problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl12686problendo-12686Research ArticleНарушения углеводного обменаCarbohidrates metabolism disturbanciesПодготовка пациента с сахарным диабетом 1 типа на заместительной почечной терапии диализом к трансплантации почкиPreparation of the dialysis patient with type 1 diabetes mellitus for kidney transplantationhttps://orcid.org/0000-0003-2257-3224МартыновС. А.MartynovS. A.

Мартынов Сергей Андреевич - доктор медицинских наук.117036, Москва, ул. Дм. Ульянова, д. 11.eLibrary SPIN: 6231-2450

Sergey A. Martynov - MD, PhD.11 Dm Ulyanova str., 117036, Moscow.eLibrary SPIN: 6231-2450

smartynov@inbox.ruhttps://orcid.org/0000-0002-0296-4933СеверинаА. С.SeverinaA. S.

Северина Анастасия Сергеевна - кандидат медицинских наук, ведущий научный сотрудник.117036, Москва, ул. Дм. Ульянова, д. 11.eLibrary SPIN: 3182-9510

Anastasia S. Severina - MD, PhD, leading research associate.11 Dm Ulyanova str., 117036, Moscow.eLibrary SPIN: 3182-9510

ansev1@mail.ruhttps://orcid.org/0000-0001-6783-4200ЛаринаИ. И.LarinaI. I.

Ларина Ирина Игоревна - научный сотрудник.117036, Москва, ул. Дм. Ульянова, д. 11.eLibrary SPIN: 1220-6080

Irina I. Larina - MD, research associate.11 Dm Ulyanova str., 117036, Moscow.eLibrary SPIN: 1220-6080

rina.larina1993@mail.ruhttps://orcid.org/0000-0002-3433-0142ШамхаловаМ. Ш.ShamhalovaM. S.

Шамхалова Минара Шамхаловна - доктор медицинских наук.117036, Москва, ул. Дм. Ульянова, д. 11.eLibrary SPIN: 4942-5481

Minara S. Shamhalova - MD, PhD.11 Dm Ulyanova str., 117036, Moscow.eLibrary SPIN: 4942-5481

shamkhalova@mail.ruhttps://orcid.org/0000-0001-7358-3364АрзумановС. В.ArzumanovS. V.

Арзуманов Сергей Викторович - доктор медицинских наук.Москва.eLibrary SPIN: 8317-3723

Sergey V Arzumanov - MD, PhD.Moscow.eLibrary SPIN: 8317-3723

kidneytranspl@gmail.comhttps://orcid.org/0000-0001-9019-9567ПинчукА. В.PinchukA. V.

Пинчук Алексей Валерьевич - доктор медицинских наук.Москва.eLibrary SPIN: 8875-2456

Aleksey V. Pinchuk - MD, PhD.Moscow.eLibrary SPIN: 8875-2456

avpin@rambler.ruhttps://orcid.org/0000-0002-5057-127XШестаковаМ. В.ShestakovaM. V.

Шестакова Марина Владимировна - доктор медицинских наук, профессор, академик РАН.117036, Москва, ул. Дм. Ульянова, д. 11.eLibrary SPIN: 7584-7015

Marina V. Shestakova - MD, PhD, Professor.11 Dm Ulyanova str., 117036, Moscow.eLibrary SPIN: 7584-7015

nephro@endocrincentr.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian FederationНаучно-исследовательский институт урологии и интервенционной радиологии им. Н.А. Лопаткина — филиал ­Национального медицинского исследовательского центра радиологииРоссияN.A. Lopatkin Research Institute of Urology and Interventional Radiology — branch of the National Medical Radiological Research CentreRussian FederationНаучно-исследовательский институт скорой помощи им. Н.В. СклифосовскогоРоссияSklifosovsky Research Institute for Emergency MedicineRussian Federation2020301220206661830Copyright © Мартынов С.А., Северина А.С., Ларина И.И., Шамхалова М.Ш., Арзуманов С.В., Пинчук А.В., Шестакова М.В., 20202020Мартынов С.А., Северина А.С., Ларина И.И., Шамхалова М.Ш., Арзуманов С.В., Пинчук А.В., Шестакова М.В.Martynov S.A., Severina A.S., Larina I.I., Shamhalova M.S., Arzumanov S.V., Pinchuk A.V., Shestakova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/12686

Трансплантация почки (ТП) считается уникальным методом заместительной почечной терапии, позволяющим пациентам с сахарным диабетом 1 типа (СД1) с диабетической нефропатией на терминальной стадии почечной недостаточности, находящимся на лечении программным диализом (перитонеальный диализ и гемодиализ), повысить качество жизни и ее продолжительность. В настоящее время создание и внедрение инновационных технологий по управлению диабетом и современных иммуносупрессантов позволяют достигать лучших результатов реабилитации пациента с СД1 после пересадки почки, особенно в короткие сроки после начала диализной терапии. Для снижения ранних и поздних осложнений после ТП важнейшее значение имеет предтрансплантационное обследование пациента с СД1 перед включением его в лист ожидания. Подготовка к пересадке почки охватывает такие мероприятия, как эффективный контроль гликемии, проведение адекватной диализной терапии, диагностика других осложнений диабета и различных сопутствующих заболеваний, особенно сердечно-сосудистой системы, тяжесть которых является определяющим фактором в принятии решения о перспективе ТП. Кроме того, выявление и лечение любого инфекционного процесса, своевременная вакцинопрофилактика, тщательный онкопоиск представляют основу программы подготовки пациента к пересадке почки, обеспечивающей наилучшую выживаемость почечного трансплантата и реципиента.

Kidney transplantation is unique method of renal replacement therapy, allowing to improve quality and duration of life for patients with diabetes mellitus type 1 (DM1) and end-stage renal disease (ESRD) on dialysis therapy. Recently using of innovation technologies for diabetes management and modern immunosuppression enable achieving better results of posttransplant rehabilitation for patients with DM1, especially if kidney transplantation is performed early after initiation of dialysis. Detailed examination of patient with DM1 before potential kidney transplantation is very important to reduce of early and late postoperative complications. Kidney transplantation preparation includes effective glycemic control, adequate dialysis therapy, treatment of diabetes and ESRD complications and concomitant conditions, especially cardiovascular diseases, accounting for kidney transplantation perspective. Furthermore, diagnostics and treatment of any infectious process, timely vaccination, cancer screening are basic approaches of kidney transplantation preparation program, providing the best survival rate of kidney graft and patient.

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