clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2024-102-5-6-454-467clinmed-866Research ArticleДИСКУССИЯDISCUSSIONРетроспективный анализ результатов ферротерапии у пациентов с хронической сердечной недостаточностью и хронической болезнью почекRetrospective analysis of ferrotherapy methodology in patients with chronic heart failure and chronic kidney diseaseМакароваН. А.MakarovaN. A.

Макарова Надежда Александровна — д-р мед. наук, профессор кафедры пропедевтики внутренних болезней

Челябинск

Nadezhda A. Makarova —Doctor of Medical Sciences, Professor of the Department of Propaedeutics of Internal Diseases

Chelyabinsk

makarova.nadezhdachel@mail.ruФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РоссииРоссияSouth Ural State Medical UniversityRussian Federation2024091120241025-6454467Copyright © Макарова Н.А., 20242024Макарова Н.А.Makarova N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/866

Течение хронических неинфекционных заболеваний часто сопровождается развитием коморбидных состояний. При хронической сердечной недостаточности и хронической болезни почек особое внимание привлекают дефицит железа и анемия. В качестве профилактики и лечения анемии, способствующей прогрессированию структурных изменений в жизненно важных органах, стали широко использоваться внутривенные препараты железа. Однако попытки внедрения высокодозной внутривенной ферротерапии в качестве рутинной стратегии компенсации дефицита железа у пациентов с сердечной недостаточностью с анемией и без анемии вызывают вопросы, которые связаны с поиском ориентиров в диагностике железодефицитных состояний, целей и условий проведения ферротерапии. В статье для обоснования выбора стратегии и тактики ферротерапии у пациентов с сердечной недостаточностью и хронической болезнью почек рассматриваются влияния совокупности противодействующих факторов (воспаления, гипоксии) на примере собственных исследований системы эритрона, его гуморальных регуляторов и обмена железа.

The course of chronic non-infectious diseases is often accompanied by the development of comorbid conditions. In chronic heart failure and chronic kidney disease, special attention is drawn to iron deficiency and anemia. Intravenous iron preparations have become widely used for the prevention and treatment of anemia. Their use contributes to the progression of structural changes in vital organs. However, attempts to implement high-dose intravenous ferrotherapy as a routine strategy for compensating iron deficiency in patients with heart failure, with or without anemia, raise questions related to the search for diagnostic markers of iron deficiency states, goals, and conditions for its use. The article discusses the influences of a combination of opposing factors (inflammation, hypoxia) on the erythron system, its humoral regulators, and iron metabolism based on the author’s own research to justify the choice of strategy and tactics for ferrotherapy in patients with heart failure and chronic kidney disease.

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