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Challenges and opportunities for stem cell therapy in patients with chronic kidney disease

LaTonya J Hickson1, Alfonso Eirin1, Lilach O Lerman1

  • 1Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.

Kidney International
|March 1, 2016
PubMed

Insights

Regenerative cell therapies show promise for chronic kidney disease (CKD). However, factors in CKD patients may impair stem cell function, necessitating methods to enhance cell vitality for effective treatment.

Area of Science:

  • Nephrology
  • Regenerative Medicine
  • Cell Biology

Background:

  • Chronic kidney disease (CKD) is a significant global health issue with limited effective treatments.
  • The kidney's regenerative capacity is poor, driving the need for novel therapeutic approaches like cell-based therapies.
  • Autologous cell transplantation is preferred for CKD to avoid allosensitization, but requires verified cell function.

Purpose of the Study:

  • To review current knowledge on stem and progenitor cell function in the context of CKD.
  • To identify barriers within the uremic environment that may compromise cell-based therapies.
  • To explore novel strategies for improving stem cell function for potential CKD transplantation.

Main Methods:

  • Literature review of studies on stem and progenitor cells in regenerative medicine.
  • Analysis of factors contributing to reduced cell function in CKD patients (age, comorbidities, uremia).
  • Examination of paracrine and differentiation mechanisms of endothelial progenitor cells and mesenchymal stem cells.

Main Results:

  • Endothelial progenitor cells and mesenchymal stem cells offer therapeutic potential via paracrine effects (angiogenesis, anti-inflammation, antifibrosis).
  • CKD-specific factors like uremia, inflammation, and comorbidities can significantly impair autologous stem cell function and vitality.
  • Existing knowledge highlights challenges in achieving therapeutic efficacy with current autologous cell-based approaches for CKD.

Conclusions:

  • Stem and progenitor cells hold promise for CKD treatment, but their effectiveness is challenged by the uremic milieu.
  • Further research is needed to develop methods that enhance stem cell function and overcome barriers in CKD patients.
  • Optimizing cell vitality and function is crucial for the successful clinical application of regenerative cell therapies in chronic kidney disease.

Keywords:
end-stage renal diseasesenescencestem cellsuremia

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