Хирургическое лечение вторичного гиперпаратиреоза у пациентов с хронической болезнью почек
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.
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