Chronic kidney disease (CKD) is a complex condition that damage kidney and also down-regulate the potential ability of kidney to function properly. In such condition damaged kidney cannot filter blood. Due to this, waste and excess fluid from blood remain in the body which can leads to other health complications such as stroke and heart disease. CKD includes several stages of seriousness. If it is left untreated, CKD can further leads to kidney failure and early cardiovascular disease. CKD also called as chronic renal disease, chronic kidney failure, or chronic renal failure, is much more prevalent than people realize. Generally, CKD does not show any symptoms until the disease is well advance. Usually, it can be detected at initial stages via urine and blood tests. Major symptoms of advanced kidney disease comprise: swollen ankles, feet or hands (due to water retention), tiredness, shortness of breath, blood in the urine, nausea [1-4]. The eGFR is a blood test used to evaluate how efficiently the kidneys filter waste from the blood. The stages of kidney disease are generated on the eGFR number. For example: Stage 1 CKD: It means kidney damage and an eGFR higher than 90; Stage 2 CKD: It involves kidney damage and an eGFR between 60 and 89; Stage 3 CKD: This stage contains eGFR between 30 and 59; Stage 4 CKD: It contains eGFR between 15 and 30; Stage 5 CKD: This stage contains eGFR less than 15 . Several researchers describe the potential of mesenchymal stem cells (MSCs) in treating kidney disease.
MSCs are the major source of cell therapy due to their potential ability to differentiate into various cell types, including blood, connective tissue and adipose tissue. MSCs can easily grow in vitro and show intriguing immunomodulatory properties, multi-potentiality with high genetic stability and non-teratogenicity. MSCs can uphold their regenerative potential even after cryopreservation. These properties make MSCs as a significant therapeutic tool for the treatment of various diseases such as neurological disorders, heart disease and joint disorders. Recently, several experimental studies uncovered the potential ability of MSCs to improve renal function in different models of CKD, and numerous clinical studies demonstrated their safety and efficacy in CKD . Over the past few years, various preclinical studies demonstrated the successful application of MSCs in experimental models of CKD for example; diabetes, hypertension, and chronic allograft nephropathy. These studies stated that a single intravenous dosage of MSCs lead to β-pancreatic islet regeneration, inhibited renal damage in streptozotocin-induced type 1 diabetes in mice model , and down-regulate hyperglycemia and glycosuria that continue for two months after injection. In addition to this, MSC-treated diabetic mice revealed histologically normal glomeruli, and albuminuria fell. On the hand, a recent prospective, open-label, randomized study indicated that, patients experiencing renal transplant, intravenous infusion of bone marrow-derived autologous mesenchymal stem cells (BM-MSCs) (1 × 106 to 2 × 106/kg) at kidney reperfusion and 2 weeks later reduced the occurrence of acute rejection and of opportunistic infection, and enhanced renal function at 1 year in comparison to anti-IL-2 receptor antibody induction therapy . Significantly, administration of autologous MSCs showed no adverse events, nor did it compromise graft survival which suggest safety and clinical feasibility of MSCs in the condition of kidney transplantation. In conclusion, recent studies showed the possibility of mesenchymal stem cells for their application in the treatment of CKD. Further clinical trials are needed for the application of mesenchymal stem cell therapy as an important therapeutic tool in treating chronic kidney disease.
- National Health Service. Chronic Kidney Disease, 2016.
- Chronic Kidney Disease, 2018.
- National Kidney Foundation. Chronic Kidney Disease, 2017.
- Centers for disease control and prevention. Chronic kidney disease initiative, 2018.
- American Kidney Fund. Stages of chronic kidney disease, 2019.
- Rahyussalim AJ, Saleh I, Kurniawati T, et al. Improvement of renal function after human umbilical cord mesenchymal stem cell treatment on chronic renal failure and thoracic spinal cord entrapment: a case report. J Med Case Rep. 2017;11(1):334.
- Ezquer FE, Ezquer ME, Parrau DB, et al. Systemic administration of multipotent mesenchymal stromal cells reverts hyperglycemia and prevents nephropathy in type 1 diabetic mice. Biol Blood Marrow Transplant. 2008;14:631–640.
- Tan J, Wu W, Xu X, et al. Induction therapy with autologous mesenchymal stem cells in living-related kidney transplants: a randomized controlled trial. JAMA. 2012;307:1169–1177.