Therapeutic use of stem and endothelial progenitor cells in acute renal injury: ça ira

Acute renal failure (ARF) seriously worsens prognosis of hospitalized patients. The dysfunction and apoptosis/necrosis of tubular epithelial cells is of key importance for the pathophysiological consequences of the syndrome. ARF also affects the structure and function of the renal endothelium because these cells undergo an early swelling with narrowing of the vascular lumen, resulting in prolonged renal hypoperfusion. The dysfunctional renal epithelium and endothelium have remarkable capacity to recover. With the growing knowledge in the field of stem cell research, these regenerative mechanisms become more and more elucidated. Recent data suggest that bone marrow derived mesenchymal stem cells can ameliorate ARF through both paracrine effects and repair of injured microvasculature by providing endothelial progenitor cells. Evidence for resident adult renal stem cells is also now emerging.