Аннотация. В статье изучается распространенность депрессии у пациентов с хронической болезнью почек (ХБП) С5, получающих терапию программным гемодиализом (ПГД) и его влияние на качество жизни (КЖ). На базе ООО «Северо-Кавказский Нефрологический Центр» в 2018 г. обследованы 86 пациентов (60 мужчин и 26 женщин) с ХБП С5, получающих лечение ПГД. Средний возраст пациентов составил 55,5±13,9 лет. Уровень депрессии по шкале CES-D, уровень КЖ-по опроснику KDQOL-SF™. Обследованная авторами популяция пациентов ХБП С5, получающих терапию ПГД, характеризуется высокой распространенностью депрессии. Симптомы депрессии негативно воздействуют на КЖ пациентов с ХБП С5 на ПГД. Внедрение использованных нами методик оценки КЖ и уровня депрессии в протокол ведения пациентов с ХБП С5 в диализных центрах позволит мониторить показатели КЖ и симптомов депрессии пациентов для своевременной коррекции их лечения. Полученные нами результаты можно использовать при планировании психологического и психофармакологического сопровождения пациентов на ПГД. Ключевые слова: хроническая болезнь почек, качество жизни, депрессия, программный гемодиализ.

The purpose of the research is to study the features of comorbid status in patients with chronic kidney disease (CKD) Stage 5 on programmed hemodialysis (PHD) and its impact on quality of life (QOL). Methodology: we examined 86 patients (60 men and 26 women) with CKD Stage 5 receiving PHD treatment. The average age of the patients was 55.5±13.9 years. The study protocol included an assessment of the QOL level according to the KDQOL-SF™ questionnaire, the comorbidity index according to M.E. Charlson (CCI), clinical and instrumental studies in accordance with clinical guidelines. Results: the most common causes of CKD Stage 5 in the examined patients were chronic glomerulonephritis and diabetes mellitus (26.7% each), tubulointerstitial renal diseases (23.3%) and polycystic kidney disease (13.3%). High and medium levels of CCI were found in 67.4% of the examined patients. Among the comorbidities, cardiovascular diseases rank first (51.2%). QOL of patients with CKD Stage 5 on PHD was characterized by the lowest scores on the scales of physical functioning and the burden of kidney disease. Correlation analysis revealed that comorbidities in patients with CKD Stage 5 who are on PHD negatively affect their QOL. Conclusion: the obtained results can be used in planning and organizing the provision of medical care to patients with CKD. The introduction of the used QOL and CCI assessment methods in the protocol for the management of patients with CKD Stage 5 in dialysis centers will make it possible to monitor the individual QOL indicators of patients, evaluate the effectiveness of patient treatment and correct it in a timely manner.

Idiopathic pulmonary fibrosis (IPF) is the commonest form of idiopathic interstitial pneumonias with very poor prognosis. Currently, diagnostic and treatment approaches to this disease have been revised. Confirmation of the diagnosis requires careful exclusion of other known causes of interstitial lung diseases and the presence of usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRTC) and/or on lung biopsy. Also, multidisciplinary discussion involving experts with experience in the diagnosis of interstitial lung diseases is recommended. Given recent knowledge on pathogenesis of IPF antifibrotic drugs are recommended for the therapy of this disease. A clinical case that demonstrates the multidisciplinary approach to diagnosis of IPF is reported in this article.