Therapeutic potential of stem cell and cell-free therapies for acute and chronic kidney failure

Despite the global increase in the number of patients requiring care for end-stage chronic kidney disease (CKD), the demand for renal replacement therapy continues to exceed healthcare capacity. This gap underscores the need for innovative strategies to prevent the progression of acute kidney injury (AKI) to CKD. One promising approach is stem cell (SC) therapy, involving cells derived from various tissues or their secretory products (SC secretome). This review examines current evidence on the potential of cell-based therapies to promote regeneration of damaged renal structures by enhancing adaptive and compensatory mechanisms and suppression of maladaptive responses in kidney injury. Experimental studies demonstrate that SC therapy significantly improves renal function, accelerates recovery in AKI, and reduces the risk of progression to CKD. Notably, SC secretome therapy appears to be comparably effective to the use of stem cells themselves. Factors limiting the efficacy of cell therapy and potential strategies to overcome these challenges are also discussed.