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Adult stem cells in the repair of the injured renal tubule

Nature Clinical Practice Nephrology volume 1, pages 22–32 (2005)Cite this article

Abstract

The capacity of the kidney to regenerate functional tubules following episodes of acute injury is an important determinant of patient morbidity and mortality in the hospital setting. After severe injury or repeated episodes of injury, kidney recovery can be significantly impaired or even fail completely. Although significant advances have been made in the clinical management of such cases, there is no specific therapy that can improve the rate or effectiveness of the repair process. Recent studies have indicated that adult stem cells, either in the kidney itself or derived from the bone marrow, could participate in this repair process and might therefore be utilized clinically to treat acute renal failure. This review will focus on our current understanding of these stem cells, the controversies surrounding their in vivo capacity to repopulate the renal tubule, and further investigations that will be required before stem cell therapy can be considered for use in the clinical setting.

Key Points

  • A population of tubule progenitor cells may persist in the renal interstitium of adults

  • Stem cells from the bone marrow mobilize to the kidney after injury

  • Mobilizing or infusing bone-marrow stem cells (BMSCs) can have a protectiveeffect in animal models of acute renal failure

  • It is not clear whether BMSCs differentiate to form tubule cells, or fuse with existing tubule elements

  • The low frequency of BMSC differentiation and fusion make it unlikely that these processes account for functional recovery of injured tubules

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Figure 1: Proposed mechanisms of tubule repair after acute injury.
Figure 2: Proposed differentiation capacities of bone-marrow stem cells.
Figure 3: Bone-marrow stem cells may rarely contribute to renal tubule repair.
Figure 4: Possible roles for bone-marrow stem cells in facilitating renal repair.

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Acknowledgements

The author would like to thank M Egalka for the images in Figure 3, and D Krause for her helpful comments on the manuscript.

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Authors and Affiliations

  1. an Associate Professor in the Section of Nephrology at Yale University School of Medicine, New Haven, CT, USA

    Lloyd G Cantley

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  1. Lloyd G Cantley
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Correspondence to Lloyd G Cantley.

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Cantley, L. Adult stem cells in the repair of the injured renal tubule. Nat Rev Nephrol 1, 22–32 (2005). https://doi.org/10.1038/ncpneph0021

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  • DOI: https://doi.org/10.1038/ncpneph0021

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