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Efficacy of stem cell therapy for diabetic kidney disease: a systematic review and meta-analysis
Hongyu Du1, Chen Xie1, Yiqin Yuan1
1School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, Jiangxi, China.
Background/Objectives:
Animal studies have demonstrated the ability of stem cell therapy (SCT) to treat diabetic kidney disease (DKD). However, the efficacy of SCT in patients with DKD remain unclear. This systematic review and meta-analysis aimed to investigate the efficacy of SCT in patients with DKD.
Methods:
A comprehensive and systematic literature search was conducted using PubMed, EMBASE, Cochrane Library, and Web of Science to identify articles on SCT for DKD published up to March 2024. RevMan V.5.4 software was used for statistical analysis.
Results:
We identified four studies that included 90 participants, 53 (58%) of whom underwent SCT. SCT improved estimated glomerular filtration rate (eGFR) [mean difference (MD) = 0.41, 95% confidence interval (CI): 0.08-0.74; p = 0.02], serum creatinine (SCr) reduction (standardized MD = -0.65, 95% CI: -1.19 to -0.1, p = 0.02), and microalbuminuria (MAU) (MD = -32.10, 95% CI: -55.26-8.94; p = 0.007) compared to the control group, but did not improve urine microalbumin/creatinine ratio (UACR) (MD = -63.36, 95% CI: -194.52-67.79, p = 0.56) or blood sugar (MD = 0.49, 95% CI: 4.16-2.01, p = 0.49). Adverse events (AEs) were common (67 events in 60 SCT subjects vs. 35 in 28 controls), with urinary system AEs occurring exclusively in the SCT group and nervous system AEs markedly higher.
Conclusion:
SCT can effectively improve eGFR and SCr levels by lowering the MAU but cannot improve UACR and blood sugar levels.
Insights
Stem cell therapy (SCT) shows promise for diabetic kidney disease (DKD), improving kidney function markers like eGFR and SCr. However, it did not significantly impact blood sugar or UACR, and adverse events were noted.
Area of Science:
- Nephrology
- Regenerative Medicine
- Diabetology
Background:
- Diabetic kidney disease (DKD) is a major complication of diabetes.
- Animal studies suggest stem cell therapy (SCT) efficacy for DKD.
- Clinical evidence for SCT in DKD patients remains limited.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of SCT in patients with DKD.
- To evaluate the impact of SCT on key renal function and glycemic parameters.
- To assess the safety profile of SCT in DKD patients.
Main Methods:
- Comprehensive literature search across major databases (PubMed, EMBASE, Cochrane, Web of Science) up to March 2024.
- Inclusion of four studies with a total of 90 participants (53 receiving SCT).
- Statistical analysis performed using RevMan V.5.4 software.
Main Results:
- SCT significantly improved estimated glomerular filtration rate (eGFR) and reduced serum creatinine (SCr).
- Microalbuminuria (MAU) levels were reduced post-SCT, but urine albumin-to-creatinine ratio (UACR) showed no significant improvement.
- Blood sugar levels were not significantly affected by SCT, and adverse events, particularly urinary and nervous system events, were more frequent in the SCT group.
Conclusions:
- Stem cell therapy demonstrates potential in improving renal function (eGFR, SCr) and reducing microalbuminuria in DKD patients.
- SCT does not appear to improve glycemic control or UACR in this patient population.
- Further research is needed to optimize SCT protocols and manage associated adverse events in DKD treatment.
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