòðèâàåòñÿ ñåé÷àñ íå òîëüêî êàê ïîêàçàòåëü, àäåêâàòíî îòðàæàþùèé ñòåïåíü ïîâðåæäåíèÿ ïî÷åê ïðè íåôðîïàòèÿõ ðàçëè÷íîãî ïðîèñõîæäåíèÿ, íî è êàê ôàêòîð, êîòîðûé ñïîñîáñòâóåò óñêîðåíèþ ïðîãðåññèðîâàíèÿ ÕÁÏ
    Exact
    [41]
    Suffix
    . Ó÷àñòèå èíäîêñèë ñóëüôàòà â ïîâðåæäåíèè ïî÷åê ó ëèö ñ ÕÑÍ êîñâåííî ïîäòâåðæäàåòñÿ äàííûìè, ïîëó÷åííûìè ïðè èçó÷åíèè êëèíè÷åñêîé ýôôåêòèâíîñòè íîâîãî ïðåïàðàòà êðåìåçèíà (AST-120), ïðåäñòàâëÿþùåãî ñîáîé âûñîêîñåëåêòèâíûé àäñîðáåíò, ïðåïÿòñòâóþùèé âñàñûâàíèþ â êèøå÷íèêå èíäîëà è ïîäîáíûõ åìó ñîåäèíåíèé.

42
Shibahara H, Shibahara N. Cardiorenal protective effects of the oral uremic toxin adsorbent AST-120 in chronic heart disease patients with moderate CKD. J Nephrol 2010; 23 (5): 535-540
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    Prefix
    Âêëþ÷åíèå ýòîãî ïðåïàðàòà â îáû÷íóþ ëåêàðñòâåííóþ òåðàïèþ áîëüíûõ ÕÑÍ ñ óìåðåííîé ÕÁÏ íå òîëüêî çàìåäëÿåò ñïóñòÿ äâà ãîäà ëå÷åíèÿ ñêîðîñòü íàðóøåíèÿ ôóíêöèè ïî÷åê, íî è ñóùåñòâåííî ñíèæàåò â ýòîé ãðóïïå ïàöèåíòîâ êîëè÷åñòâî ïîâòîðíûõ ãîñïèòàëèçàöèé è äëèòåëüíîñòü èõ ïðåáûâàíèÿ â ñòàöèîíàðå
    Exact
    [42]
    Suffix
    . Ïîäõîäû ê íåôðîïðîòåêòèâíîé òåðàïèè áîëüíûõ ñ õðîíè÷åñêèì êàðäèîðåíàëüíûì ñèíäðîìîì Ïîÿâëåíèå ó áîëüíûõ ÕÑÍ ìèêðîàëüáóìèíóðèè, ÿâíîé ïðîòåèíóðèè è/èëè äðóãèõ êëèíè÷åñêèõ ïðèçíàêîâ ÕÁÏ ÿâëÿåòñÿ ñëåäñòâèåì ôîðìèðîâàíèÿ ó íèõ «ñåðäå÷íîé» íåôðîïàòèè, èìåþùåé íåáëàãîïðèÿòíîå ïðîãíîñòè÷åñêîå çíà÷åíèå.

43
Ahmed A, Love TE, Sui X, Rich MW. Effects of angiotensin-converting enzyme inhibitors in systolic heart failure patients with chronic kidney disease: a propensity score analysis. J Card Fail 2006; 12 (7): 499-506
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    Äåéñòâèòåëüíî, ðåòðîñïåêòèâíûé àíàëèç ðåçóëüòàòîâ ðàííèõ êëèíè÷åñêèõ èññëåäîâàíèé ïîêàçûâàåò, ÷òî âêëþ÷åíèå èíãèáèòîðîâ ÀÏÔ èëè áëîêàòîðîâ ÀÒ1-àíãèîòåíçèíîâûõ ðåöåïòîðîâ (ÁÐÀ) â ëåêàðñòâåííóþ òåðàïèþ òàêèõ ïàöèåíòîâ ñóùåñòâåííî ñíèæàåò ðèñê ïîâòîðíîé ãîñïèòàëèçàöèè è îáùåé ñìåðòíîñòè
    Exact
    [43, 44]
    Suffix
    .  íàñòîÿùåå âðåìÿ èíãèáèòîðû ÀÏÔ è çàìåíÿþùèå èõ ÁÐÀ èñïîëüçóþòñÿ äëÿ ëå÷åíèÿ áîëüíûõ ñ ÕÑÍ â êà÷åñòâå ïðåïàðàòîâ ïåðâîé ëèíèè, â òîì ÷èñëå è äëÿ ëåêàðñòâåííîé òåðàïèè ëèö ñ íàðóøåííîé ôóíêöèåé ïî÷åê.

44
Berger AK, Duvals S, Manske C et al. Angiotensinconverting enzyme inhibitors and angiotensin receptor blockers in patients with congestive heart failure and chronic kidney disease. Am Heart J 2007; 153 (6): 1064-1073
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    Prefix
    Äåéñòâèòåëüíî, ðåòðîñïåêòèâíûé àíàëèç ðåçóëüòàòîâ ðàííèõ êëèíè÷åñêèõ èññëåäîâàíèé ïîêàçûâàåò, ÷òî âêëþ÷åíèå èíãèáèòîðîâ ÀÏÔ èëè áëîêàòîðîâ ÀÒ1-àíãèîòåíçèíîâûõ ðåöåïòîðîâ (ÁÐÀ) â ëåêàðñòâåííóþ òåðàïèþ òàêèõ ïàöèåíòîâ ñóùåñòâåííî ñíèæàåò ðèñê ïîâòîðíîé ãîñïèòàëèçàöèè è îáùåé ñìåðòíîñòè
    Exact
    [43, 44]
    Suffix
    .  íàñòîÿùåå âðåìÿ èíãèáèòîðû ÀÏÔ è çàìåíÿþùèå èõ ÁÐÀ èñïîëüçóþòñÿ äëÿ ëå÷åíèÿ áîëüíûõ ñ ÕÑÍ â êà÷åñòâå ïðåïàðàòîâ ïåðâîé ëèíèè, â òîì ÷èñëå è äëÿ ëåêàðñòâåííîé òåðàïèè ëèö ñ íàðóøåííîé ôóíêöèåé ïî÷åê.

45
Whaley-Connell A, Habibi J, Johnson M et al. Nebivolol reduces proteinuria and renal NADPH oxidase-generated reactive oxygen species in the transgenic Ran2 rat. J Am Nephrol 2009; 30 (4): 356-360
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    Îñîáîå ìåñòî ñðåäè íèõ çàíèìàþò ïðåïàðàòû 3-ãî ïîêîëåíèÿ íåáèâîëîë è êàðâåäèëîë, îòëè÷àþùèåñÿ îò ñâîèõ ïðåäøåñòâåííèêîâ äîïîëíèòåëüíûìè ñîñóäîðàñøèðÿþùèìè, àíòèîêñèäàòíûìè è àíòèïðîëèôåðàòèâíûìè ñâîéñòâàìè, áëàãîäàðÿ êîòîðûì â ìîäåëüíûõ ýêñïåðèìåíòàõ îíè îêàçûâàþò âûðàæåííîå íåôðîïðîòåêòèâíîå äåéñòâèå
    Exact
    [45, 46]
    Suffix
    . Íå èñêëþ÷åíî, ÷òî ýòè ïðåïàðàòû ìîãóò îêàçàòüñÿ ýôôåêòèâíûìè ëåêàðñòâåííûìè ñðåäñòâàìè äëÿ ëå÷åíèÿ áîëüíûõ ÕÑÍ ñ íàðóøåííîé ôóíêöèåé ïî÷åê. Ïåðâûå êëèíè÷åñêèå íàáëþäåíèÿ ïîäòâåðäèëè, ÷òî íåáèâîëîë ïðè äîáàâëåíèè ê îáû÷íîé òåðàïèè ïîæèëûõ áîëüíûõ ÕÑÍ II–IV ÔÊ NYHA ñ óðîâíåì ÑÊÔ ìåíåå 55,5 ìë/ìèí ñíèæàåò ñïóñòÿ 21 ìåñ ëå÷åíèÿ ðèñê ïîâòîðíîé ãîñïèòàëèçàöèè è îáùåé ñìåðòíîñòè íà 16% ïî ñðàâíåíèþ ñ ã

46
Wong WY, Laping NG, Helson AH et al. Renoprotective effects of carvedilol in hypertensive-stroke prone rats may involve inhibition of TGFв expression. Brit J Pharmacol 2001; 134 (5): 977-984
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    Îñîáîå ìåñòî ñðåäè íèõ çàíèìàþò ïðåïàðàòû 3-ãî ïîêîëåíèÿ íåáèâîëîë è êàðâåäèëîë, îòëè÷àþùèåñÿ îò ñâîèõ ïðåäøåñòâåííèêîâ äîïîëíèòåëüíûìè ñîñóäîðàñøèðÿþùèìè, àíòèîêñèäàòíûìè è àíòèïðîëèôåðàòèâíûìè ñâîéñòâàìè, áëàãîäàðÿ êîòîðûì â ìîäåëüíûõ ýêñïåðèìåíòàõ îíè îêàçûâàþò âûðàæåííîå íåôðîïðîòåêòèâíîå äåéñòâèå
    Exact
    [45, 46]
    Suffix
    . Íå èñêëþ÷åíî, ÷òî ýòè ïðåïàðàòû ìîãóò îêàçàòüñÿ ýôôåêòèâíûìè ëåêàðñòâåííûìè ñðåäñòâàìè äëÿ ëå÷åíèÿ áîëüíûõ ÕÑÍ ñ íàðóøåííîé ôóíêöèåé ïî÷åê. Ïåðâûå êëèíè÷åñêèå íàáëþäåíèÿ ïîäòâåðäèëè, ÷òî íåáèâîëîë ïðè äîáàâëåíèè ê îáû÷íîé òåðàïèè ïîæèëûõ áîëüíûõ ÕÑÍ II–IV ÔÊ NYHA ñ óðîâíåì ÑÊÔ ìåíåå 55,5 ìë/ìèí ñíèæàåò ñïóñòÿ 21 ìåñ ëå÷åíèÿ ðèñê ïîâòîðíîé ãîñïèòàëèçàöèè è îáùåé ñìåðòíîñòè íà 16% ïî ñðàâíåíèþ ñ ã

47
Cohen-Solal A, Kotecha D, van Veldhuisen DJ et al. Efficacy and safety of nebivolol in elderly heart failure patients with impaired renal function: insights from RENIORS trial. Eur J Heart Fail 2009; 11 (9): 872-880
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  1. In-text reference with the coordinate start=31549
    Prefix
    Ïåðâûå êëèíè÷åñêèå íàáëþäåíèÿ ïîäòâåðäèëè, ÷òî íåáèâîëîë ïðè äîáàâëåíèè ê îáû÷íîé òåðàïèè ïîæèëûõ áîëüíûõ ÕÑÍ II–IV ÔÊ NYHA ñ óðîâíåì ÑÊÔ ìåíåå 55,5 ìë/ìèí ñíèæàåò ñïóñòÿ 21 ìåñ ëå÷åíèÿ ðèñê ïîâòîðíîé ãîñïèòàëèçàöèè è îáùåé ñìåðòíîñòè íà 16% ïî ñðàâíåíèþ ñ ãðóïïîé ïëàöåáî
    Exact
    [47]
    Suffix
    . Îñëàáëåíèå ãèïîêñè÷åñêîãî ïîâðåæäåíèÿ ïî÷å÷íîé òêàíè. Îäíîé èç ïðè÷èí õðîíè÷åñêîé ãèïîêñèè ïî÷åê ïðè ÕÑÍ ÿâëÿåòñÿ àíåìèÿ, ÷àñòîòà âûÿâëåíèÿ êîòîðîé äîñòèãàåò 37,2% â ãðóïïå èç 153180 áîëüíûõ ñ ÕÑÍ ðàçíîé ñòåïåíè òÿæåñòè [48].

48
Groenveld HF, Januzzi JC, Damman K et al. Anemia and mortality in heart failure patients. A systematic review and meta-analysis. J Am Coll Cardiol 2008; 52 (10): 818-827
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  1. In-text reference with the coordinate start=31771
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    Îñëàáëåíèå ãèïîêñè÷åñêîãî ïîâðåæäåíèÿ ïî÷å÷íîé òêàíè. Îäíîé èç ïðè÷èí õðîíè÷åñêîé ãèïîêñèè ïî÷åê ïðè ÕÑÍ ÿâëÿåòñÿ àíåìèÿ, ÷àñòîòà âûÿâëåíèÿ êîòîðîé äîñòèãàåò 37,2% â ãðóïïå èç 153180 áîëüíûõ ñ ÕÑÍ ðàçíîé ñòåïåíè òÿæåñòè
    Exact
    [48]
    Suffix
    . Ïàòîôèçèîëîãè÷åñêîå çíà÷åíèå àíåìèè â ïðîãðåññèðîâàíèè ÕÑÍ íå âïîëíå ïîíÿòíî, õîòÿ èìåþòñÿ îñíîâàíèÿ ïîëàãàòü, ÷òî îíà ìîæåò ñïîñîáñòâîâàòü íàðóøåíèþ ñîêðàòèòåëüíîé ñïîñîáíîñòè ìèîêàðäà, àêòèâàöèè íåéðîãóìîðàëüíûõ ñèñòåì è óõóäøåíèþ ôóíêöèè ïî÷åê, óâåëè÷èâàÿ ðèñê îáùåé ñìåðòíîñòè áîëüíûõ êàê ïðè ñèñòîëè÷åñêîé, òàê è ïðè äèàñòîëè÷åñêîé äåêîìïåíñàöèè ñåðäöà.

49
Palazzuoli A, Qvatrini I, Calabro A et al. Anemia correction by erythropoietin reduces BNP levels, hospitalization rate and NYHA class in patients with cardio-renal anemia syndrome. Clin Exp Med 2010;
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     ïîñëåäíåå âðåìÿ ïðåäïðèíÿòû ïîïûòêè îöåíèòü âëèÿíèå âêëþ÷åíèÿ â ñòàíäàðòíóþ ëåêàðñòâåííóþ òåðàïèþ ýðèòðîïîýòèíà èëè åãî êîìáèíàöèè ñ ïðåïàðàòàìè æåëåçà íà ÷àñòîòó ïîâòîðíîé ãîñïèòàëèçàöèè è äðóãèå êëèíè÷åñêèå èñõîäû ó àíåìè÷íûõ áîëüíûõ ÕÑÍ ñ íàðóøåííîé ôóíêöèåé ïî÷åê
    Exact
    [49]
    Suffix
    . Ñíèæåíèå ïîâðåæäàþùåãî äåéñòâèÿ ëåêàðñòâåííûõ ñðåäñòâ íà ïî÷êè. Ê òàêèì ïðåïàðàòàì ñëåäóåò, ïðåæäå âñåãî, îòíåñòè òèàçèäíûå è ïåòëåâûå äèóðåòèêè, êîòîðûå ïðè ÕÑÍ èñïîëüçóþòñÿ äëÿ ñèìïòîìàòè÷åñêîé òåðàïèè îòå÷íîãî ñèíäðîìà.

50
Ahmed A, Husain A, Love TE et al. Heart failure, chronic diuretic use and increase in mortality and hospitalization: an observational study using propensity score methods. Eur Heart J 2006; 27 (12): 1431-1439
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    Ðåçóëüòàòû, ïîëó÷åííûå íåäàâíî ïðè ðåòðîñïåêòèâíîì àíàëèçå èñõîäîâ ëå÷åíèÿ 7788 àìáóëàòîðíûõ áîëüíûõ ñ ÕÑÍ, ïîêàçàëè, ÷òî äëèòåëüíîå ïðèìåíåíèå äèóðåòèêîâ ìîæåò ñîïðîâîæäàòüñÿ ñóùåñòâåííûì ïðèðîñòîì ÷àñòîòû ïîâòîðíûõ ãîñïèòàëèçàöèé è ñìåðòíîñòè êàê â îáùåé ïîïóëÿöèè, òàê è, îñîáåííî, ó ëèö ïîæèëîãî âîçðàñòà
    Exact
    [50, 51]
    Suffix
    . Ïðè íàðóøåíèè ôóíêöèè ïî÷åê è, îñîáåííî, ïðè ïåðåõîäå ÕÁÏ â III è áîëåå òÿæåëûå ñòàäèè çàáîëåâàíèÿ ðèñê ïîáî÷íûõ ýôôåêòîâ ýòèõ ïðåïàðàòîâ çíà÷èòåëüíî âîçðàñòàåò áëàãîäàðÿ ñíèæåíèþ êëèíè÷åñêîé ýôôåêòèâíîñòè è èçáûòî÷íîìó íàêîïëåíèþ â îðãàíèçìå.

51
Ahmed A, Young JB, Love TE et al. A propensity-matched study of the effects of chronic diuretic therapy on mortality and hospitalization in older adults with heart failure. Int J Cardiol 2008; 125 (2): 246-253
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    Ðåçóëüòàòû, ïîëó÷åííûå íåäàâíî ïðè ðåòðîñïåêòèâíîì àíàëèçå èñõîäîâ ëå÷åíèÿ 7788 àìáóëàòîðíûõ áîëüíûõ ñ ÕÑÍ, ïîêàçàëè, ÷òî äëèòåëüíîå ïðèìåíåíèå äèóðåòèêîâ ìîæåò ñîïðîâîæäàòüñÿ ñóùåñòâåííûì ïðèðîñòîì ÷àñòîòû ïîâòîðíûõ ãîñïèòàëèçàöèé è ñìåðòíîñòè êàê â îáùåé ïîïóëÿöèè, òàê è, îñîáåííî, ó ëèö ïîæèëîãî âîçðàñòà
    Exact
    [50, 51]
    Suffix
    . Ïðè íàðóøåíèè ôóíêöèè ïî÷åê è, îñîáåííî, ïðè ïåðåõîäå ÕÁÏ â III è áîëåå òÿæåëûå ñòàäèè çàáîëåâàíèÿ ðèñê ïîáî÷íûõ ýôôåêòîâ ýòèõ ïðåïàðàòîâ çíà÷èòåëüíî âîçðàñòàåò áëàãîäàðÿ ñíèæåíèþ êëèíè÷åñêîé ýôôåêòèâíîñòè è èçáûòî÷íîìó íàêîïëåíèþ â îðãàíèçìå.

52
Tamirisa KP, Aaronson KD, Koelling TM. Spironolactoneinduced renal insufficiency and hyperkaliemia in patients with heart failure. Am Heart J 2004; 148 (6): 971-978
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  1. In-text reference with the coordinate start=34428
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    Äèñôóíêöèþ ïî÷åê ñïîñîáåí âûçûâàòü òàêæå àíòàãîíèñò ðåöåïòîðîâ àëüäîñòåðîíà ñïèðîíîëàêòîí, íàçíà÷åíèå êîòîðîãî ïàöèåíòàì ñ ÕÑÍ â êîìáèíàöèè ñ èíãèáèòîðàìè ÀÏÔ è/èëè β-àäðåíîáëîêàòîðàìè, ïî äàííûì ýïèäåìèîëîãè÷åñêèõ èññëåäîâàíèé, îñëîæíÿåòñÿ ãèïåðêàëèåìèåé è óõóäøåíèåì ôóíêöèè ïî÷åê â 7,2% ñëó÷àåâ
    Exact
    [52]
    Suffix
    . Ïðîãðåññèðóþùåå ñíèæåíèå ÑÊÔ è ôîðìèðîâàíèå ó òàêèõ ëèö ÕÏÍ ñîïðîâîæäàåòñÿ óìåíüøåíèåì ïîòåðè êàëèÿ ñ ìî÷îé, êîòîðîå âåäåò ê çíà÷èòåëüíîìó óâåëè÷åíèþ ðèñêà ðàçâèòèÿ ãèïåðêàëèåìèè è ñâÿçàííûõ ñ íåé ñåðäå÷íî-ñîñóäèñòûõ îñëîæíåíèé.

53
Национальные рекомендации ВНОК и ОССН по диагностике и лечению ХСН (третий пересмотр). Журнал Сердечная недостаточность 2009; 10 (2): 64-106 Ïîñòóïèëà â ðåäàêöèþ 15.09.2010 ã. Ïðèíÿòà â ïå÷àòü 09.02.2011 ã.
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     ñâÿçè ñ ýòèì ïîâûøåíèå óðîâíÿ êðåàòèíèíà â ñûâîðîòêå êðîâè áîëåå 130 ìêìîëü/ë, íàëè÷èå â àíàìíåçå ïî÷å÷íîé íåäîñòàòî÷íîñòè èëè óìåðåííûé ïðèðîñò êîíöåíòðàöèè êàëèÿ â êðîâè (áîëåå 5,2 ììîëü/ë) ÿâëÿþòñÿ îñíîâàíèåì äëÿ ïðîâåäåíèÿ ó áîëüíûõ ÕÑÍ, ïîëó÷àþùèõ àíòàãîíèñòû àëüäîñòåðîíà è èíãèáèòîðû ÀÏÔ, òùàòåëüíîãî êëèíè÷åñêîãî è ëàáîðàòîðíîãî êîíòðîëÿ
    Exact
    [53]
    Suffix
    . Çàêëþ÷åíèå ÕÁÏ, âîçíèêàþùàÿ ó ïàöèåíòîâ ñ ÕÑÍ, ÿâëÿåòñÿ êëèíè÷åñêèì ïðîÿâëåíèåì õðîíè÷åñêîãî ÊÐÑ, êîòîðûé óñêîðÿåò ïîâðåæäåíèå ñåðäöà, ñîñóäîâ è çíà÷èòåëüíî ïîâûøàåò ðèñê îáùåé è ñåðäå÷íî-ñîñóäèñòîé ñìåðòíîñòè.