bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.35754/0234-5730-2020-65-4-473-482bloodjour-251Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS OF LITERATUREКлиническое значение нарушений плазменного звена гемостаза и методы их коррекции у больных хроническим гломерулонефритом c нефротическим синдромомClinical impact of plasma haemostasis disorders and their correction in chronic glomerulonephritis with nephrotic syndromehttps://orcid.org/0000-0003-2128-8560ЧеботареваН. В.ChebotarevaN. V.

Чеботарева Наталья Викторовна, доктор медицинских наук, профессор, кафедра внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н. В. Склифосовского

119991, Москва

Natalia V. Chebotareva, Doc. Sci. (Med.), Professor, Department of Internal and Occupational Diseases and Rheumatology

119991, Moscow

natasha_tcheb@mail.ruhttps://orcid.org/0000-0002-6838-0754БернсА. С.BernsA. S.

Бернс Ангелина Сергеевна, аспирант кафедры внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н. В. Склифосовского

119991, Москва

Angelina S. Berns, Postgraduate Student, Department of Internal and Occupational Diseases and Rheumatology

119991, Moscow

89099172603@mail.ruhttps://orcid.org/0000-0002-5923-1837ЛебедеваМ. В.LebedevaM. V.

Лебедева Марина Валерьевна, кандидат медицинских наук, доцент, кафедра внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н. В. Склифосовского

119991, Москва

Marina V. Lebedeva, Cand. Sci. (Med.), Associate Professor, Department of Internal and Occupational Diseases and Rheumatology

119991, Moscow

marinaamica@mail.ruhttps://orcid.org/0000-0002-7232-4640МоисеевС. В.MoiseevS. V.

Моисеев Сергей Валентинович, доктор медицинских наук, профессор, заведующий кафедрой внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н. В. Склифосовского

119991, Москва

Sergey V. Moiseev, Doc. Sci. (Med.), Professor, Head of the Department of Internal and Occupational Diseases and Rheumatology

119991, Moscow

avt420034@gmail.comФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202010122020654473482Copyright © Чеботарева Н.В., Бернс А.С., Лебедева М.В., Моисеев С.В., 20202020Чеботарева Н.В., Бернс А.С., Лебедева М.В., Моисеев С.В.Chebotareva N.V., Berns A.S., Lebedeva M.V., Moiseev S.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/251Введение

Введение. Тромбозы и тромбоэмболии являются частыми осложнениями у больных хроническим гломерулонефритом (ХГН) с нефротическим синдромом (НС), несмотря на применение антикоагулянтной терапии. В связи с этим вопросы оценки риска тромбозов и профилактики тромботических осложнений при НС сохраняют актуальность до настоящего времени.

Цель — представить данные о частоте и локализации тромбоэмболических осложнений у больных ХГН с НС, а также рассмотреть подходы к оценке риска и профилактике этих осложнений.

Основные сведения

Основные сведения. Рассмотрены основные предикторы риска венозных тромбозов у больных с НС, такие как низкая сывороточная концентрация альбумина, высокая плазменная концентрация D-димера, возраст старше 60 лет, гиповолемические состояния. Риск развития артериальных тромбозов определяется общепопуляционными факторами: возрастом, полом, курением, наличием сахарного диабета и артериальной гипертензии. Основной локализацией венозных тромбозов, которые могут протекать бессимптомно, являются глубокие вены нижних конечностей, почечные вены и ветви легочной артерии. Среди морфологических форм ХГН, протекающих с НС, к группе высокого риска относятся мембранозная нефропатия и мембранопролиферативный ХГН. Освещены вопросы оценки риска тромботических осложнений, их профилактики и лечения.

Introduction

Introduction. Thrombosis and thromboembolism are frequent complications in chronic glomerulonephritis (CGN) with nephrotic syndrome (NS), despite the use of anticoagulant therapy. Therefore, the questions of thrombosis risk assessment and thrombotic complication prevention in NS are still relevant.

Aim

Aim. Description of the frequency and localisation of thromboembolic complications in CGN-NS patients and a review of approaches to their risk assessment and prevention.

Main findings

Main findings. The main risk predictors of venous thrombosis in NS are considered, including low serum albumin, high plasma D-dimer, age over 60 and hypovolemic conditions. The risk of arterial thrombosis is determined by general population factors: age, gender, smoking, diabetes mellitus and arterial hypertension. Venous thrombosis may be asymptomatic and mainly occurs in deep lower limb veins, renal veins and branches of pulmonary artery. Among the NS-associated CGN morphotypes of high risk are membranous nephropathy and membranoproliferative CGN. Issues in the thrombotic complication risk assessment, prevention and treatment are highlighted.

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