Stem cells and kidney injury

Purpose of review: The most commonly used therapies in nephrology target the reduction of acute injury, reduction of the rate of progression, or renal replacement therapy. The purpose of this review is to examine new evidence that renal progenitors can be used for therapeutic purposes. Stem cells possess two characteristics, self-renewal and the capacity for multilineage differentiation. They are typically classified as derived from embryos or from the adult. Recent findings: New studies on embryonic stem cells show that they can be use to enrich for specific renal progenitors, which integrate into mature structures. Studies on adult stem cells show that almost all kidney cell types can be renewed by adult stem cells originating in bone marrow. Moreover, some animal studies demonstrate that a phenotype such as the aging and diabetic phenotype can be transferred from progenitors residing in the bone marrow, suggesting that the bone marrow contains renal progenitors that may be useful for therapeutic purposes. Summary: Stem cell therapy opens the door to regenerative nephrology. Embryonic stem cells are a useful tool to determine the pathways to convert a pluripotent stem cell into renal progenitors. Adult stem cells in the bone marrow or in a specific kidney niche may provide a source of stem cells with a therapeutic potential.