Mesenchymal Stem Cells in the Treatment of Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) and the AKI-to-CKD Transition

Abstract

ABSTRACT Acute kidney injury (AKI) and chronic kidney disease (CKD) are global health burdens that result in high economic costs to healthcare systems. AKI is a known risk factor for progression to CKD. The global absolute CKD prevalence increased by 28.2% from 2007–2017 among females and 25.4% among males. Current best clinical practice only slows the progress of renal fibrosis, the final pathological consequence of renal injury, in CKD. Kidney transplantation and dialysis are the only options for the management of kidney failure, which results in a significant burden on the health system. Hence innovative strategies are urgently needed to both prevent and treat CKD. Many studies have demonstrated that mesenchymal stem cells (MSCs) exert a therapeutic role through regenerating/repairing damaged tissues primarily through cargo secreted in extracellular vesicles. In recent years, the therapeutic effect of stem cells in the treatment of acute and chronic kidney disease have been primarily assessed in preclinical studies. This review outlines the safety and efficacy of MSCs in AKI, CKD and the AKI-to-CKD transition based on recent animal studies and clinical trials. It elucidates the antifibrotic mechanisms of MSCs and provides novel insights into MSC therapy in AKI, CKD and the transition from AKI to CKD.