Stem cells in kidney regeneration following acute renal injury.

Acute renal failure has 50-80% mortality. Currently, treatment options for this life-threatening disease are limited. Stem cells offer an exciting potential for kidney regeneration. This review discusses pathogenesis of acute renal failure resulting from ischemia-reperfusion injury and the role of stem cells in reversing or mitigating this disorder. Specifically, the issues of differentiation of kidney cells from embryonic stem cells and bone marrow stem cells, and whether adult kidney stem/progenitor cells exist in the postnatal kidney are discussed. Evidence to support the conclusion that intra-renal cells, including surviving tubular epithelial cells and potential renal stem/progenitor cells, are the main source for renal regeneration is provided. Future research in selecting the type(s) of stem cells and optimizing the dose, frequency and route of administration of the cells will be fundamental in successful cell replacement therapy in acute renal failure. Methods for enhancing endogenous renal cell proliferation and differentiation for renal repair continue to be important research directions.