diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12228diaendo-12228Research ArticleОбзорыReviewДиабетическая нефропатия у беременных с сахарным диабетом 1 типа, современный взгляд на проблемуDiabetic nephropathy in type 1 diabetes and pregnancy. Modern view of the problemhttps://orcid.org/0000-0002-5225-6054ШиловаЕкатерина СергеевнаShilovaEkaterina S.

eLibrary SPIN: 9703-5970

199034 Санкт-Петербург, Менделеевская линия, д. 3

eLibrary SPIN: 9703-5970

3, Mendeleyevskaya Line, 199034 St. Petersburg

katia.shilova@gmail.comhttps://orcid.org/0000-0003-0835-6741БоровикНаталья ВикторовнаBorovikNatalya V.

Кандидат медицинских наук, eLibrary SPIN: 9010-7276.

Санкт-Петербург

MD, PhD, eLibrary SPIN: 9010-7276.

St. Petersburg

borovik1970@yandex.ruhttps://orcid.org/0000-0002-6551-4147ЯрмолинскаяМария ИгоревнаYarmolinskayaMaria I.

Доктор медицинских наук, профессор, eLibrary SPIN: 3686-3605

Санкт-Петербург

MD, PhD, Professor, eLibrary SPIN: 3686-3605

St. Petersburg

m.yarmolinskaya@gmail.comНаучно-исследовательский институт акушерства, гинекологии и репродуктологии им. Д.О. Отта; Национальный медицинский исследовательский центр им. В.А. АлмазоваРоссияThe Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; Almazov National Medical Research CenterRussian FederationНаучно-исследовательский институт акушерства, гинекологии и репродуктологии им. Д.О. ОттаРоссияThe Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. OttRussian FederationНаучно-исследовательский институт акушерства, гинекологии и репродуктологии им. Д.О. Отта; Северо-Западный государственный медицинский университет им. И.И. МечниковаРоссияThe Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; North-Western State Medical University named after I.I. MechnikovRussian Federation202002122020234340348Copyright © Шилова Е.С., Боровик Н.В., Ярмолинская М.И., 20202020Шилова Е.С., Боровик Н.В., Ярмолинская М.И.Shilova E.S., Borovik N.V., Yarmolinskaya M.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/12228

Диабетическая нефропатия (ДН) - специфическое поражение почек при сахарном диабете (СД), которое относительно часто встречается у беременных с прегестационным СД (5,9-26%) и является одним из основных факторов, препятствующих благоприятному течению беременности у этой группы женщин. Выраженная ДН увеличивает риски неблагоприятных исходов беременности как для матери, так и для плода, способствуя прогрессированию хронической болезни почек (ХБП), развитию преэклампсии, большей частоте преждевременных родов, оперативного родоразрешения, повышению перинатальной смертности и неонатальной заболеваемости. В то же время в мире продолжает накапливаться опыт относительно благополучных исходов беременности у женщин с тяжелой ХБП.

В данном обзоре систематизируется мировой и российский опыт планирования и ведения беременности у женщин с СД 1 типа и ДН разной степени выраженности. Обсуждаются значение нефропротективной терапии на преграви-дарном этапе, достижения и поддержания целевых значений артериального давления и гликемии, необходимость наблюдения междисциплинарной командой специалистов для улучшения течения беременности и исхода родов у данной категории больных.

Diabetic nephropathy (DN) is specific kidney damage in patients with diabetes mellitus. DN develops relatively often in pregestational diabetes patients (5,9-26%) and stills one of the main limitations for successful pregnancy in this patients’ group. Advanced DN increases risks of poor pregnancy outcomes for women and fetuses including chronic kidney disease (CKD) progression, high rate of preeclampsia, preterm deliveries, Cesarean sections, perinatal mortality and neonatal morbidity. At the same time there are more and more successful pregnancies with advanced DN in the wold.

In our paper we systematize global experience of planning and management pregnancies with type 1 diabetes and DN in different stages of renal impairment. We discuss role of nephroprotective therapy in preconception care, achievement and maintaining blood pressure goals, multidisciplinary team care for improvement pregnancy outcomes in type 1 diabetic women with DN.

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