Tuganbekova Saltanat, Gaipov Abduzhappar, Turebekov Zaiyrkhan, Saparbayev Samat, Shaimardanova Galiya, Popova Nadezhda, Taubaldiyeva Zhannat, Serebrennikova Dina, Trimova Rakhat
From the Department of Internal Medicine, National Scientific Medical Research Center, Astana, Kazakhstan.
Exp Clin Transplant. 2015 Nov;13 Suppl 3:156-9. doi: 10.6002/ect.tdtd2015.P88.
Proteinuria is a major cause of glomerulosclerosis progression in glomerular diseases, and the development of end-stage renal disease is more rapid in nephrotic patients than in nonnephrotic ones. The renal parenchyma is less regenerable because it is a tissue consisting of renal cells. Thus, stem cells obtained from fetal kidney tissue might be effective for reducing proteinuria and delaying glomerulosclerosis in these patients.
This report presents preliminary data from a prospective cohort study that included 17 patients with chronic glomerulonephritis in stage 2 to 4 chronic kidney disease who completed 3 visits during 1 year of follow-up. Fetal renal stem cells (multiple cells in suspension) were injected into the patient every 6 months. Patients were divided into 2 groups according to their nephrotic status, and 24-hour maximal proteinuria was recorded for at least 6 months (first group with proteinuria < 3.5 g/24 h, and second group with proteinuria > 3.5 g/24 h).
During follow-up, group 1 was observed to have stable hemoglobin and total protein levels but significantly decreased albumin levels and glomerular filtration rates. In group 2, total protein with serum albumin significantly increased, and proteinuria and glomerular filtration rates significantly decreased. There was no significant difference in glomerular filtration rate decline between groups.
Treatment with fetal renal stem cells significantly decreased proteinuria in nephrotic patients. However, this outcome also might have resulted from a reduction in glomerular filtration rate. Further studies with a larger number of patients and a control group would help to achieve better results that measure the efficacy of this treatment.
蛋白尿是肾小球疾病中肾小球硬化进展的主要原因，肾病患者终末期肾病的发展比非肾病患者更快。肾实质再生能力较差，因为它是由肾细胞组成的组织。因此，从胎儿肾脏组织中获取的干细胞可能对减少这些患者的蛋白尿和延缓肾小球硬化有效。
本报告展示了一项前瞻性队列研究的初步数据，该研究纳入了17例2至4期慢性肾脏病的慢性肾小球肾炎患者，他们在1年的随访期间完成了3次就诊。每6个月向患者注射胎儿肾干细胞（悬浮的多个细胞）。根据患者的肾病状态将其分为2组，并记录至少6个月的24小时最大蛋白尿（第一组蛋白尿<3.5 g/24 h，第二组蛋白尿>3.5 g/24 h）。
在随访期间，观察到第1组血红蛋白和总蛋白水平稳定，但白蛋白水平和肾小球滤过率显著下降。在第2组中，血清白蛋白总蛋白显著增加，蛋白尿和肾小球滤过率显著下降。两组之间肾小球滤过率下降无显著差异。
胎儿肾干细胞治疗可显著降低肾病患者的蛋白尿。然而，这一结果也可能是由于肾小球滤过率降低所致。对更多患者和对照组进行进一步研究将有助于取得更好的结果，以衡量这种治疗方法的疗效。
