Recent Updates on Mesenchymal Stem Cell Based Therapy for Acute Renal Failure

Abstract

Acute kidney injury, formerly known as acute renal failure, is a pathological condition in which ischemia or toxic damage contributes to the loss of renal proximal tubule epithelial cells. Pathophysiological events such as oxidative stress, mitochondrial dysfunction, and direct renal tubular epithelial cells toxicity are responsible for the progression of the disease. This devastating decline in renal function affects mostly patients in the intensive care units and requires costly and invasive treatments such as dialysis and organ transplant. Fortunately, recent therapies such as the use of mesenchymal stem cells (MSCs) were proven to be effective in ameliorating renal failure via paracrine and immunomodulatory mechanisms. These fibroblast-like adult stem cells that differentiate multilineagely can be isolated from dental pulps, umbilical cords, amniotic fluids, adipose tissues, and bone marrows. Depending on their sources, the therapeutical application of each MSC type has its own capacities, advantages, and drawbacks. The review discusses and compares the latest research studies on the use of different MSCs sources to treat renal failure. Concerns about the future clinical application of MSCs such as homing, toxicity, and the risk of immune rejection are also highlighted.

Keywords: Acute kidney injury; Acute renal failure; Cisplatin; Glomerular filtration rate; Ischemia/reperfusion injury; Mesenchymal stem cells.

Fig. 1

Location of the nephron in the kidney and its main constitutes. The proximal tubule connects the Bowman's capsule to the loop of Henle (this figure is original for this article).

Fig. 2

Horizontal transfer of EV-embedded mRNA as part of paracrine mechanism (this figure is original for this article).