ОЦЕНКА КЛЮЧЕВЫХ ЛАБОРАТОРНЫХ МАРКЕРОВ У ПАЦИЕНТОВ НА ПРОГРАММНОМ ГЕМОДИАЛИЗЕ (обзор литературы)

Аннотация

Обзор посвящен комплексной оценке ключевых лабораторных маркеров у пациентов с терминальной стадией хронической болезни почек (ХБП 5Д), находящихся на программном гемодиализе (ГД). Рассматриваются патогенетическая значимость, клиническая интерпретация и целевые значения ключевых лабораторных параметров: общего анализа крови, креатинина, мочевины, альбумина, электролитов и показателей фосфорно-кальциевого обмена. Актуальность темы обзора обусловлена глобальным ростом распространенности ХБП, ее вкладом в преждевременную смертность и уникальностью лабораторных параметров популяции пациентов на ГД. У этой категории больных радикально изменен гомеостаз, в связи с чем стандартные референсные интервалы лабораторных показателей неприменимы. Вместе с тем лабораторный мониторинг является важнейшим составным звеном терапии, поскольку его результаты напрямую влияют на выживаемость и качество жизни пациентов. Очевидна необходимость комплексной оценки лабораторных данных у пациентов на гемодиализе, она является одним из ключевых требований персонализированной терапии и возможна лишь при интегральном подходе к интерпретации клинических и лабораторных показателей.

Annotation

This review is devoted to the comprehensive assessment of key laboratory markers in patients with end-stage chronic kidney disease stage 5D (CKD G5D) undergoing maintenance hemodialysis (HD). It examines the pathogenetic significance, clinical interpretation, and target values of key laboratory parameters, including complete blood count, creatinine, urea, albumin, electrolytes, and indices of calcium–phosphorus metabolism. The relevance of this review is determined by the global increase in the prevalence of CKD, its contribution to premature mortality, and the unique laboratory profile of the hemodialysis patients. In this category of patients, the metabolic homeostasis is profoundly altered, making standard reference intervals for laboratory tests inapplicable. At the same time, laboratory monitoring is a critical component of therapy, as its results directly affect patient survival and quality of life. The need for a comprehensive assessment of laboratory data in hemodialysis patients is evident; it is one of the key prerequisites for personalized therapy and is feasible only within an integrated approach to the interpretation of clinical and laboratory parameters.
Key words: hemodialysis; chronic kidney disease; laboratory monitoring; review

Об авторах

Список литературы

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