Stem cell technology for the treatment of acute and chronic renal failure

Acute and chronic renal failure are disorders with high rates of morbidity and mortality. Current treatment is based upon conventional dialysis to provide volume regulation and small solute clearance. There is growing recognition that renal failure is a complex disease state requiring a multifactorial therapy to address the short-comings of the conventional monofactorial approach. Kidney transplantation remains the most effective treatment, however, organ availability lags far behind demand. Many key kidney functions including gluconeogenesis, ammoniagenesis, metabolism of glutathione, catabolism of important peptide hormones, growth factors, and cytokines critical to multiorgan homeostasis and immunomodulation are provided by renal tubule cells. Therefore, cell-based therapies are promising multifactorial treatment approaches. In this review, current stem cell technologies including adult stem cells, embryonic stem cells and induced pluripotent stem cells will be discussed as cell sources for the treatment of acute and chronic renal failure.

Abbreviations: AKI, acute kidney injury, ARF, acute renal failure, BRECS, bioartificial renal epithelial cell system, CVVH, continuous venovenous hemofiltration, ERSD, end-stage renal disease, EP, endothelial progenitor, EPO, erythropoietin, ES, embryonic stem, iPS, induced pluripotent stem, MAPC, multipotent adult progenitor cell, MM, metanephric mesenchyme, MOF, multiple organ failure, MSC, mesenchymal stem cell, PEC, parietal epithelial cell, RAD, renal tubule assist device, SC, stem cell, UB, ureteric bud