Organ donation is a critical component of healthcare, yet donation rates in Kazakhstan remain low. Understanding the socio-demographic factors, knowledge levels, and perceived barriers influencing individuals’ willingness to consent to organ donation is essential for developing effective interventions. This cross-sectional study surveyed 1,294 participants across Kazakhstan. The sample was predominantly female (78.3%), urban (79.4%), and well-educated, with a significant proportion having medical backgrounds. Data were collected on socio-demographic characteristics, knowledge about organ donation, and perceived barriers. Comparison methods and binomial logistic regression analysis was used to identify significant predictors of willingness to express consent for organ donation. Age, ethnicity, family status, and knowledge about organ donation were significant predictors of willingness to donate. Older participants and Russian ethnic group members were less likely to consent, while widowed individuals and those with higher knowledge levels were more likely to express consent. Although several factors did not have significant prediction with willingness to donate in the regression analysis, chi-square and U-tests revealed significant associations for residence, occupation, educational level, and religious affiliation. Key barriers to donation included distrust in the medical system, fears of organ trafficking, and insufficient awareness, particularly among non-medical participants. These barriers were significant deterrents and correlated with lower willingness to donate. However, due to the overrepresentation of urban, educated, and medical-affiliated participants in the sample, findings may not fully reflect the general population of Kazakhstan. The findings highlight the need for targeted educational campaigns to increase public awareness and address misconceptions about organ donation. Building trust in the medical system and dispelling fears of unethical practices are essential for improving donation rates. The study underscores the complex interplay of socio-demographic factors, knowledge, and perceived barriers in shaping organ donation decisions in Kazakhstan, while also emphasizing the need for future research with a more representative sample.

Optimizing immunosuppressant dosing presents significant challenges in kidney transplantation due to narrow therapeutic ranges and considerable inter-patient pharmacokinetic differences. Emerging strategies for precision dosing, encompassing Bayesian population pharmacokinetic models, pharmacogenomic integration, and artificial intelligence algorithms, aim to enhance drug monitoring by moving beyond traditional trough-based approaches. This review critically assesses available evidence for predictive dosing models targeting immunosuppressants, including calcineurin inhibitors, antimetabolites, and mTOR inhibitors in kidney transplant patients. Available observational and simulation studies demonstrate substantial methodological diversity, with Bayesian PopPK-guided strategies showing 15–35% better target exposure achievement compared to trough-based monitoring. The absence of pooled estimates precludes a precise summary effect size, and evidence from randomized controlled trials remains limited. Machine learning models, particularly for tacrolimus, frequently reduced prediction error relative to traditional regression approaches, but substantial heterogeneity in study design, outcome definitions, and external validation limits quantitative synthesis. Hybrid Bayesian–AI frameworks and explainable AI tools show conceptual promise but are largely supported by proof-of-concept studies rather than reproducible clinical implementations. Overall, Bayesian pharmacokinetic modelling represents the most mature and clinically interpretable approach for precision dosing in transplantation, whereas AI-driven and hybrid systems remain investigational. Key gaps include the need for standardized reporting, rigorous risk-of-bias assessment, prospective validation, and clearer regulatory and implementation pathways to support safe and equitable clinical adoption.

Background: Kidney transplantation (KTx) significantly improves survival and quality of life in patients with end-stage renal disease. However, post-transplant well-being is influenced by multiple factors, including healthcare accessibility, satisfaction with medical care, and psychological health. This study aimed to assess the well-being of post-KTx patients in Kazakhstan and examine its associations with healthcare access, satisfaction, and anxiety. Methods: A cross-sectional study was conducted among 223 post-KTx patients in Kazakhstan. Participants were recruited through online surveys and telephone interviews. Only patients who had undergone transplantation within Kazakhstan were included. The WHO-5 Well-Being Index was used to measure well-being, and additional surveys assessed healthcare access, satisfaction with post-KTx care, and treatment-related anxiety. Multiple linear regression was performed to identify predictors of well-being. Results: The mean WHO-5 well-being score was 66.1 (SD = 24.6), indicating moderate well-being. Satisfaction with post-transplant information (β = 0.287, p = 0.015) and educational level (β = 0.172, p = 0.019) were significant positive predictors of well-being. In contrast, post-KTx anxiety (β = −0.154, p = 0.024) and difficulties in accessing medical care (β = −0.216, p = 0.014) negatively affected well-being. Patients residing in rural areas reported greater barriers to post-transplant care compared to those in urban settings (χ² = 31.6, p = 0.002). Conclusions: Post-KTx well-being in Kazakhstan is influenced by educational level, access to healthcare, satisfaction with medical information, and anxiety levels. Targeted interventions to improve access to post-transplant care, enhance patient education, and address psychological distress may help improve outcomes for post-KTx patients.

Background: Understanding the factors influencing posthumous organ donation decisions is essential for developing effective strategies to increase donor registration. While previous studies have explored reasons for consent and refusal, less attention has been given to individuals who defer the decision to their families (Decision Left to Close Relatives, DLCR). This study examines the sociodemographic, institutional, and cultural factors influencing donation preferences, with a focus on the DLCR group as a transitional category between consent (LC) and refusal (LR).Methods: A cross-sectional survey was conducted among 1,333 participants in Kazakhstan. Donation preferences were categorized into Lifetime Consent (35.3%), Lifetime Refusal (21.4%), and DLCR (43.4%). Participants completed measures assessing knowledge, attitudes, and perceived barriers to organ donation. Principal Component Analysis (PSA) identified two key dimensions of perceived barriers: institutional and cultural barriers. Linear regression and mediation analyses were performed to examine predictors of attitudes toward organ donation.Results: The DLCR group held intermediate attitudes toward donation, significantly higher than LR but lower than LC (p < 0.001), moreover, 44.4% of the DLCR group had a favorable attitude toward organ donation. A critical finding was the high level of uncertainty about how to declare donation status among DLCR participants, significantly higher than in both LC and LR (p < 0.05). PCA revealed that DLCR individuals were institutionally closer to LC but culturally aligned with LR, suggesting that cultural concerns are the stronger barrier preventing proactive consent. Among DLCR participants, knowledge positively predicted donation attitudes (β = 0.223, p < 0.001), while cultural and religious barriers had the strongest negative effect (β = −0.290, p < 0.001). Language preference also emerged as a factor, with Russian speakers demonstrating significantly more favorable attitudes than Kazakh speakers. Specialization (medical vs. non-medical) had no direct effect on donation attitudes (p = 0.777), but it influenced attitudes indirectly through institutional (β = −0.223, p < 0.001) and cultural barriers (β = 0.194, p = 0.003).Conclusion: Both procedural uncertainty and cultural-religious factors influence the hesitation of DLCR individuals to commit to donation, with cultural concerns having a stronger effect. Language preference also shapes attitudes, reflecting broader sociocultural framings. Reducing uncertainty and addressing cultural misconceptions, particularly among the DLCR group, may be key to increasing donor registration.

Background: The Kidney Disease and Quality of Life Short Form (KDQOL-SF™ 1.3) is widely used to assess health-related quality of life (HRQoL) in patients with end-stage renal disease. However, no prior validation had been conducted in Kazakhstan, where both Kazakh and Russian are commonly spoken. This study aimed to validate the Kazakh and Russian versions of the KDQOL-SF™ 1.3 and to identify predictors of HRQoL among hemodialysis patients in Kazakhstan. Methods: A cross-sectional survey was conducted among 217 adult hemodialysis patients from February to April 2025 using a mixed-methods approach (in-person interviews and online data collection). Psychometric testing included Cronbach’s alpha, floor and ceiling effect analysis, and Pearson correlations with self-rated overall health. Multiple linear regression was used to identify predictors of the Kidney Disease Component Summary (KDCS), Physical Component Summary (PCS), and Mental Component Summary (MCS) scores. Results: Both language versions demonstrated acceptable to excellent internal consistency (Cronbach’s α = 0.692–0.939). Most subscales were significantly correlated with self-rated health, supporting construct validity. Regression analyses revealed that greater satisfaction with care, better economic well-being, and more positive dialysis experiences were significant predictors of higher KDCS and MCS scores. Lower PCS scores were associated with female gender, comorbidities, and financial burden. Importantly, financial hardship and access challenges emerged as strong negative influences on HRQoL, underscoring the role of socioeconomic and care-related factors in patient well-being. Conclusions: The KDQOL-SF™ 1.3 is a valid and reliable tool for assessing quality of life among Kazakh- and Russian-speaking hemodialysis patients in Kazakhstan. Integrating this instrument into routine clinical practice may facilitate more personalized, patient-centered care and help monitor outcomes beyond traditional clinical indicators. Addressing economic and access-related barriers has the potential to significantly improve both physical and mental health outcomes in this vulnerable population.

Background: Global nurse shortages are well documented, yet empirical evidence from Central Asia remains scarce. In Kazakhstan, where the health system is undergoing reform, little is known about the factors shaping nurses’ job satisfaction and retention. Objectives: This study aimed to (1) assess overall levels of job satisfaction and retention intention among nurses in Kazakhstan, (2) examine the association between practice environment characteristics and nurses’ job satisfaction, and (3) identify demographic and professional factors influencing job satisfaction. Methods: A cross‐sectional survey was conducted with 359 nurses using the Casey–Fink Nurse Retention Survey and the Practice Environment Scale of the Nursing Work Index (PES‐NWI). Retention intention was assessed using Casey–Fink items that ask nurses about their plans to remain in their current position and within the profession. Data were analyzed with descriptive statistics, Pearson correlations, and multiple regression models to identify predictors of job satisfaction. Results: Recognition and rewards, mentorship, scheduling flexibility, and professional role were significant predictors of job satisfaction ( p < 0.05). Recognition and mentorship demonstrated a strong correlation ( r = 0.84). Limited scheduling flexibility negatively affected satisfaction, while the overall regression model explained a meaningful proportion of variance in outcomes. Conclusion: These findings underscore the importance of mentorship, recognition, and flexible scheduling as key drivers of job satisfaction, with potential implications for improving retention intentions. These findings highlight the need for targeted workforce strategies that strengthen recognition systems, mentorship programs, and flexible scheduling policies. Future longitudinal research is recommended to examine causal relationships and evaluate the effectiveness of interventions.