STEM CELL (STC30) AND KIDNEY DISEASE

CHRONIC KIDNEY DISEASE 

The kidney: are a pair of fist-sized organs located at the bottom of the rib cage. There is one kidney on each side of the spine.

Kidneys are essential to having a healthy body. They are mainly responsible for filtering waste products, excess water, and other impurities out of the blood. These toxins are stored in the bladder and then removed during urination. The kidneys also regulate pH, salt, and potassium levels in the body. They produce hormones that regulate blood pressure and control the production of red blood cells. The kidneys even activate a form of vitamin D that helps the body absorb calcium.

The term “chronic kidney disease” means lasting damage to the kidneys that can get worse over time. If the damage is very bad, your kidneys may stop working. This is called kidney failure, or end-stage renal disease (ESRD). If your kidneys fail, you will need dialysis or a kidney transplant in order to live.

Causes of chronic kidney disease(CKD)

In most cases, kidney failure is caused by other health problems that have done permanent damage (harm) to your kidneys little by little, over time.

When your kidneys are damaged, they may not work as well as they should. If the damage to your kidneys continues to get worse and your kidneys are less and less able to do their job, you have chronic kidney disease. Kidney failure is the last (most severe) stage of chronic kidney disease. This is why kidney failure is also called end-stage renal disease, or ESRD for short.

Diabetes is the most common cause of ESRD. High blood pressure is the second most common cause of ESRD. Other problems that can cause kidney failure include:

• Autoimmune diseases, such as lupus and IgA nephropathy
• Genetic diseases (diseases you are born with), such as polycystic kidney disease
• Nephrotic syndrome
• Urinary tract problems

Sometimes the kidneys can stop working very suddenly (within two days). This type of kidney failure is called acute kidney injury or acute renal failure. Common causes of acute renal failure include:

• Heart attack
• Illegal drug use and drug abuse
• Not enough blood flowing to the kidneys
• Urinary tract problems

This type of kidney failure is not always permanent. Your kidneys may go back to normal or almost normal with treatment and if you do not have other serious health problems.

Having one of the health problems that can lead to kidney failure does not mean that you will definitely have kidney failure. Living a healthy lifestyle and working with your doctor to control these health problems can help your kidneys work for as long as possible.

Signs and Symptoms of kidney disease

The Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Signs and symptoms of kidney disease may include:

• Nausea
• Vomiting
• Loss of appetite
• Fatigue and weakness
• Sleep problems
• Changes in how much you urinate
• Decreased mental sharpness
• Muscle twitches and cramps
• Swelling of feet and ankles
• Persistent itching
• Chest pain, if fluid builds up around the lining of the heart
• Shortness of breath, if fluid builds up in the lungs
• High blood pressure (hypertension) that’s difficult to control

Signs and symptoms of kidney disease are often nonspecific, meaning they can also be caused by other illnesses. Because your kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.

What are the types and causes of kidney disease?

Chronic kidney disease

The most common form of kidney disease is chronic kidney disease. Chronic kidney disease is a long-term condition that doesn’t improve over time. It’s commonly caused by high blood pressure.

High blood pressure is dangerous for the kidneys because it can increase the pressure on the glomeruli. Glomeruli are the tiny blood vessels in the kidneys where blood is cleaned. Over time, the increased pressure damages these vessels, and kidney function begin to decline.

Kidney function will eventually deteriorate to the point where the kidneys can no longer perform their job properly. In this case, a person would need to go on dialysis. Dialysis filters extra fluid and wastes out of the blood. Dialysis can help treat kidney disease but it can’t cure it. A kidney transplant may be another treatment option depending on your circumstances.

Diabetes is also a major cause of chronic kidney disease. Diabetes is a group of diseases that causes high blood sugar. The increased level of sugar in the blood damages the blood vessels in the kidneys over time. This means the kidneys can’t clean the blood properly. Kidney failure can occur when your body becomes overloaded with toxins.

Kidney stones

Disease such as Kidney stones is another common kidney problem. They occur when minerals and other substances in the blood crystallize in the kidneys, forming solid masses (stones). Kidney stones usually come out of the body during urination. Passing kidney stones can be extremely painful, but they rarely cause significant problems.

Glomerulonephritis

Glomerulonephritis is an inflammation of the glomeruli. Glomeruli are extremely small structures inside the kidneys that filter the blood. Glomerulonephritis can be caused by infections, drugs, or congenital abnormalities (disorders that occur during or shortly after birth). It often gets better on its own.

Polycystic kidney disease

Polycystic kidney disease is a genetic disorder that causes numerous cysts (small sacs of fluid) to grow in the kidneys. These cysts can interfere with kidney function and cause kidney failure. (It’s important to note that individual kidney cysts are fairly common and almost always harmless. Polycystic kidney disease is a separate, more serious condition.)

Urinary tract infections

Urinary tract infections (UTIs) are bacterial infections of any part of the urinary system. Infections in the bladder and urethra are the most common. They are easily treatable and rarely lead to more health problems. However, if left untreated, these infections can spread to the kidneys and cause kidney failure.

How is kidney disease treated?

Treatment for kidney disease usually focuses on controlling the underlying cause of the disease. This means your doctor will help you better manage your blood pressure, blood sugar, and cholesterol levels. They may use one or more of the following methods to treat kidney disease.

Drugs and medication

Your doctor will either prescribe angiotensin-converting enzymes (ACE) inhibitors, such as lisinopril and ramipril, or angiotensin receptor blockers (ARBs), such as irbesartan and olmesartan. These are blood pressure medications that can slow the progression of kidney disease. Your doctor may prescribe these medications to preserve kidney function, even if you don’t have high blood pressure.

You may also be treated with cholesterol drugs (such as simvastatin). These medications can reduce blood cholesterol levels and help maintain kidney health. Depending on your symptoms, your doctor may also prescribe drugs to relieve swelling and treat anemia (decrease in the number of red blood cells).

Dietary and lifestyle changes

Making changes to your diet is just as important as taking medication. Adopting a healthy lifestyle can help prevent many of the underlying causes of kidney disease. Your doctor may recommend that you:

• control diabetes through insulin injections
• cut back on foods high in cholesterol
• cut back on salt
• start a heart-healthy diet that includes fresh fruits, veggies, whole grains, and low-fat dairy products
• limit alcohol consumption
• quit smoking
• increase physical activity
• lose weight

Dialysis and kidney disease

Dialysis is an artificial method of filtering the blood. It’s used when someone’s kidneys have failed or are close to failing. Many people with late-stage kidney disease must go on dialysis permanently or until a donor’s kidney is found.

STEM CELL AND KIDNEY  DISEASE

Chronic kidney disease (CKD) is increasing at the rate of 6-8% per annum in the US alone. At present, dialysis and transplantation remain the only treatment options. However, there is hope that stem cells and regenerative medicine may provide additional regenerative options for kidney disease. Such new treatments might involve the induction of repair using endogenous or exogenous stem cells or the reprogramming of the organ to reinitiate development.

This review addresses the current state of understanding with respect to the ability of non-renal stem cell sources to influence renal repair, the existence of endogenous renal stem cells, and the biology of normal renal repair in response to damage. It also examines the remaining challenges and asks the question of whether there is one solution for all forms of renal disease.