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Современные подходы к коррекции минеральных и костных нарушений у реципиентов почечного трансплантата

https://doi.org/10.15825/1995-1191-2017-4-130-140

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Аннотация

Синдром минерально-костных нарушений у пациентов с хронической болезнью почек, перенесших трансплантацию почки, включает гипофосфатемию, гиперкальциемию, гиповитаминоз D, гиперпаратиреоз и снижение минерализации кости (вторичный остеопороз). Современная стратегия профилактики и лечения посттрансплантационных нарушений минерального обмена и костного метаболизма опирается на принципы индивидуального подхода с учетом оценки факторов риска и минимизации причин, вызвавших эти нарушения. Попытка восполнения недостатка фосфора обычно неэффективна и даже опасна возникновением осложнений. Рассмотрены разнообразные способы коррекции симптоматической гиперкальциемии и гиперкальциемии, обусловленной посттрансплантационным гиперпаратиреозом. Представлены современные подходы к профилактике и лечению посттрансплантационного остеопороза. Анализируются эффективность и показания к использованию иммуносупрессивной терапии с минимизацией глюкокортикостероидов в раннем послеоперационном периоде, витамина D и активаторов рецептора витамина D, медикаментозной и хирургической коррекции ГПТ, бисфосфонатов и других лекарственных средств.

Об авторе

О. Н. Ветчинникова
ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского».
Россия
Москва.


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Для цитирования:


Ветчинникова О.Н. Современные подходы к коррекции минеральных и костных нарушений у реципиентов почечного трансплантата. Вестник трансплантологии и искусственных органов. 2017;19(4):130-140. https://doi.org/10.15825/1995-1191-2017-4-130-140

For citation:


Vetchinnikova O.N. Modern approaches to correction mineral and bone disorders in kidney transplant recipients. Russian Journal of Transplantology and Artificial Organs. 2017;19(4):130-140. (In Russ.) https://doi.org/10.15825/1995-1191-2017-4-130-140

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ISSN 1995-1191 (Print)
ISSN 2412-6160 (Online)