B.G. Rgebayev

https://orcid.org/0000-0002-5201-3888

Найдено статей: 2

  • Genetic determinants of tacrolimus metabolism associated with CYP3A5 in kidney transplantation: a literature review (Выпуск № 1, 2025)

    A. Aubakirova, I. Madadov, B. Rgebayev, V. Kumar, M. Doskhanov
    2025-03-31
    4–13
    Аннотация

    Background. Kidney transplantation is the most effective treatment for end-stage chronic kidney disease, improving quality of life and reducing mortality compared with dialysis. The success of transplantation depends on HLA compatibility, immune sensitization, immune status and immunosuppressive therapy. Tacrolimus, a key immunosuppressant, prevents graft rejection by suppressing T-cell activity and is metabolized by CYP3A4 and CYP3A5 enzymes. CYP3A5 gene polymorphisms influence enzyme activity and tacrolimus metabolism.

    Methods. The review analyzed 46 of 141 publications from PubMed, MEDLINE, Embase, Scopus, and Cochrane Library databases that met the inclusion criteria and focused on the role of CYP3A5 gene polymorphisms in tacrolimus metabolism in renal transplant patients.

    Results. CYP3A5 gene polymorphisms significantly affect tacrolimus pharmacokinetics. Carriers of the *1 allele (expressers) demonstrated accelerated metabolism requiring higher doses, while patients with the *3/*3 genotype (non-expressers) exhibited slower metabolism, allowing for reduced doses but increasing the risk of toxicity, including nephrotoxicity. An analysis of 46 publications and randomized studies confirmed that CYP3A5 genotyping enables personalized tacrolimus dosing. For expressers, genotyping facilitated faster achievement of therapeutic concentrations, while for non-expressers, it reduced the risk of toxic effects. However, long-term differences in clinical outcomes between groups with and without genotyping remain statistically insignificant, emphasizing the need for larger-scale studies to validate the efficacy of this approach.

    Conclusion. CYP3A5 polymorphisms play a key role in the personalization of immunosuppressive therapy. Genotyping optimizes tacrolimus dosing and reduces the risk of rejection and toxicity. Integration of pharmacogenetic testing into clinical practice may improve transplantation outcomes.

    Ключевые слова

    tacrolimus, CYP3A5 gene, kidney transplantation, immunosuppression, genotyping

  • Surgical management of renal cell carcinoma with inferior vena cava thrombosis: a clinical case (Выпуск № 3, 2024)

    B.B. Baimakhanov, I.K. Madadov, E.B. Belgibaev, E. S. Nabiev, B.G. Rgebayev, N. T. Saduakas, D. Akhmetov
    2024-09-30
    26–32
    Аннотация

    Kidney cancer with inferior vena cava thrombosis represents a complex condition that requires meticulous surgical treatment. The most common malignant kidney tumor in adults is renal cell carcinoma. The incidence of renal cell carcinoma has increased recently due to the enhanced resolution of imaging techniques. Most cases are discovered incidentally. Renal cell carcinoma's ability to spread to vascular systems without developing metastases is a significant feature. Venous involvement can manifest as a tumor thrombus in the renal vein on the affected side, potentially extending to the right atrium or the inferior vena cava. The risk of having a tumor thrombus in the renal vein or inferior vena cava ranges from 2-10%, with the right side being more frequently affected. The level of tumor thrombus extension can reach the hepatic veins and even the right atrium. This condition thus requires a multidisciplinary approach and a rational surgical strategy, focusing on achieving favorable outcomes in such complex cases.

    Ключевые слова

    renal cell carcinoma, inferior vena cava, thrombus, nephrectomy