BACKGROUND 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 e...BACKGROUND 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 m^(2).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 m^(2)),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 m^(2)/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.展开更多
文摘BACKGROUND 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 m^(2).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 m^(2)),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 m^(2)/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.
