КЛИНИКО-ФУНКЦИОНАЛЬНОЕ СОСТОЯНИЯ ПОЧЕК У БОЛЬНЫХ С ОСТРЫМ ЛЕЙКОЗОМ ПОСЛЕ ТРАНСПЛАНТАЦИИ КОСТНОГО МОЗГА
Актуальность. Трансплантация костного мозга (ТКМ) - это фундаментальная терапия при резистентных гематологических заболеваниях высокого риска. По мировым данным ежегодно проводится более 50 000 ТКМ, а пятилетняя выживаемость составляет более 50% для многих пролеченных форм. Недавние исследования показали, что распространенность хронической болезни почек (ХБП) составляет примерно 16,6% у реципиентов ТКМ. Известно, что трансплантация костного мозга связана с несколькими известными побочными эффектами, однако почечные осложнения четко не определены. В развивающихся странах, где ТКМ проводится несколько десятков лет, имеются единичные работы по изучению осложнений нарушений функции почек у больных с острым лейкозом после трансплантации костного мозга. В Республике Казахстан подобного рода исследования не проводились.
В данном обзоре мы попытались сосредоточиться на наиболее изученных и известных почечных нарушений, развивающихся после трансплантации костного мозга.
Целью данного литературного обзора является анализ литературных источников по изучению функционального состояния почек после трансплантации костного мозга.
Стратегия поиска: Проведен поиск научных публикаций в поисковых системах PubMed, eLibrary.ru, Google Scholar. Глубина поиска научной литературы составил 13 лет (2009-2022гг.) Были использованы ключевые слова: трансплантация костного мозга, острый лейкоз, хроническая болезнь почек, острая почечная недостаточность, нефротический синдром, тромботическая микроангиопатия. Критерии включения составили: период 13 лет (2009-2022гг.), публикации на английском русском языках, возраст пациентов старше 18 лет, вид статей – обзорная статья, рандомизированные контролируемые исследования, метаанлиз, систематический обзор, серии клинических случаев, нормативно-правовые документы на английском и русском языках. Критерии исключения: публикации с неясными выводами, повторно встречающиеся публикации, материалы конференций и описание клинических случаев. В результате поиска нами было изучено 133 зарубежных и отечественных публикаций, из них в данный обзор вошли 97 публикаций.
Результаты и выводы: Анализ данных литературы показал, что повреждение почек является частым явлением после трансплантации костного мозга. Повреждение почек различной этиологии часто встречается в первые 100 дней после ТКМ. В дальнейшем у реципиентов ТКМ развивается хроническая болезнь почек с частотой от 7 до 48% и прогрессирует до терминальной стадии почечной недостаточности примерно у 4% пациентов с ХБП.
Айгерим О. Мурзахметова1, https://orcid.org/0000-0002-1487-5487
Индира М. Азимбаева2,
Асель М. Мейрамова1, https://orcid.org/0000-0002-4030-0783
Павел A. Воробьев3, https://orcid.org/0000-0003-2500-1555
Баян А. Айнабекова1, https://orcid.org/0000-0002-5427-3931
1 НАО «Медицинский университет Астана», г. Нур-Султан, Республика Казахстан;
2 Управление здравоохранением Восточно-Казахстанской области,
г. Усть-Каменогорск, Республика Казахстан;
3 Московское городское научное общество терапевтов, Москва, Российская Федерация.
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Мурзахметова А.О., Азимбаева И.М., Мейрамова А.М., Воробьев П.A., Айнабекова Б.А. Клинико-функциональное состояния почек у больных с острым лейкозом после трансплантации костного мозга // Наука и Здравоохранение. 2022. 4(Т.24). С. 165-175. doi 10.34689/SH.2022.24.4.021Похожие публикации:
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