Уремические токсины микробного происхождения: роль в патогенезе коморбидной патологии у пациентов с хронической болезнью почек

Цель публикации. Проанализировать значение уремических токсинов микробного происхождения (УТМП) в патогенезе коморбидной патологии у пациентов с хронической болезнью почек (ХБП).

Основные положения. Повышенная экскреция продуктов азотистого обмена в кишечник при ХБП ассоциирована с уремическим дисбиозом; изменениями метаболической активности микробиоты и синдромом повышенной эпителиальной проницаемости кишечника; которые во многом обусловливают накопление во внутренних средах организма УТМП: индоксил сульфата; р-крезил сульфата; триметиламин-N-оксида и др. Результаты исследований последних лет позволяют рассматривать эти соединения в качестве самостоятельного фактора риска неблагоприятных исходов у лиц с ХБП вследствие прогрессирования дисфункции почек до терминальной стадии; а также частых сердечно-сосудистых; неврологических; минерально-костных; алиментарных и других осложнений.

Выводы. УТМП являются одними из ключевых модуляторов перекрестной патогенетической взаимосвязи между кишечником и почками. Воздействие на кишечную микробиоту можно считать перспективной стратегией предупреждения осложнений; связанных с уремией.

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