I.K. Madadov

https://orcid.org/0000-0003-2241-8603

Articles found: 3

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

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

    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.

    Keywords

    tacrolimus, CYP3A5 gene, kidney transplantation, immunosuppression, genotyping

  • Surgical management of renal cell carcinoma with inferior vena cava thrombosis: a clinical case (Issue № 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
    Abstract

    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.

    Keywords

    renal cell carcinoma, inferior vena cava, thrombus, nephrectomy

  • KIDNEY TRANSPLANTATION FROM LIVING DONOR WITH RENAL MASS: CLINICAL CASE (Issue № 2, 2024)

    B.B. Baimakhanov, I.K. Madadov, E.B. Belgibaev, E.S. Nabiev, N.T. Saduakas
    2024-06-28
    25–31
    Abstract

    Introduction. Renal transplantation is the best treatment option for end-stage renal disease, but organ demand continues to overweight organ supply. The transplantation of kidneys from donors with small renal masses represent a potential avenue to expand the donor pool. We represent the clinical case of kidney transplantation from living related donor with small renal mass and performed literature review of results of these cases.

    Methods. Саse presentation of kidney transplantation from living related donor with incidental finding of small renal mass. Mass was excised and subsequently kidney was engrafted successfully. Up to date both patients are under follow up during 8 months and any signs of recurrence were seen.

    Results. Donor kidney was procuredby laparosopic hand-assissted technique. Intraoperatively small renal mass was encountered whereas during preop evaluation renal cyst was diagnosed. Renal mass was excised fully and defect was closed with interruptive suture. Histological evaluation has revealed highly differentiated renal cell carcinoma. Postoperative period was uneventful. Patient was discharged with good graft function.

    Conclusion. Careful use of kidneys from donors with single renal masses is feasible and safe, with an overall recurrence rate of less than 1.5%. The use of such kidneys could help alleviate the organ shortage crisis.

    Keywords

    Renal Mass, Transplantation