vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2018-15-4-465-482vestim-461Research ArticleОБЗОРЫREVIEWSХирургическое лечение вторичного гиперпаратиреоза у пациентов с хронической болезнью почекSurgical treatment of secondary hyperparathyroidism in patients with chronic kidney diseaseПисаренкоА. М.PisarenkaA. M.

заведующий отделением

Head of the Department

a.pisarenko@tut.byМинский городской клинический онкологический диспансер, МинскMinsk City Clinical Oncology Dispensary, Minsk201814012019154465482Copyright © Писаренко А.М., 20192019Писаренко А.М.Pisarenka A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/461

Предполагается, что повышенная смертность пациентов с хронической болезнью почек при тяжелом вторичном гиперпаратиреозе обусловлена большим количеством сердечно-сосудистых, метаболических, гематологических и иммунологических нарушений, которые вызваны высокими концентрациями уремического токсина паратиреоидного гормона. Для предотвращения прогрессирования вторичного гиперпаратиреоза помимо метаболитов витамина Д дополнительно предлагается применять более активный кальцимиметик – цинакалцет, являющийся агонистом кальций-чувствительного рецептора. Однако при наступлении терминальной стадии почечной недостаточности именно хирургический метод лечения вторичного гиперпаратиреоза является важной составляющей нарушений минерального обмена, так как снижает частоту осложнений и существенно продлевает жизнь пациентов, получающих заместительную почечную терапию.

Surgery of patients with secondary hyperparathyroidism in the era of calcimimetics continues to play an important role in selected patients and achieves an efficient control of hyperparathyroidism. Taken together, the results of literature review suggest a clinically significant beneficial effect of surgical parathyroidectomy to decrease the overall and cardiovascular mortality in patients with secondary hyperparathyroidism due to chronic kidney disease. However, the independent randomized controlled trial comparing surgery with medical therapy to clarify the outcome and to improve the quality of life is in need.

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