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Хроническая болезнь почек как фактор риска острого инсульта

https://doi.org/10.23873/2074-0506-2021-13-4-382-397

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Аннотация

Одной из актуальных тем нефрологии, неврологии и кардиологии является ведение и лечение пациентов с хронической болезнью почек и инсультом. Пациенты c хронической болезнью почек имеют риск как тромботических осложнений, так и кровотечений, у них высок риск как ишемического, так и геморрагического инсульта. Гемодиализ, вызывая резкие гемодинамические и биохимические изменения, приводит к «стрессу» сосудистой системы головного мозга, повышая риск развития инсульта; трансплантация почки за счет восстановления функции органа уменьшает риск инсульта. Хроническая болезнь почек значительно ухудшает исход инсульта, ограничивая лечение из-за снижения клиренса лекарств и побочных эффектов. Хроническая болезнь почек и инсульт имеют существенные социально-экономические последствия. Пациентов с терминальной стадией хронической болезни почек, как правило, не включают в клинические исследования, для них не разработана тактика лечения инсульта.

В данной работе рассматривается взаимосвязь почек и головного мозга, вопросы патофизиологии и эпидемиология инсульта при всех стадиях хронической болезни почек, после трансплантации почки и обсуждается тактика ведения и лечения пациентов с хронической болезнью почек с инсультом. Изучение факторов, ответственных за высокую распространенность поражения головного мозга при хронической болезни почек, позволит разработать новые способы лечения.

Об авторах

О. Н. Ржевская
ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»; Кафедра трансплантологии и искусственных органов ФГБОУ ВО МГМСУ им. А.И. Евдокимова МЗ РФ
Россия

Ольга Николаевна Ржевская, д-р мед. наук, ведущий научный сотрудник отделения трансплантации почки и поджелудочной железы; профессор

129090, Москва, Большая Сухаревская пл., д. 3; 127473, Москва, Делегатская ул., д. 20, стр. 1



А. Ю. Моисеева
ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»
Россия

Александра Юрьевна Моисеева, клинический ординатор по специальности «Кардиология»

129090, Москва, Большая Сухаревская пл., д. 3 



А. Н. Эсауленко
ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»
Россия

Анна Николаевна Эсауленко, клинический ординатор по специальности «Кардиология»

129090, Москва, Большая Сухаревская пл., д. 3



А. В. Пинчук
ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»; Кафедра трансплантологии и искусственных органов ФГБОУ ВО МГМСУ им. А.И. Евдокимова МЗ РФ; ГБУ «НИИ организации здравоохранения и медицинского менеджмента ДЗМ»
Россия

Алексей Валерьевич Пинчук, д-р мед. наук, заведующий научным отделением трансплантации почки и поджелудочной железы; доцент; заведующий организационно-методическим отделом по трансплантологии

129090, Москва, Большая Сухаревская пл., д. 3; 127473, Москва, Делегатская ул., д. 20, стр. 1; 115184, Москва, Большая Татарская ул., д. 30



Х. Г. Алиджанова
ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»
Россия

Хафиза Гафуровна Алиджанова, д-р мед. наук, старший преподаватель учебного центра, старший научный сотрудник отделения неотложной клинической кардиологии с методами неинвазивной функциональной диагностики

129090, Москва, Большая Сухаревская пл., д. 3



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Рецензия

Для цитирования:


Ржевская О.Н., Моисеева А.Ю., Эсауленко А.Н., Пинчук А.В., Алиджанова Х.Г. Хроническая болезнь почек как фактор риска острого инсульта. Трансплантология. 2021;13(4):382-397. https://doi.org/10.23873/2074-0506-2021-13-4-382-397

For citation:


Rzhevskaya O.N., Moiseeva A.Y., Esaulenko A.N., Pinchuk A.V., Alidzhanova K.G. Chronic kidney disease as a risk factor for acute stroke. Transplantologiya. The Russian Journal of Transplantation. 2021;13(4):382-397. https://doi.org/10.23873/2074-0506-2021-13-4-382-397

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