Mechanism of mesenchymal stem cells in treating diabetic kidney disease

Diabetic kidney disease (DKD) is a serious microvascular complication of diabetes, with symptoms of progressive kidney dysfunction, proteinuria, and fibrosis, ultimately causing end-stage renal disease. Mesenchymal stem cells (MSCs) represent a promising therapeutic approach for DKD, primarily through their paracrine effects. In this review, we concluded the mechanism of MSCs in treating DKD, including the inhibition of inflammation, fibrosis, oxidative stress, and modulate vascular endothelial growth factor (VEGF). Additionally, we discuss strategies to enhance MSC efficacy, such as preconditioning, genetic engineering, and combination therapies with pharmacological agents. Furthermore, we provide an overview of completed clinical trials assessing the effectiveness and safety of MSCs transplantation in DKD patients. The purpose of this review is to highlight the MSCs' potential as an innovative treatment for DKD and to guide future research toward optimizing their therapeutic applications, ultimately improving DKD patients' quality of life.