Stem Cell Therapy for Chronic Kidney Disease

What is Chronic Kidney Disease (CKD)? 

Chronic kidney disease, also called chronic kidney failure, involves a gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then removed in your urine. Advanced chronic kidney disease can cause dangerous levels of fluid, electrolytes and wastes to build up in your body.

In early stages only a few signs or symptoms can be present and the patient might not realize that they have kidney disease until the condition is advanced. 

The leading cause of chronic kidney disease worldwide is diabetic nephropathy (DN) and is also the most detrimental microvascular complication of diabetes.

The incidence of DN can reach 30%-40% after 20 years of diabetes, of which 5%~10% of patients will progress to end-stage renal disease. Epidemiological surveys predict that by 2030, DN will become the seventh leading cause of death in the world.

Risk factors for DN include advanced age, gender, long disease course, obesity, high salt diet, dyslipidemia, nephrotoxic substances, acute kidney injury and excessive protein intake. Hyperglycemia and hypertension are the most significant risk factors.

What are some of the common symptoms? 

Signs and symptoms develop over time if kidney damage progresses slowly. Loss of kidney function can cause a buildup of fluid or body waste, and even electrolyte problems. Some of the common sign and symptoms are: 

• Loss of appetite.
• Fatigue and weakness. 
• Nausea and vomiting. 
• Sleep problems.
• Urinating more or less.
• Decreased mental sharpness.
• Muscle cramps.
• Swelling of feet and ankles.
• High blood pressure that’s difficult to control. 
• Shortness of breath if fluid builds up in the lungs. 

What causes Chronic Kidney Disease? 

Chronic kidney disease occurs when a disease or condition impairs kidney function, causing damage to worsen over several months or years. Some diseases that can cause chronic kidney disease are: 

• Type 1 or 2 diabetes. 
• High blood pressure.
• Glomerulonephritis.
• Polycystic kidney disease. 
• Interstitial nephritis. 

Prevention 

Some preventive measures include: 

• Manage medical conditions causing kidney damage. 
• Maintain a healthy weight. 
• Stop smoking. 
• Follow up instructions on over the counter medications that may cause kidney damage, like non-steroidal antiinflamatories (NSAIDs).

The prevention and treatment of DN are mainly divided into pre-diabetes prevention (active screening, early detection, and reasonable intervention), early treatment (tight control of blood glucose and blood pressure) to delay the development of DN and comprehensive treatment of advanced DN (including alternative treatments such as dialysis or kidney transplantation) to reduce the risk of cardiovascular events and death.

Treatments

Treatment for chronic kidney disease focuses on slowing the progression of kidney damage, usually by controlling the cause. But, even controlling the cause might not keep kidney damage from progressing. Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

There is no cure for CKD, but treatment can help relieve the symptoms and stop it getting worse. The main treatments are: 

• Lifestyle changes.
• Medicine control for associated problems, such as high blood pressure. 
• Dialysis.
• Kidney transplant.

Due to the lack of curative treatment and the high costs of dialysis treatments and difficulty of  getting a transplant when there are no other available treatments for the patients, other treatment options have been evaluated over recent years. One of them is stem cell therapy. 

Stem Cell Therapy with Mesenchymal Stem Cells

Effective therapeutic strategies to counteract and reverse the progression of DN are lacking, and therefore, it is imperative to develop new strategies for treating DN. One of the therapies that has become most likely a new breakthrough in the treatment of DN is stem cell therapy, due to its self-renewal capacity, multilineage differentiation potential, paracrine effects and immunomodulatory properties. 

Mesenchymal stem cells (MSCs) are derived from a diverse range of human tissues. They are multipotent and have immunomodulatory effects to assist in the recovery from tissue injury and the inhibition of inflammation.

Numerous studies have investigated the feasibility, safety and efficacy of MSC-based therapies for kidney disease. 

Umbilical cord Mesenchymal stem cells are considered to be the better choice of Mesenchymal Stem cells (MSCs) for clinical applications due to their easy collection, low immunogenicity and high paracrine potential. 

Clinical Trials

Xiang E, et al using a rat model with streptozotocin (STZ)-inducen DN and in vitro high glucose induced HK2 cells and hrGEC injury models, they evaluated the efficacy and mechanisms of Umbilical cord mesenchymal stem cells (UC-MSCs) in the treatment of DN and confirmed that UC-MSCs could migrate to the kidneys and effectively repair renal dysfunction, including reducing proteinuria, serum creatinine levels and urea nitrogen levels and elevating Creatinine clearance blood (CCr) in DN rats. Importantly, UC-MSCs significantly reduce the inflammatory response and improve renal fibrosis of DN.

The researchers demonstrated with their model the potential benefits of UC-MSCs treatment and how it can effectively improve the renal function, inhibit inflammation and fibrosis and prevent the progression of early diabetic nephropathy. More studies are needed to evaluate its utility in humans with the realization of randomized clinical trials.

Stem Cell Therapy at Zignagenix 

At our clinic we use the same type of stem cells derived from the umbilical cord Warthon’s jelly, as they have shown the best results in clinical trials for kidney disease. Our protocols are based on different research studies and can improve the patient’s quality of life and slow the progression of the disease. The results depend on the patient’s underlying conditions and the extension of the kidney damage.  

We use intravenously infused stem cells at high doses (depending on the patient’s weight) combined with exosomes to increase the effectiveness of our therapies. 

Source: 

Xiang E, Han B, Zhang Q, Rao W, Wang Z, Chang C, Zhang Y, Tu C, Li C, Wu D. Human umbilical cord-derived mesenchymal stem cells prevent the progression of early diabetic nephropathy through inhibiting inflammation and fibrosis. Stem Cell Res Ther. 2020 Aug 3;11(1):336. 

https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521

Image from: 

https://www.businessinsider.es/insuficiencia-renal-sintomas-consecuencias-problemas-rinon-826285