Keyword: Renal Function

ABSTRACT: Introduction: Kidney transplantation has been actively developing in Kazakhstan, data on outcomes remain limited. This study aimed to evaluate recipient characteristics, patient survival, causes of ESKD, and renal graft function after KT.
Methods: We retrospectively analyzed 37 consecutive kidney transplant recipients who underwent KT between January 2020 and July 2025. Body mass index (BMI), etiology of ESKD, donor type, pre-transplant hemodialysis, mortality, and renal graft function were evaluated. Renal graft function was assessed using serial serum creatinine measurements during follow-up. Some recipients were lost to follow-up, which limited assessment of long-term graft function in these patients.
Results: In the available follow-up data, renal function was generally satisfactory and remained stable in most recipients with observations. Graft survival was 86.5%, with graft loss documented in five recipients: three surviving recipients experienced rejection-associated graft loss, and two patients died following rejection.
Among the five deaths, two were associated with confirmed COVID-19 infection, one was attributed to cerebral infarction caused by cerebral arterial thrombosis, and two were related to graft rejection. Among the three recipients with rejection-related complications, all experienced adverse effects associated with immunosuppressive therapy, including significant infectious complications.
Discussion: An important consideration is that the study period overlapped with the COVID-19 pandemic. Registry data showed substantially increased infection-related mortality among kidney transplant recipients receiving chronic immunosuppression during 2020, with infection and COVID-19 accounting for a major proportion of excess deaths. Therefore, mortality and survival outcomes should be interpreted in the context of the pandemic, limiting direct comparison with pre-COVID-19 cohorts.
Conclusion: Kidney transplantation at our center demonstrated favorable medium-term outcomes, with improvement in renal function and satisfactory outcomes in most recipients. Overall patient survival was 86.5%, and graft survival was also 86.5%. Continued monitoring of immunosuppression-therapy, complications, and long-term follow-up is important for improving patient and graft outcomes.

ABSTRACT: Background: Iron deficiency anemia is common in patients with chronic kidney disease (CKD) and is associated with adverse clinical outcomes. Ferric carboxymaltose (FCM) is an effective and well-tolerated treatment for iron deficiency anemia in CKD. However, its potential effects on renal function remain insufficiently understood. This study aimed to evaluate changes in renal function following FCM administration in patients with CKD stages 3–4 and to assess whether these changes were associated with the administered dose.
Methods: This prospective study included patients with CKD stages 3–4, anemia, and iron deficiency (serum ferritin <100 μg/L or <200 μg/L with transferrin saturation <20%) who received intravenous FCM (Fercari) and were followed for 24 weeks. Patients were stratified according to the administered dose: 500 mg or 1000 mg. Clinical and laboratory parameters were assessed at baseline and after 24 weeks. Renal function was evaluated using estimated glomerular filtration rate (eGFR) calculated by the CKD-EPI equation.
Results: A total of 56 patients were included; mean age was 64.3 ± 6.7 years, and 25 (44.6%) were men. Diabetes mellitus, chronic heart failure, and arterial hypertension were present in 34 (60.7%), 31 (55.3%), and 45 (80.3%) patients, respectively. CKD stage 3 was present in 20 (35.7%) patients and stage 4 in 36 (64.3%). Thirty-two patients (57.1%) received 1000 mg FCM. Baseline mean hemoglobin was 98.3 ± 4.23 g/L and mean eGFR was 39.18 ± 15.14 mL/min/1.73 m². After 24 weeks, hemoglobin increased by 12.3 ± 1.51 g/L in the overall cohort (P=0.001), with increases of 15.6 ± 3.71 g/L in the 1000 mg group and 8.8 ± 1.5 g/L in the 500 mg group (both P=0.001). Mean eGFR increased by 5.86 ± 2.13 mL/min/1.73 m² in the overall cohort (P=0.042). In the 1000 mg group, eGFR increased by 6.64 ± 2.55 mL/min/1.73 m² (P=0.049), whereas no statistically significant change was observed in the 500 mg group.
Conclusions: FCM effectively improved hemoglobin levels in patients with CKD stages 3–4 and iron deficiency anemia. Treatment with 1000 mg FCM was associated with a modest improvement in eGFR over 24 weeks, whereas no significant change was observed with 500 mg. These findings suggest a possible dose-related association between FCM treatment and renal function; however, controlled randomized studies are required to determine whether this represents a true nephroprotective effect.

ABSTRACT: A 41-year old female patient who underwent kidney transplantation as an outcome of chronic glomerulonephritis came to the hospital with the signs of acute upper respiratory tract infection. As the patient further developed oliguria, peripheral edema, fever, and an increased BP, she was further relocated to the University Medical Center (UMC). Upon admission to UMC, signs of septic shock were detected, and acute transplant rejection was suspected, to exclude which kidney biopsy was performed and stage 3 chronic kidney disease (CKD) in allograft kidney was detected. Antibacterial treatment as well as pulse therapy were performed as patient had septic shock and tubulointerstitial nephritis (TIN).