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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vedomostiregmed</journal-id><journal-title-group><journal-title xml:lang="ru">Регуляторные исследования и экспертиза лекарственных средств</journal-title><trans-title-group xml:lang="en"><trans-title>Regulatory Research and Medicine Evaluation</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3034-3062</issn><issn pub-type="epub">3034-3453</issn><publisher><publisher-name>Federal State Budgetary Institution ‘Scientific Centre for Expert Evaluation of Medicinal Products’ of the Ministry of Health of the Russian Federation (FSBI ‘SCEEMP’)</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30895/1991-2919-2022-392</article-id><article-id custom-type="elpub" pub-id-type="custom">vedomostiregmed-392</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ВОПРОСЫ ПАТОГЕНЕЗА ЗАБОЛЕВАНИЙ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PATHOGENESIS ISSUES</subject></subj-group></article-categories><title-group><article-title>Особенности развития токсической нефропатии при проведении антибиотикотерапии</article-title><trans-title-group xml:lang="en"><trans-title>Features of toxic nephropathy development during antibiotic therapy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0802-4229</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Казаков</surname><given-names>Р. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Kazakov</surname><given-names>R. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Казаков Руслан Евгеньевич, канд. биол. наук</p><p>Петровский б-р, д. 8, стр. 2, Москва, 127051, Российская Федерация</p></bio><bio xml:lang="en"><p>Ruslan E. Kazakov, Cand. Sci. (Biol.)</p><p>8/2 Petrovsky Blvd, Moscow 127051, Russian Federation</p></bio><email xlink:type="simple">kazakov@expmed.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7322-3323</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Городецкая</surname><given-names>Г. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Gorodetskaya</surname><given-names>G. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Городецкая Галина Ивановна</p><p>Петровский б-р, д. 8, стр. 2, Москва, 127051, Российская Федерация</p><p>Трубецкая ул., д. 8, стр. 2, Москва, 119991, Российская Федерация</p></bio><bio xml:lang="en"><p>Galina I. Gorodetskaya</p><p>8/2 Petrovsky Blvd, Moscow 127051, Russian Federation</p><p>8/2 Trubetskaya St., Moscow 119991, Russian Federation</p></bio><email xlink:type="simple">gorodetskaya@expmed.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8872-967X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Арчвадзе</surname><given-names>Р. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Archvadze</surname><given-names>R. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Арчвадзе Регина Владимировна</p><p>Яузская ул., д. 11, Москва, 109240, Российская Федерация</p></bio><bio xml:lang="en"><p>Regina V. Archvadze</p><p>11 Yauzskaya St., Moscow 109240, Russian Federation</p></bio><email xlink:type="simple">Rg3@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5975-4072</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Завтоньев</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zavtonev</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Завтоньев Александр Валентинович</p><p>Яузская ул., д. 11, Москва, 109240, Российская Федерация</p></bio><bio xml:lang="en"><p>Alexander V. Zavtonev</p><p>11 Yauzskaya St., Moscow 109240, Russian Federation</p></bio><email xlink:type="simple">monky_92@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1691-8591</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Данилов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Danilov</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Данилов Александр Владимирович</p><p>Яузская ул., д. 11, Москва, 109240, Российская Федерация</p></bio><bio xml:lang="en"><p>Alexander V. Danilov</p><p>11 Yauzskaya St., Moscow 109240, Russian Federation</p></bio><email xlink:type="simple">dr_dav@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5477-4920</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Фетлам</surname><given-names>Д. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Fetlam</surname><given-names>D. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Фетлам Дмитрий Леонидович</p><p>Яузская ул., д. 11, Москва, 109240, Российская Федерация</p></bio><bio xml:lang="en"><p>Dmitry L. Fetlam</p><p>11 Yauzskaya St., Moscow 109240, Russian Federation</p></bio><email xlink:type="simple">dmfetlam@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9854-9904</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ишалев</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Ishalev</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ишалев Дмитрий Алексеевич</p><p>Яузская ул., д. 11, Москва, 109240, Российская Федерация</p></bio><bio xml:lang="en"><p>Dmitry A. Ishalev</p><p>11 Yauzskaya St., Moscow 109240, Russian Federation</p></bio><email xlink:type="simple">DmitriyIshalyov11@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2036-7403</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бердникова</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Berdnikova</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бердникова Надежда Георгиевна, канд. мед. наук</p><p>Трубецкая ул., д. 8, стр. 2, Москва, 119991, Российская Федерация</p><p>Яузская ул., д. 11, Москва, 109240, Российская Федерация</p></bio><bio xml:lang="en"><p>Nadezhda G. Berdnikova, Cand. Sci. (Med.)</p><p>8/2 Trubetskaya St., Moscow 119991, Russian Federation</p><p>11 Yauzskaya St., Moscow 109240, Russian Federation</p></bio><email xlink:type="simple">berdnad@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1972-4386</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Демченкова</surname><given-names>Е. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Demchenkova</surname><given-names>E. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Демченкова Елена Юрьевна, канд. фарм. наук</p><p>Петровский б-р, д. 8, стр. 2, Москва, 127051, Российская Федерация</p></bio><bio xml:lang="en"><p>Elena Yu. Demchenkova, Cand. Sci. (Pharm.)</p><p>8/2 Petrovsky Blvd, Moscow 127051, Russian Federation</p></bio><email xlink:type="simple">demchenkova@expmed.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific Centre for Expert Evaluation of Medicinal Products</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской Федерации; Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет им. И.М. Сеченова» Министерства здравоохранения</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific Centre for Expert Evaluation of Medicinal Products; I.M. Sechenov First Moscow State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Государственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница имени И.В. Давыдовского Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.V. Davydovsky City Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Федеральное государственное автономное образовательное учреждение высшего образования «Первый Московский государственный медицинский университет им. И.М. Сеченова» Министерства здравоохранения; Государственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница имени И.В. Давыдовского Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University; I.V. Davydovsky City Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>01</day><month>08</month><year>2022</year></pub-date><volume>13</volume><issue>4</issue><fpage>531</fpage><lpage>539</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Казаков Р.Е., Городецкая Г.И., Арчвадзе Р.В., Завтоньев А.В., Данилов А.В., Фетлам Д.Л., Ишалев Д.А., Бердникова Н.Г., Демченкова Е.Ю., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Казаков Р.Е., Городецкая Г.И., Арчвадзе Р.В., Завтоньев А.В., Данилов А.В., Фетлам Д.Л., Ишалев Д.А., Бердникова Н.Г., Демченкова Е.Ю.</copyright-holder><copyright-holder xml:lang="en">Kazakov R.E., Gorodetskaya G.I., Archvadze R.V., Zavtonev A.V., Danilov A.V., Fetlam D.L., Ishalev D.A., Berdnikova N.G., Demchenkova E.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.vedomostincesmp.ru/jour/article/view/392">https://www.vedomostincesmp.ru/jour/article/view/392</self-uri><abstract><sec><title>Актуальность</title><p>Актуальность. Антибактериальные препараты могут оказывать нефротоксическое действие, поскольку препараты этой группы преимущественно элиминируются почками.</p></sec><sec><title>Цель</title><p>Цель. Анализ данных литературы о механизмах, факторах риска и особенностях развития токсической нефропатии при проведении антибиотикотерапии.</p></sec><sec><title>Обсуждение</title><p>Обсуждение. Рассмотрены механизмы развития острого интерстициального нефрита, острого некроза канальцев, отложения кристаллов внутри канальцев, проксимальной или дистальной тубулопатии с аномалиями расходования электролитов на фоне применения антибиотиков. Показано, что нефротоксичность наиболее часто ассоциирована с применением аминогликозидных, бета-лактамных антибактериальных средств, ванкомицина. Проанализирована зависимость нефротоксичности от липофильности антибактериальных препаратов и межлекарственного взаимодействия. Определено, что основными факторами риска развития нефропатии являются пожилой возраст, мужской пол, негроидная раса, гиповолемия, артериальная гипотензия, прием ингибиторов ангиотензинпревращающего фермента, блокаторов рецепторов ангиотензина II, нестероидных противовоспалительных препаратов или их комбинации, индивидуальные генетические особенности. Отмечена связь нефротоксичности и генетических особенностей систем метаболизма и выведения антибактериальных средств: изоферментов цитохрома P450, Р-гликопротеина, белков семейства множественной лекарственной резистентности MRP (multidrug resistance-associated protein) и MATE (multidrug and toxin extrusion protein), белка резистентности рака молочной железы BCRP (breast cancer resistance protein). Тяжелая генерализованная инфекция изменяет фармакокинетические параметры антибактериальных лекарственных средств, что следует учитывать при назначении гидрофильных антибиотиков, которые выводятся путем канальцевой секреции и реабсорбируются в почечных канальцах.</p></sec><sec><title>Выводы</title><p>Выводы. Показано, что коррекция дозирования антибактериальных лекарственных препаратов на основе результатов терапевтического лекарственного мониторинга в совокупности с контролем функции почек является эффективным методом повышения безопасности антибиотикотерапии.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Scientist relevance</title><p>Scientist relevance. Antibacterials can have nephrotoxic effects because medicinal products of this class are primarily excreted by the kidneys.</p></sec><sec><title>Aim</title><p>Aim. The study aimed to analyse literature data on the mechanisms, risk factors and specific features of toxic nephropathy development during antibiotic therapy.</p></sec><sec><title>Discussion</title><p>Discussion. The article considers mechanisms of development of acute interstitial nephritis, acute tubular necrosis, crystal deposits in the tubules, proximal or distal tubulopathy with electrolyte abnormalities during the use of antibiotics. Nephrotoxicity was shown to be most often associated with the use of aminoglycosides, beta-lactams, and vancomycin. The authors analysed the dependence of nephrotoxicity on antibacterial agent lipophilicity and drug–drug interactions. The main risk factors for developing nephropathy are older age; male sex; black race; hypovolaemia; arterial hypotension; angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, non-steroidal anti-inflammatory drugs or their combinations; and individual genetic characteristics. Nephrotoxicity is associated with genetic characteristics of the systems responsible for metabolism and excretion of antibacterial products: cytochrome P450 isoenzymes, P-glycoprotein, multidrug resistance protein (MRP), multidrug and toxin extrusion (MATE), breast cancer resistance protein (BCRP), and organic anion transporters. Severe generalised infections change pharmacokinetic parameters of antibacterial products. This should be taken into account when prescribing the hydrophilic antibiotics that are excreted by tubular secretion and reabsorbed in the renal tubules.</p></sec><sec><title>Conclusions</title><p>Conclusions. The study demonstrated the effectiveness of the method comprising a combination of dose adjustment based on therapeutic drug monitoring results and renal function monitoring for improving the safety of antibiotic therapy.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>оксическая нефропатия</kwd><kwd>острый интерстициальный нефрит</kwd><kwd>острый некроз канальцев</kwd><kwd>нежелательные реакции</kwd><kwd>антибиотики</kwd><kwd>безопасность фармакотерапии</kwd></kwd-group><kwd-group xml:lang="en"><kwd>toxic nephropathy</kwd><kwd>acute interstitial nephritis</kwd><kwd>acute tubular necrosis</kwd><kwd>adverse drug reactions</kwd><kwd>antibiotics</kwd><kwd>safety of pharmacotherapy</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена в рамках государственного задания ФГБУ «НЦЭСМП» Минздрава России № 056-00001-22-00 на проведение прикладных научных исследований (номер государственного учета НИР 121022400082-4).</funding-statement><funding-statement xml:lang="en">The study reported in this publication was carried out as part of a publicly funded research project № 056-00001-22-00 and was supported by the Scientific Centre for Expert Evaluation of Medicinal Products (R&amp;D public accounting No. 121022400082-4).</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Rolland AL, Garnier AS, Meunier K, Drablier G, Briet M. 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