russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2018-12-russjcardiol-2980Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWНефропротективная стратегия в лечении артериальной гипертензии как современная общемедицинская задачаNephroprotective strategy in the treatment of hypertension as a modern general medical problemhttps://orcid.org/0000-0002-0758-5609ПодзолковВ. И.PodzolkovV. I.

Москва

podzolkov@list.ruhttps://orcid.org/0000-0002-2699-1610БрагинаА. Е.BraginaA. E.

Москва

anna.bragina@mail.ruhttps://orcid.org/0000-0001-7720-0770ИшинаТ. И.IshinaT. I.

Ишина Татьяна Ивановна — кандидат медицинских наук, доцент кафедры факультетской терапии № 2 лечебного факультета

Москва

ishin@newmail.ruhttps://orcid.org/0000-0002-0558-7096БрагинаГ. И.BraginaL. V.

Брагина Галина Ивановна — кандидат медицинских наук, доцент кафедры поликлинической терапии лечебного факультетао факультета

Москва

galinabragina@list.ruhttps://orcid.org/0000-0001-5730-7837ВасильеваЛ. В.VasilyevaL. V.

Васильева Любовь Викторовна — кандидат медицинских наук, ассистент кафедры факультетской терапии № 2 лечебного факультета

Москва

vlubv@mail.ruФГАОУ ВО Первый Московский государственный медицинский университет им.И.М.Сеченова (Сеченовский Университет) Минздрава РоссииРоссияI. M. Sechenov First Moscow State Medical UniversityRussian Federation201820122018012107118Copyright © Подзолков В.И., Брагина А.Е., Ишина Т.И., Брагина Г.И., Васильева Л.В., 20182018Подзолков В.И., Брагина А.Е., Ишина Т.И., Брагина Г.И., Васильева Л.В.Podzolkov V.I., Bragina A.E., Ishina T.I., Bragina L.V., Vasilyeva L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/2980

Современное население характеризуется высокой распространенностью факторов риска развития хронической болезни почек: артериальной гипертензии, сахарного диабета, ожирения, метаболического синдрома, гиподинамии, курения. Все это вместе с прогрессивным старением определяет нарастание заболеваемости хронической болезнью почек. Развитие тяжелых, инвалидизирующих и дорогостоящих осложнений, тесная связь с потенциально фатальными сердечно-сосудистыми заболеваниями делают это заболевание социально и экономически значимой проблемой. Лечение хронической болезни почек на далеко зашедших стадиях входит в обязанности врача-нефролога. Однако, успех превентивных вмешательств напрямую зависит от срока их начала, что делает актуальным выявление заболевание и начала превентивных вмешательств на наиболее ранних, доклинических стадиях, в том числе в группах повышенного риска его развития. Использование врачами широкого спектра специальностей (терапевтами, врачами общей практики, кардиологами, геронтологами, нефрологами, эндокринологами) имеющихся нефропротективных подходов может позволить существенно улучшить прогноз как лиц с риском развития дисфункции почек, так и с уже имеющимся заболеванием. В обзоре приводятся данные о клинической и лабораторной эффективности применения блокаторов ренин-ангиотензиновой системы, а также комбинации блокаторов рецепторов ангиотензина II с дигидропиридиновыми антагонистами кальция. На примере использования комбинации блокатора рецепторов ангиотензина II ирбесартана и амлодипина продемонстрированы возможности нефропротективного вмешательства у пациентов с дисфункцией почек разной степени выраженности.

The current population is characterized by a high prevalence of risk factors for the development of chronic kidney disease: hypertension, diabetes, obesity, metabolic syndrome, physical inactivity, smoking. The development of severe complications and a close connection with potentially fatal cardiovascular disorders make this disease a socially and economically significant problem. Treatment of chronic kidney disease in advanced stages belong to nephrologist duties. However, the success of preventive interventions depends on the time of their onset, which makes it relevant to identify the disease. The use of nephroprotective approaches by physicians of different specialties (general practitioners, cardiologists, gerontologists, nephrologists, endocrinologists) can significantly improve the prognosis of both those at risk of developing renal dysfunction and the existing disease. The review presents data on the clinical and laboratory efficacy of angiotensin-renin blocker use, as well as the combination of angiotensin II receptor blockers with calcium antagonists. Using the combination of the angiotensin II receptor blocker irbesartan and amlodipine as an example, we demonstrated the possibilities of nephroprotective therapy in patients with renal dysfunction.

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The authors declare that there are no conflicts of interest present.