pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2018-28-5-613-621pulmo-1060Research ArticleОБЗОРЫREVIEWКардиоренальные взаимоотношения у больных хронической обструктивной болезнью легких: роль витамина DCardiorenal relationships and a role of vitamin D in patients with chronic obstructive pulmonary diseaseБолотоваЕ. В.BolotovaE. V.

350063, Краснодар, ул. М.Седина, 4

Elena V. Bolotova, Doctor of Medicine, Professor, Department of Therapy No.1, Faculty of Postgraduate Physician Training

ul. Sedina 4, Krasnodar, 350063

bolotowa_e@mail.ruЯвлянскаяВ. В.YavlyanskayaV. V.

Являнская Валерия Валерьевна – заочный аспирант кафедры терапии № 1 факультета повышения квалификации и профессиональной переподготовки специалистов Федерального государственного бюджетного образовательного учреждения высшего образования «Кубанский государственный медицинский университет» Министерства здравоохранения Российской Федерации; врач-эндокринолог, терапевт Государственного бюджетного учреждения здравоохранения «Краевая клиническая больница № 2» Министерства здравоохранения Краснодарского края

350063, Краснодар, ул. М.Седина, 4, 

350012, Краснодар, ул. Красных партизан, 6 / 2

Valeriya V. Yavlyanskaya, Postgraduate Student, Department of Therapy No.1, Faculty of Postgraduate Physician Training, Kuban State Medical University, Healthcare Ministry of Russia; an endocrinologist and a therapeutist at Krasnodar Territorial Teaching Hospital No.2, Healthcare Ministry of Krasnodar krai

ul. Sedina 4, Krasnodar, 350063, 

ul. Krasnykh partisan 6/2, Krasnodar, 350012

yavliansckaiavaleria@yandex.ruДудниковаА. В.DudnikovaA. V.

Дудникова Анна Валерьевна – заочный аспирант кафедры терапии № 1 факультета повышения квалификации и профессиональной переподготовки специалистов Федерального государственного бюджетного образовательного учреждения высшего образования «Кубанский государственный медицинский университет» Министерства здравоохранения Российской Федерации, врач-терапевт Государственного бюджетного учреждения здравоохранения «Краевая клиническая больница № 2» Министерства здравоохранения Краснодарского края

350063, Краснодар, ул. М.Седина, 4, 

350012, Краснодар, ул. Красных партизан, 6 / 2

Anna V. Dudnikova, Postgraduate Student, Department of Therapy No.1, Faculty of Postgraduate Physician Training, Kuban State Medical University, Healthcare Ministry of Russia; a therapeutist at Krasnodar Territorial Teaching Hospital No.2, Healthcare Ministry of Krasnodar krai

ul. Sedina 4, Krasnodar, 350063, 

ul. Krasnykh partisan 6/2, Krasnodar, 350012

avdudnikova@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Кубанский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияKuban State Medical University, Healthcare Ministry of RussiaRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Кубанский государственный медицинский университет» Министерства здравоохранения Российской Федерации; Государственное бюджетное учреждение здравоохранения «Краевая клиническая больница № 2» Министерства здравоохранения Краснодарского краяРоссияKuban State Medical University, Healthcare Ministry of Russia; Krasnodar Territorial Teaching Hospital No.2, Healthcare Ministry of Krasnodar kraiRussian Federation201824122018285613621Copyright © Болотова Е.В., Являнская В.В., Дудникова А.В., 20182018Болотова Е.В., Являнская В.В., Дудникова А.В.Bolotova E.V., Yavlyanskaya V.V., Dudnikova A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1060

В обзоре обсуждаются особенности кардиоренальных взаимоотношений у больных хронической обструктивной болезнью легких (ХОБЛ). Патофизиология кардиоренального синдрома (КРС) до настоящего времени до конца не изучена, однако имеется предположение, что она представляет собой сложное сочетание активации нейрогуморальной системы, эндотелиальной дисфункции, протеинурии, окислительного стресса, уремических токсинов и других факторов. В условиях снижения бронхиальной проводимости, развивающейся при ХОБЛ, эти патофизиологические механизмы приобретают еще большую значимость. Ввиду сложности формирования КРС и высокой смертности данное явление стало серьезным бременем для современного общества. Несмотря на множество работ последних лет, посвященных терапии КРС, в которых рассматриваются такие стратегии лечения, как коррекция гемодинамических расстройств и воздействие на нейрогуморальные факторы, в настоящий момент требуется дальнейшее изучение терапевтических подходов. В обзоре также рассматривается возможная роль легких как компонента кардиоренопульмонального синдрома. Описаны эффекты витамина D в отношении основных констант КРС и его влияние на наиболее значимые составляющие легочной патологии в составе ХОБЛ. Современные клинические и экспериментальные данные позволяют считать витамин D не только маркером течения КРС, но и терапевтической мишенью в лечении больных ХОБЛ.

 

Cardiorenal relationships in patients with chronic obstructive pulmonary disease (COPD) are discussed in this review. Pathophysiology of cardiorenal syndrome is not fully understood, but supposed to be a complex condition resulted from neurohumoral activation, endothelial dysfunction, proteinuria, oxidative stress, uremia, and other factors. The airflow limitation in COPD could enhance those mechanisms. Recent studies discussed such therapeutic strategies as therapy of haemodymanic or neurohumoral abnormalities, but therapeutic approaches in this disease need further investigations. The lungs could play a role as a part of the cardiorenopulmonary syndrome. Effects of vitamin D on the main parameters of the cardiorenal syndrome and on COPD course have been published. Recent clinical and experimental findings consider vitamin D not only as a marker of the cardiorenal syndrome, but also as a therapeutic target in COPD.

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