Журнал нефрологии и терапии

???????? ? ??????????? ???????? ????? (???) ?????. ??????????, ????? ???????? ?????????????? ???????? ??????? ? ????, ???????? ???????????? ????????? ???????? ?? ???????????. ??? ?????????? ???, ?????????? ????????? ??????????. ????? ??????? ???????????? ???????? ?????? ?????????????????? ????????????? ?????????? ??? ???????????. ?? ??????? ???????????????, ?????????????, ???????????? ???????????? ? ????? ??????. ???????????? ?? ?????? ??????? ??????????? ? ?????? ??????????? Befelatanana ? ????????????, ???????. ???? ???????? ??? ??????????? ??????????????????? ????????, ? ??????? ???? ?????????? ????????. ???? ??????????? ????? 136 ????????, ?? ?????? 33,8% ?? ??? ???? ???????????????? ? ??????? ????????????? ?????????????. ? 42,65% ??????? ???????? ???????? ? ??????? 20 ???? ????? ??????? ?????? ???????????. ?????? ? ??????? ? ?????????????? ???????? ???????? ???????? ?????????? ???????? ? 49,06%, ?? ??? ??????? ???????? ????????. Staphylococcus aureus (34,3%) ??? ???????? ????? ????????????? ?????????. ?????? ?????? ? 98,52% ???????, ? ? ???? ????????? ?????????? ??????????? ???. ??? ???????? ???????? ????????????????? ????????????????? ??????? ? ???????????? ? ????????????? ?? ???????????????. ??????? ???????????? ???????? 100%. ??????? ??????????? ??????? ????? ?? ??????????? ????? ???????, ? 3% ????????? ????? ??????????? ?????? ??????????. ??? ????????? ???? ???????????????? ????????? ?????????. ? ????? ??????? ?????????? ??????, ????????? ? ????????? ?????????, ???????????? ????? ???????????????? ???????? ???????? (49,06%). ??? ?????????????????? ????, ??? ? ?????? ???????????? ?????????????. ???????? ??????? ????????? ? ???????? ? ???????????? ??????? ??????????? ??????? ?????, ???????????? ?????? ??????????? ? ?????????? ??????? ? ?????????. ?????? ???????? ???????? ??? ????????? ? ?????? ?????. ???????? ????? ????? ?????????? ????????? ?????????? ?? ???????????. ?????????????? ????????? ????????????? ????????. ? ?????????? ??????? ???????, ??? ????????????? ??????????? ??????? ? ????????? ????????? ? ????? ??????. ????? ????????? ???, ?????????? ??????????? ????????? ????? ? ?????? ??????????????? ??????????? ??????????? ????? ???? ??????? ????????. ? ????????? ????? ? ?????????????? ? ?????????????? ??????????? ?????????? ?????????????? ????? ?? ?????? ?????? — ?????? ? ????? ????????? ????? ???????, ??? ??????????? ??????????.

????: ???????? ? ?????????? ?????? ????? ???????? ???????????? ??? ?????? ?????????? ? ??? ?????????????? ??????????. ??????????: ?????? ?????????, 33 ????, ??? ???????????????? ?? ??????????????? ???????????. ?? ?????? ?????? ???????? ?????? ???????????? ??????????? ????? ??-?? ????? ???????? ????????????. ????????????????? ??????? ??? ?????????? ?? ????????? ??????????? ?????????, ????????????? ? ?????????? ????????????. ??????????: ? ???????? ?? ???? ?????? ? ???????? ??????????? ???????????, ????? ?? ??????? ???????? 20 ?? ?? ??? ?????? ?? ??????????????. ??? ??????????? ? ???? ??????????????? ?????????? 220/140 ?? ??. ??., ? ?? ???? ?????? ?????????? ????????????. ??????? ????? ???????? ??????????? ??????????? ????? ? ????????? ????????? ??????????? ?????????? ????? 2 ??/???/1,73 ?2. ?-?????????? ????? ??? ?????????????, ? ???????? ???????? ??????????? ? ?????? ??? ???? ???????? ?? 119 ??. ??????????? ????????? 0,8 ?/24 ????. ???????? ?????? ??????????????? ???????-??????????, ?????????????????????? ????????, ?????????????? ???????? ???? ????????? ????????? ???, ?? ???? ??????????????. ???????????? ??????????? ??????? ????????? ??????????, ????? ??? ?????? ?????? ? ????????????. ?????????????? ?????? ??????? ??????????? ? ???????? ??????? ? ??????????? ??????????. ?????????????? ????? ??????????? ??????????????? ??????? ????? ????? ? ??????? ???????? ????????????? ? ?????? ???????. ??????? ????? ?? ???????????. ????? ????? ??????? ????????? ?????????? ???? ??????? ?? ????? ???????. ??????? ??????? ??????????? ???????????????????????? ????????, ??????????? ??????? ? ?????? ??????????? ?????????? ?? ???????????? ??????????, ? ???????? ? ????????? ????????????? ???????? (120/70 ?? ??. ??.). ??????????: ????? ??????????????? ??????????? ??? ???????????? ??? ?????????? ?????? ?????? ? ??????? ?????????? ??????? ????? ?????? ?????? ????? ?????? ? ????????????????? ???????? ?????, ?????? ????????? ? ?????????????? ?????????? ?? ?????? ???????????.

????: ????????????? ???????? ???????? ???????????????? ?????????? ?????????????? ???????, ??????????? ? ??????????????????? ?????????. ??????????, ??? ?????????????????? ?????????? 5–30 % ? ??????????? ?? ??????????? ????????. ????? ??????? ???????????? ???? ??????????? ?????????????????? ? ????????? ????????????? ? ?????????, ??????? ? ????????? ????? ???????? ??????? ? ????? ????????. ??????: ?? ???????? ?????? ? ??????? ???? ????????? ???? ? ???????? ? ???? ?????, ????? ??????? ??????? ?????????????????? ? ????????? ????????????? ? ????????? ? ????? ????????. ?? ?????????? ????????????? ??? ??????? ????????????? ?????? ????? 135 ????/?. ?? ????? ????????? ????????? ? ?????????????? ?? 2 ?????? ? ??????????? ?? ????????, ????? ??????? ????????? ???????? ? ?????????. ??????????: ?? ??????????, ??? 41 ?? 879 ????????? (4,7 %) ???????? ??????????????. ? ???????????? ???? ????????? ????????? ?????????? ???????????? ?????? 130–134 ????/?. ??????????? ??????? ????????????? ???? ??????? ? ??????? ???????? (34,1 %). ?????? ????????????? ?????????: ???????????, ??????????????? ???????????????, ??????????? ??????, ????????? ????????? ??????????????? (???), ???????? ?? ??????? ? ????????????????? ????????. ? ?????????? ????????? ???? ??????, ??????????????? ???????? ???????????? ???????? ?????????????????? ??????? (SIADH). ??? ???????? ????????, 56% ????????? ???? ?????? 65 ???. ????????, ??????????? ?????????, ???? ?????? ?????????? ? ??????? ?????, ? ?? ????? ??? ????????? ??????? ???? ?????????????? ? ??????? ?????????. ??????????: ???? ?????????? ??????????, ??? ??????? ?????????????????? ????????????? ?? ??? ??????, ??? ?????????? ? ????????? ?????????? ?????????????. ????? ????, ??????????? ?????????????, ??? ???????, ???????? ??????, ? ??????? ????????????? ????????? ???????? ????????? ?? ????????? ???????. ????????????? ???????? ?????????? ?????????? ???????????????? ????????????? ????????.

????: ?????????? ????????? ?????????? ??? ?????????? ?????????, ??????????? ?? ?????????? ??? ????????????? ?????????? ?? ????? ??? ????? ????????? ??????? ???????????? ??? ??, ??? ?? ???????? «????? ?????» DW, ???????? ????????? ??? ??????????? ??????????. ??? ?????????? ???? ???? ???? ??????????? ????????? ??????. ?? ??????? ??? ????????????, ????? ??????? ? ???????? ??? ????????? ??????????? ??????????? (2 ??????????? ??????? ? 1 ???????????? ????????) ????????? ??????? ???? (BCM), ??? ??????? ?????? ? ???????? ????????????????? ?????? (BNP), ????? ????????? ?????? ? ?????????? ?????? DW ? ????????? ?? ???????????. ??????: 49 ?????????? ????????? ?? ??????????? ??????????? ?????? ?????? ?? ? ????? ??????????? ? ?????????????? ???? ????????? ???????, ?????????? ????. ??????????: ?????? BCM ????????, ??? ?? ??????? 27 ????????? (55%) ???? ???????????????? ??? ????????????????????, 18 ????????? (37%) ??? ???????????????????? ? 4 ???????? (8%) ??? ???????????????????. ???? ???????? ????? ?? ??????????? ???????? 21,4 ± 17, ? ????? ??????????? — 9,1 ± 6,9. ? 19 ????????? (39%) ???? ?? ????? ????? ?????? ??? <14, ? 21 (43%) — ?? 14 ?? 30 ??? ? ? 9 (18%) — >30. ???????? ?? ????????, ????, ?????????????? ? ??????????????? ????????? ???????? ????? ????? ???????? ?? ????. ?????? ?????????????? BNP ???????? ???????????? ???????? (33%) ?? ???????? ???????? 10443 ± 17232 ??/?? ?? ??????? ?? 6956 ± 13885 ??/?? ????? ??????? (p=0,00). ??????: ??? ??????? ??????, BCM ? ????????? BNP ? ???????? ??????????? ??? ?????? ????????? ?????? ???????? ???????????? ???????? ??????????????? ????? ???????, ??? ?????? ??????? ? ??????????? ????????? ??????, ? ?? ? ??? ??????????? ?????????? ?? ? ????? ???????????, ?????? ?? ???? ??????? ?????????? ????? ????? ????????????? ??? ????????????? ?????? ????????? ??????.

???????? — ??? ???????????? ???????????, ?????????? ? ?????? ??????? ?????? ????????. ???? ???????? ??????????? ?????, ??? ????? ???? ???????? ?????? ????? ?????????????? ?????. ??? ?????? — ??????, ? ??????? ??????????, ??? ?????????? ????? ???? ???????? ???????? ????? ?????????????? ?????. ??????? ? ???????? 34 ??? ? ??????????????? ????? ?? ???????? ??????. ??? ?????????????? ??????? ??? ?????? ?????????? ????????????. ??? ?????????? ?? ??????????? ?????? ? ??????? ????, ?? ???????????? ????? 16 ??????? ????? ?? ? ???????? ?? ??????? ? ???????????? ???????? ?? ??????????. ? ??? ???? ?????? ? ???????? ????????????? ? ????????? ?????????? ??? ???????????? ? ???????? ???????? ? ????????? ??????? ??? ???????. ????????? ???????? ???? ?????????????. ????????? ????????? ????????????? ????? ? ??????? 6 ??????? ??? ?????????. ?????????? ??? ??????? ? ????????? ?? ??????????? ?. ????? ?????? ??????? ?????? ???????, ? ?? ???????? ????? ???? ? ????????? ????????????? ??????????. ???????? ??????? ????? ???????? ?? ??????????? ? ??? ?????????????. ???????? ??????????? ????? ? ??????????? ????????????? ? ??????? ?? ?????????????? ???????????????? ??????. ? ?????????? ?? ???? ?? ?????? ??????, ? ??????? ?????????? ??? ?????? ??? ??????? ????????. ??? ?????? — ??????, ? ??????? ???????? ???? ???????????????? ????? ?????????????? ? ???????????? ???????????????? ??????, ? ?? ???????? ??? ??????????.

????????????????? ??????? ????? (AERD) ??? ??????? ??????????? ??????????? ????? ???????? ???????????? ??????????????? ??????????? ????????????. ??? ??????????????? ??????????? ? ??????????????? ???????? ???????????????? ??-?? ??????? ?????????? ???? ?????????? ???????????, ?????????? ? ?????? ?????????? ??????? ????? ?? ????????????????????? ??????. ?????? ??? ?????????? ????? ?????????? ?????????????, ?????????????? ? ???? ?????????. ??????? ??? ????? ? ???????? ?????? ???????????????. ????????? ?? ???????? ? ??????????? ?????? 62-??????? ??????? ? ?????????????, ??????????? ?????????? ?????????? ????????????? ?? ?????? ???????????? ??????????? ? ??????????? AERD ? ???????? ??????????? ???????? ????? ????????? ???? ????? ???????. ??????? ????????? ??????? ????? ???? ???????? ????? ??????? ?????????? ?????????????????.

????????: ???????????? ?????? ???????? ??????????????? ??????? ? ??????? ????????? ??????? ?????????? ?? ????????-?????????? ???????????. ?? ??????????? ???? ??? ??????? ???????????? ?? ???? ????. ????: ?????????? ??????? ?????, ????????? ?? ??????????? ? ???????????????? ????????? ?? ??????????? ???????. ??????: ???????????? ??????-???????? ???? ????????? ? 2011-2012 ????? ? ?????? ?????????, ????????. ? ???? ?????? ???? ???????? ??????? ???????? ????????. ???? ? ?????????? ?????, ??????, ???????? ??????, ??????? ?????-??? C ??? ???????? ? ????????? ???????? ???? ?????????. ??? ??????? ?????? ???? ??????? ??? ????????, ??????????????? ????????, ???? ? ????? ???????. ??????????? ?????? ???? ??????????? ??? ????? ?????????? ? ??????????????? ??????, ????????????? ???????????, ??????????? ? ??????????????? ??????????. ?????????????? ?????? ??? ???????? ? ?????????????? ???????? ??-???????, t-???????? ?????????, ???????? ?????-????? ? ???????????? ?????????????? ?????????????? ???????. ??????????: ? ???? ???????????? ???? ??????? 85 ??????? ?? 109 ??????? ????????? ? 170 ???????????. ?? ???? ?????????? ????????????? ???????? ???????? ????? ?????????, ??????????? ??????? ? ?????? ??????? ??????????? ???????????, ? ????????? ????????????? ???????????, ??????? ???, ?????????????? ????????????? ????????, ???????????, Kt/V, ???????, ???????, ?????????????, ????????? ? ??????? ?????????? ??????????????? ??????? (???). ????????-???????????? ?????, ???????????? ??? ????????? ?????????? ??? ??????????? ????? ?????? ????, ???????? ?????????? ?????? ????? ???????, ??????, ????? ??????????, ????????????? ??? ? ????????????????. ??? ???? ??????????? ? ????????? ??????? ?? ????????? ? ??????????? ???????. ??????????? ????????????? ????????????? ?????? ???????, ??? ???????, ????????? ?? ???????????, ???? ??????? ? ????????????? ????? (??????????? ?????? [OR], 2,64; 95% ????????????? ???????? [CI], 1,04–6,70) ? ????????????????? (OR, 3,0; 95% CI, 1,21–7,43). ???????????? ??????? ????? ?? ???????? ??????? ????????-???????????? ?????. ??????????: ???????????? ??????-???????? ????????, ??? ????????????? ??? ? ???????????????? ????? ????????????? ???????? ????????-???????????? ????? ? ?????????, ?????????? ?? ??????????? ?????????, ??????????? ?? ???????????.

????????: Leclercia adecarboxylata — ???????-?????????? ????????????????? ??????? ?? ?????? ??????????????, ????? ??????????. ?????? ??? ?????????????? ??? ????????? ???????? ? ????????? ? ??????????? ??????????? ? ???? ? ????????????? ????????? ? ?????????????????? ?????????. ??????????? ??????: 60-?????? ??????? ? ??????????? ???????????? ?????, ??????????? ?? ??????????? ? 2010 ????, ??????? ??-?? ??????????????? ???????, ? ? 2014 ???? — ??-?? ??????????? ???????? ? ?????? ??????? ????. ?? ????? ?????? ??????????? ? ???? ???????? ????? ? ????????? ??? ?????? ????????????? ?????; ????????????? ????????????? ????????. ????????? ?????? ?????, ? ????? ?????? ???????????? ??????? ???????????? ? ?????????? ????? ???????. ?????? ????? ??????? ??????????????? Leclercia adecarboxylata, ?????? ??????? ??????????? ????? ? ????????????? ?????? ????? ????? ???????. ??????????: L. Adecarboxylata — ???????? ????????????? ??????? ??? ??????? ????? ??????? ??????????? ? ???????????? ????????? ? ??????????. ???????? ?????? ?????? ??????????? ? ???, ??? ??? ?????? ????? ? ????????. ???? ?????? ??????? ?? ???? ?????????????? ??????????, ??? ?? ???? ???????? ?????????? ??? ??????? ?????????????, ? ??? ????????????? ??????? ???????.

??????? ?????? (??) — ?????? ??????????? ? ??????????????? ???????????? ???????????. ????????, ?????????? ??, ???????? ???????????? ???????????????????, ??????? ???????? ? ??????????? T. whipplei ?? ????? ????????? ??????. ????? ?? ???????? ? ?????? ?????? ??, ????????? ??? ????????, ? ????????? ?????????? ? ?????????-????????? ????????????, ????????? ????????????? ? ?????????? ???????????, ?????????? ? ?????? ? ?????????? ????????? ?????????????. ?? ???????? ??????? ??? ??????????? ???????, ?????? ??? ??????????? ? ?????????? ???????. ??? 27-?????? ??????? ??? ??????? ??????? ??? ????????? ???????????. ??? ??????? ?????????????? ?? ????? 23/12/1999 ? ???????? ?????????? ???. ??? ?????? HLA ??? A1 A33 B14 B35 BRB1*01 DRB1*11. ????????? ??? ? ????????? ????? ??? ?????????? ???? ? ????????. ????? ???? ??? ????? ?????????????? ?? ????????? ?? ?????? ? ????????? ??? ????????????? ?????????? ????????????? ????????????. ??? ?????????-???????? ???????? ???? ????????? ????? ????????????? ?????????? ????????????. ????????? ??? ???????????????? ? 2012 ????, ????? ?????????? ??? ????? ??????????????, ??? ???????????? ??????? ??????? ??????????? ??????????? ?????? ? ??????? ???? ? ?????????? ??????? ?????????????. ???????????? ??????? ???????? ??????? ?????????????, ?????? ? ??????????, ?? ??? ?????????????? ?????????. ???????? ? ???????? ? ???????????????????? ???? ??????????????. ?????????????????? ? ?????????????????? ??????? ????, ? ????? ?????? ????? ???? ??????????????. ??????????? ???????????????? ? ?????????? ??????? ????? ???? ??????????????. ??????? ?? ??????? ???????????? ?? ??????? ????????, ? ??????????? ??? ? ??????? ???????????? ???? ???????????? ?? ??????? ?????????????. ???????????? ??????? ??? ??????? ?? ??????????. ? ??????? 2015 ???? ?? ??? ???????????????? ? ??????????, ??????? ? ?????????? ??? ???????, ?????????????, ??????????????, ???????????? ??????? ???? ? ?????????? ??????? ?????????????. ??????????????? ???????????? ???????? ????????????? ????????? ???????? ??????????? ??????, ??????? ??????? ? ??????????????? ?????????????????? ?????. ??????? ???????? ?????????????? ????????, ??????? ???????? ? ??????????? ??? ???????? ????????? ???????????, ?????? ??????????? ??? ??????? PAS. ???? ??????????????? ?????? ?????? ????????? ?? ???????? ???????? T. whipplei. ????? ??????????? ??? ????? ?????????????? ??????? ???? ????? ??? ??? ? ????????? ??????????? ???????. ??????? WD ??? ?????????? ?? ????????? ??????????? ? ??????????????????? ?????????????.

???????????: ?????????? ???????? ???????? ???????? ????? ??????????? ??????? ?????. ? ?????? ?????????????????? ?????????? ?? ???? ???? ?????????, ??? ????? ????????? ? ??????????? ???????? ????? ????? ????. ?????? ????????? ? ??????? ????????? ? ??????????? ? ???????? ????????????????, ????? ???????, ?????????? ????? ? ???????????? ???????????????? ??????????? ?????. ????? ??????? ???????????? ???????? ????????? ??????????? ??????????? ??????? ????? (???) ????? ????????? ? ????????? ????????????? ??????????. ??????: ??? ????????????? ???????????? ????????????, ??????? ???? ????????? ? ???????? Hamad General Hospital, ???????? ????????? ? ????????? ????????????? ??????????, ??????????? ? ??????????????? ????????? ? ?????? ? ???? 2013 ???? ?? ???? 2014 ????. ??????????: ????? ? ???????????? ???? ????????????? 112 ?????????, ?????????????????? ??? ????????? 49,1%. ????????????? ?????? ???????, ??? ?????????? ?????????? (> 5 ???), ???????????? ????????, ??????? ???/????????, ??????? ???????????, ??????? ???, ??????????? ?????? ????????? (???) ?? ?????? ??? ? ?????????????? ???? ?????????? ???????????? ???. ????????? ?????????????? ????????????? ????????????? ??????, ?? ??????????, ??? ?????????? ??????????? (≥ 5 ???), ??????? ??????????? ? ???????????? ?? ??? ??? ???????? ???????????? ???????????? ???. ??????: ??? ???? ?????????? ? 49,1% ????? ?????????. ?????????? ???????????, ??????? ??????????? ? ???????????? ?? ??? ??? ???? ???????????? ???????????? ???. ?? ??????????? ???????????? ??????? ??? ????????????? ???????? ????????? ???, ????? ?????? ? ?????? ??????????? ??? ????? ????????? ? ???????????.

Introduction: Athletes are increasingly using whey protein–based dietary supplements that, used improperly, may create health risks. Objective: To evaluate changes in glomerular filtration, renal tubular function, and histopathological alterations associated with the use of protein-rich food supplements on the kidneys of Wistar rats. Method: Twelve Wistar rats were divided into control (Group I) and intervention (Group II) groups. Group II received the supplement for 14 fourteen days. Urine samples were collected from the animals for urinalysis and blood samples were collected for the determination of urea, creatinine, sodium, potassium, and chloride levels. At the end of the experiment, the animals were euthanized and the kidneys were collected for a histopathological study. Results: After the supplementation, reduced urea levels (p=0.00930) and increased urinary density (p=0.4645) were observed in Group II. The vast majority of Group II animals (67%) had significant proteinuria (p=0.040), and epithelial cells and waxy casts occurred in 50% and 67%, respectively. Histological analysis of the kidneys showed the presence of areas of peritubular blood vessel dilation and congested glomeruli. Conclusion: Use of the protein supplement changed glomerular filtration and tubular function as evidenced by significantly increased proteinuria as well as peritubular, glomerular, and vascular congestion on histopathological analysis.

???????????: ???????????????? ??????????? ????????????? ??????????????? ??????? ?????? ? ????????, ?????? ???????, ???????????, ?????????? ????????? ??????????? ? ???????? ???????????????, ? ????? ?????? ? ???????? ??????????? ??????. ??? ??????, ??????? ?????? ??????????????, ???? ??????????? ? ???????? ????????????? ???????. ??????????? ??????: ?? ???????? ? ?????? 6-???????? ??????? ? ??????? ?????????????? ????????, ????????? ?????????????? ?????? ???????. ?? ?????????? ?????? ?????????????????? ?????? ? ?????????????? ?????? ??????? ??????. ??????????: ??? ????????? ?????????????? ?????? ??????? ? ????????????? ? ?? ????????? ????????????? ????????-???????? ????????? ????? ????????? ?????????????? ??????, ????????? ?????????? ???????? ????????? ? ??????????? ????????. ?????????????? ????? ?????? ??????? ????????? ??? ???????????????? ??????????? ????????????? ??????????????? ???????.

?????????? ????? ???????? ?????? ???????? ?????????? ? ?????????? ????????????????. ??????? ? ?????: ?? ???????? ? ?????? 35-?????? ??????? ? 14-?????? ???????? ??????????? ???????? ???????????????, ? ??????? ?????????? ??????? ? ??????? ????????? ???????????????, ???????? ?? ???????????? ?????????????????? ? ???????? ?????????????? ???????????? ?????????????? ??????. ? ????????? ??????????? ???????? ? ??????? ??????? iPTH ? 1700 ??/??. ?????????: ???? ????????? ???????????? ?????????????? ????? ? 99mTc-Sestamibi. ?????? SPECT/CT ???????????? ?????????????? ?????????? ?? ???????????? ???????????? ?????? ?????? ???????????? ??????? ??????, ? ?????? ??????-?????????? ??????????. ???? ??????? ????????? ?????????? ?????????? ????????????? ?????????????. ????????????????? ??????? iPTH ??? ? ???????? ?????.

????????????? ??????????????? ? ???????????? (????) — ????????? ????????, ????????????????? ?????????????? ?????????? ?????, ?????????????? ?????? ? ?????????? ?????????? ?????????????? ???????????. ????? ?? ??? ???????? ??? ??????? ?????-???????. ?????????????? ???? ? ?????? ????? ??????, ???????????????? ????? ????? 1800 ???????. ????????? ????? ??????????? ???????? ? 20–25% ????????? ? ????, ? ???????? ???????? ??????????? ???????? ???????????? ??????????? ???????????????. ? ????????? ????????? ?? ???????? ? ?????? 69-?????? ?????? ? ?????????? ? ??????? ?????? ?????????????????? ????????????????? ?????????????????? ??????? (???-????) ? ????????????. ??????? ?? ????? ???????? ????????? ???????????????? ?????? ? ??????????, ??????? ?? ??????????????? ????????, ??? ???????? ????????? ??????????? ????????? ? ?????????. ????? ????? ??????? ?????????? (??????????? [???] 30 ??/????) ? ??? ????????? ???????????????? ??????????, ? ??? ???? ???????? ?? ????????? ?????? ???-????.

Background: Tacrolimus is immunosuppressive agent used for the prevention of rejection in kidney transplant patients, has narrow therapeutic range, and variable pharmacokinetics. Objectives: To identify the optimum Tacrolimus blood trough level for Saudi kidney transplant patients (SKTP). Method: The research population consisted of 100 SKTP at the Armed Forces Hospital in the Southern Region (AFHSR) treated with Tacrolimus and followed-up for a period of 24 months (2012 till 2014). Results: A significant relationship between Tacrolimus trough level and incidence of kidney rejection was remarkably found only after 180 days post-transplantation. During this period, Tacrolimus mean trough level (ng/ml) was 7.4 ± 0.2 in SKTP with no rejection, 5.3 ± 0.7 for those with acute rejection, and 3.8 ± 0.4 for those with chronic rejection. Furthermore, the coefficient of variation (CV%) which reflects fluctuation in Tacrolimus trough level, was obviously high in SKTP with acute rejection in all post-kidney-transplant periods. Conclusion: After 6 month post- kidney transplantation in SKTP, Tacrolimus trough level (