Mesenchymal stem cell-Based therapy for chronic kidney disease

Chronic kidney disease (CKD) remains a major contributor to the global economic burden and is associated with increased morbidity and mortality. Despite current medical advances, there is an urgent need for novel interventions to prevent the progression from CKD to end-stage renal disease (ESRD). Transplantation of mesenchymal stem/stromal cells (MSCs) has shown great promise for regenerating damaged kidneys in several experimental animal models. The safety and efficacy of this approach in humans is gradually beginning to be examined through early phase clinical trials worldwide. This chapter summarizes and appraises the available literature on the regenerative potential of MSCs for CKD therapy. In particular, three important CKD etiologies, which are likely to benefit from MSC-based therapy, are highlighted. These include polycystic kidney disease (PKD), an important inherited cause of CKD, diabetes, and hypertension-associated ESRD. Additionally, the role of extracellular vesicles as drivers of MSC regenerative potential and the current challenges for MSC therapy in patients with CKD are further explored.