diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/2072-0351-823diaendo-823Research ArticleНефропатияNephropathyОсобенности сахароснижающей терапии у больных сахарным диабетом и хронической болезнью почекGlucose-lowering therapies in patients with diabetes mellitus and chronic kidney diseaseШамхаловаМинара ШамхаловнаShamkhalovaMinara Shamkhalovna

д.м.н., зав. отделением диабетической нефропатии и гемодиализа, ФГБУ Эндокринологический научный центр, Москва

shamkhalova@mail.ruЯрек-МартыноваИвона РенатаYarek-MartynovaIvona Renata

к.м.н., в.н.с. отделения диабетической нефропатии и гемодиализа, ФГБУ Эндокринологический научный центр, Москва

shamkhalova@mail.ruТрубицынаНаталья ПетровнаTrubitcynaNatalya Petrovna

к.м.н., н.с. отделения диабетической нефропатии и гемодиализа, ФГБУ Эндокринологическийнаучный центр, Москва

shamkhalova@mail.ruШестаковаМарина ВладимировнаShestakovaMarina Vladimirovna

член-корр. РАМН, директор Института диабета, ФГБУ Эндокринологический научный центр, Москва

nephro@endocrincentr.ruФГБУ Эндокринологический научный центр, МоскваРоссияEndocrinology Research Centre, MoscowRussian Federation201305112013163Сахарный диабет97102Copyright © Шамхалова М.Ш., Ярек-Мартынова И.Р., Трубицына Н.П., Шестакова М.В., 20132013Шамхалова М.Ш., Ярек-Мартынова И.Р., Трубицына Н.П., Шестакова М.В.Shamkhalova M.S., Yarek-Martynova I.R., Trubitcyna N.P., Shestakova M.V.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/823

Рост популяции больных сахарным диабетом (СД), прежде всего СД 2 типа (СД2), с хронической болезнью почек ? одна из самых актуальных проблем современной медицины. Выживаемость и качество жизни больных диабетом, начиная с ранних стадий диабетической нефропатии и при ее прогрессировании до терминальной стадии, остаются низкими по сравнению с другими нозологическими группами, что свидетельствует о ключевой роли гипергликемии в ускоренном формировании системных метаболических нарушений, характерных для почечной недостаточности. Патология почек накладывает серьезные ограничения на выбор сахароснижающих препаратов и их дозировку при СД. Развитие почечной патологии у больных СД исключает использование ряда препаратов или требует осторожности при применении других с ужесточением гликемического контроля и учетом взаимодействия с препаратами антигипертензивной, гиполипидемической, антиагрегантной, эритропоэзстимулирующей направленности. Решение такой задачи возможно только при творческом, максимально персонифицированном подходе, нацеленном на метаболическую и кардиоваскулярную результативность.

Expansion of diabetic population (predominantly due to type 2 diabetes mellitus) with chronic kidney disease (CKD) comorbidity constitutes one of the major challenges in modern medicine.Throughout the course of diabetes nephropathy development, from its debut to the terminal stage, survival rate and quality of life are lower than those of other categories of patients. This indicates crucial role of hyperglycemia in accelerated metabolic degradation typical of CKD.Renal disease severely narrows the spectrum of available glucose-lowering agents. Concurrent treatment for hypertension and dyslipidemia, as well as anti-platelet therapy and stimulation of erythropoiesis becomes a complex issue. A creative and patient-oriented approach with clear metabolic and cardiovascular goals should be instrumental in its solution.

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