ABSTRACT: It is with great honor and enthusiasm that I present to you the first issue of the Central Asian Journal of Nephrology (CAJN). This new journal comes at a critical time for the re-gion, when the burden of chronic kidney disease (CKD), acute kidney injury and associ-ated comorbidities is steadily increasing, while systematic research and evidence-based methods, as well as the development and implementation of new technologies, remain limited. Our mission is to create a dedicated platform for knowledge sharing, collaboration and policy development aimed at improving kidney health in Central Asia and beyond.

ABSTRACT: Background: Despite the fact that the prevalence of CKD and its effects on health have been studied mainly in economically developed countries, the burden of this disease is even greater in developing countries. It has been established that more than 50% of deaths in patients with ESRD are due to cardiovascular causes. The objective of our study is to comparatively study the structure of cardiovascular diseases in dialysis patients at different levels of health care in Uzbekistan.
Methods: 165 dialysis patients (90 men and 75 women) were studied. The main initial diseases were chronic glomerulonephritis (n=76), diabetes mellitus (n=44), urolithiasis (n=14), chronic pyelonephritis (n=10), etc. Patients were included from 3 clinics of different administrative levels - republican (n=32), urban (n=72) and rural (n=61).
Results: CVDs were identified in 69% of the urban, 44% of the regional and 47% of the republican population. In the structure of CVD, AH, IHD and CHF prevailed in all groups. Also, in the groups of the republican and city level, CVD was more common in a combined form, while dialysis patients at the regional level had more isolated CVD pathology.
Conclusion: Patients of the urban population on dialysis more often suffer from CVD than patients receiving HD at the republican and regional levels of health care. The combined lesion of the CVS occupies a leading place in the structure of CVD in dialysis patients at both urban and national levels.

ABSTRACT: Diabetic kidney disease (DKD) is a major complication of diabetes mellitus and the leading cause of end-stage renal disease (ESRD) worldwide. Despite considerable research efforts, the pathogenesis of DKD remains incompletely understood, largely due to its multifactorial etiology and pronounced phenotypic heterogeneity. Genome-wide association studies (GWAS) have identified over 40 loci associated with DKD; however, these common variants collectively explain only a small fraction of the disease’s heritability. Rare and low-frequency variants, often undetected by GWAS, are increasingly recognized as important contributors, and next-generation sequencing (NGS) technologies offer valuable tools for their identification. Kazakhstan, characterized by a unique genetic landscape and substantial ethnic admixture, remains underrepresented in DKD genomics research. Expanding integrative, high-resolution genomic studies in such settings is essential for identifying population-specific risk variants, improving diagnostic accuracy, and advancing precision medicine approaches to DKD prevention and management.

ABSTRACT: A 46-year old male was admitted to the University Medical Center (UMC) hospital with the following symptoms of anuria, abdominal fullness, hypotension, exertional dyspnea, and peripheral edema. The purpose of his visit was the insertion of a peritoneal dialysis catheter. He had chronic kidney disease stage 5 as a consequence of diabetic nephropathy, liver cirrhosis due to hepatitis C infection, and HIV. His disease course was further complicated by the presence of a urinary tract infection. As a result of his multiple comorbidities, he underwent a complex treatment regimen which included renal replacement therapy with ultrafiltration, blood transfusions for his anemia, platelet transfusions for his thrombocytopenia, albumin infusion for his hypoalbuminemia, and antibiotic treatment for his concurrent infection. Additionally, he received diuretic treatment for his hypervolemia and anti-hypertensives to control his blood pressure. After peritoneal dialysis (PD) insertion, the patient successfully underwent PD and was discharged home.

ABSTRACT: The advent of targeted complement inhibitors represents a paradigm shift in managing complement-mediated nephropathies. Integrating these therapies into healthcare systems, particularly in resource-variable settings, requires strategic planning.
A national council of experts was convened in October 2024 with the purpose of obtaining a clinical expert opinion to develop practical recommendations for improving the organization and optimization of medical care for patients with C3 glomerulopathy (C3G) and IgA nephropathy (IgAN) in Kazakhstan.
The council identified critical systemic gaps, including inconsistent use of renal biopsy, lack of specialized nephropathology, absence of treatment algorithms, and fragmented patient care. A consensus was reached on key recommendations for a new national clinical protocol. These include mandating pathological confirmation, creating detailed treatment and monitoring algorithms, establishing a national registry and coordination center, and investing in specialized training for healthcare professionals.
The systematic framework proposed by the council provides an actionable roadmap to overcome barriers to care. This model ensures equitable patient access to novel therapies and may serve as a blueprint for other nations navigating the integration of advanced treatments into clinical practice.