BACKGROUND
Newswise — To date, no specific treatment has been established to reverse progressive chronic kidney disease (CKD).
AIM
To evaluate the safety and efficacy of autologous CD34+ cell transplantation in CKD patients who exhibited a progressive decline in renal function.
METHODS
The estimated glomerular filtration rate (eGFR) at the beginning of the study was 15.0-28.0 mL/minute/1.73 m2. After five days of treatment with the granulocyte colony-stimulating factor, mononuclear cells were harvested and CD34+ cells were magnetically collected. CD34+ cells were directly injected into the bilateral renal arteries twice (at 0 and 3 months), and their safety and efficacy were evaluated for 6 months.
RESULTS
Four patients were enrolled and completed the study. Three of four patients showed improvement in eGFR slope (eGFR slope > 0 mL/minute/1.73 m2), with the monthly slope of eGFR (delta eGFR) changing from -1.36 ± 1.1 (pretreatment) to +0.22 ± 0.71 (at 6 months) mL/minute/1.73 m2/month (P = 0.135) after cell therapy. Additionally, intrarenal resistive index (P = 0.004) and shear wave velocity (P = 0.04) were significantly improved after cell therapy. One patient experienced transient fever after cell therapy, and experienced bone pain during granulocyte colony-stimulating factor administration. However, no severe adverse events were reported.
CONCLUSION
In conclusion, our findings suggest that repetitive peripheral blood-derived autologous CD34+ cell transplantation into the renal arteries is safe, feasible, and may be effective for patients with progressive CKD. However, a large-scale clinical trial is warranted to validate the efficacy of repetitive regenerative cell therapy using autologous CD34+ cells in patients with progressive CKD.
Key Words: CD34+ cell; Chronic kidney disease; Clinical trial; Granulocyte colony-stimulating factor; Regenerative therapy
Core Tip: Chronic kidney disease (CKD) progresses to end-stage renal disease, and it is often very difficult to retard its progression. Therefore, new and effective therapies for CKD are urgently needed. We administered granulocyte colony-stimulating factor-mobilized autologous CD34 positive cells directly into renal arteries. The progressive decline in the estimated glomerular filtration rate improved after 1st cell therapy in three of four patients and was almost preserved after 2nd cell therapy. Although this was an exploratory small clinical trial, the results provide new insights in the field of regenerative medicine for progressive CKD.
- Citation: Ohtake T, Sato T, Tsukiyama T, Muraoka S, Mitomo A, Maruyama H, Yamano M, Mochida Y, Ishioka K, Oka M, Moriya H, Hidaka S, Masuda H, Asahara T, Kobayashi S. Preliminary evidence of renal function improvement in chronic progressive kidney disease using autologous CD34+ cell therapy: A clinical trial. World J Stem Cells 2024; 16(12): 1012-1021
- URL: https://www.wjgnet.com/1948-0210/full/v16/i12/1012.htm
- DOI:
