Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya31078Research ArticleNEPHROTIC CRISIS — AN URGENT CONDITION IN PATIENTS WITH NEPHROTIC SYNDROMEKozlovskayaL VChair of therapy and occupational diseasesirbo.mma@mail.ruBobkovaI NNephrology Department-ChebotarevaN VNephrology Departmentnatasha_tcheb@mail.ruFominV VChair of therapy and occupational diseasesfomin_vic@mail.ruRoschupkinaS V-I.M. Sechenov Moscow State Medical UniversityResearch Institute of Uronephrology and Human Reproductive Health, I.M. Sechenov First Moscow State Medical UniversityE.M. Tareev clinic of I.M. Sechenov First Moscow State Medical University15062012846687310042020Copyright © 2012, Consilium Medicum2012The lecture considers mechanisms of potassium and water retention underlying nephrotic syndrome, clinical differences between hypo- and hypervolemic variants of nephrotic syndrome, risk factors of nephrotic crisis and its clinical symptoms, current approaches to its treatment.nephrotic syndromenephrotic (hypovolemic) crisisrisk factors of nephrotic crisisclinical manifestations of nephrotic crisistreatment of nephrotic crisisнефротический синдромнефротический (гиповолемический) кризфакторы риска развития нефротического кризаклинические проявления нефротического кризалечение нефротического криза[Тареева И. Е., Полянцева Л. Р. Протеинурия и нефротический синдром. В кн.: Тареева И. Е. (ред.). Нефрология: Руководство для врачей. М.: Медицина; 2000. 124—131.][Козловская Л. В., Фомин В. В. Протеинурия и нефротический синдром. Шилов Е. М. (ред.). Нефрология: Учеб. пособие для послевузовского образования. М.: Гэотар-Медиа; 2007. 147—154.][Hamm L., Batuman V. Edema in the nephrotic syndrome: new aspect of an old enigma. J. Am. Soc. Nephrol. 2003; 14: 3288—3289.][Vande Walle J. G. J., Donckerwolcke R.A. Pathogenesis of edema formation in the nephrotic syndrome. Pediatr. nephrol. 2001; 16: 283—293.][Ichikawa I. et al. Role for intrarenal mechanisms in the impaired salt excretion of experimental nephrotic syndrome. J. Clin. Invest. 1983; 71: 91—103.][Doucet A. et al. Molecular mechanism of edema formation in nephrotic syndrome: therapeutic implications. Pediatr. Nephrol. 2007; 22: 1983—1990.][Soo Wan Kim et al. Pathogenesis of edema in nephrotic syndrome: role of epithelial sodium channel. Nephrology 2007; 12: S8—S10.][Rondon-Berrios H. New insights into the pathophysiology of edema in nephrotic syndrome. Nefrologia 2011; 31 (2): 148—154.][Мухин Н. А., Фомин В. В. Отечный синдром: современное понимание проблемы. Врач 2008; 6: 7—12.][Jespersen B., Eiskjaer H., Mogensen C. E. et al. Reduced natriuretic effect of natriuretuc peptide in nephritic syndrome: a possible role of decreased cyclic guanosin monophosphate. Nephron 1995; 71 (1): 44—53.][Kapur G. et al. Treatment of severe edema in children with nephrotic syndrome with diuretics alone — a prospective study. Clin. J. Am. Soc. Nephrol. 2008; 28: 907—913.][Полянцева Л. Р. Клиника и дифференциальный диагноз нефротического криза. Тер. арх. 1985; 6: 46—49.][Vasudevan A., Mantan M., Bagga A. Management of oedema in nephrotic syndrome. Indian Pediatr. 2004; 17: 787—795.][Charlesworth J. A. et al. Adult nephrotic syndrome: non-specific strategies for treatment. Nephrology 2008; 13: 45—50.]