Kidney Res Clin Pract 2019 Jun; 38(2): 176-185  
Adipose tissue-derived mesenchymal stromal cells for treating chronic kidney disease: A pilot study assessing safety and clinical feasibility
Sandra Villanueva1 , Fernando González2 , Eduardo Lorca2 , Andrés Tapia3 , Valentina López G4, Rocío Strodthoff1 , Francisca Fajre1 , Juan E. Carreño1 , Ricardo Valjalo2 , César Vergara1 , Manuel Lecanda1 , Jorge Bartolucci4 , Fernando E. Figueroa3,5,6,* , Maroun Khoury3,4,5,*
1Laboratory of Molecular and Integrative Physiology, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
2Department of Nephrology, Hospital Salvador, Santiago, Chile
3Laboratory of Nano-regenerative Medicine, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
4Cells for Cells, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
5Program for Translational Research in Cell Therapy and 6Consorcio Regenero, the Chilean Consortium for Regenerative Medicine, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
Correspondence to: Fernando E. Figueroa
Universidad de Los Andes, Monseñor Álvaro del Portillo 12445, Santiago, Chile. E-mail: ffigueroa@uandes.cl
Maroun Khoury
Cells for Cells, Monseñor Alvaro del Portillo 12445, Santiago, Chile. E-mail: mkhoury@c4c.cl
*Fernando E. Figueroa and Maroun Khoury contributed equally to this article as co-senior authors.
Received: November 12, 2018; Revised: January 25, 2019; Accepted: February 18, 2019; Published online: June 30, 2019.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Chronic kidney disease (CKD) is a growing public health concern, and available treatments are insufficient in limiting disease progression. New strategies, including regenerative cell-based therapies, have emerged as therapeutic alternatives. Results from several groups, including our own, have reported evidence of a supportive role for mesenchymal stromal cells (MSCs) in functional recovery and prevention of tissue damage in murine models of CKD. Prompted by these data, an open pilot study was conducted to assess the safety and efficacy of a single injection of autologous adipose tissue-derived MSCs (AT-MSCs) for treatment of CKD.
Methods: AT-MSCs were infused intravenously into six CKD patients at a dose of 1 million cells/kg. Patients were stabilized and followed for one year prior to MSC infusion and one year following infusion.
Results: No patients presented with adverse effects. Statistically significant improvement in urinary protein excretion was observed in AT-MSCs transplanted patients, from a median of 0.75 g/day (range, 0.15–9.57) at baseline to 0.54 g/day (range, 0.01–2.66) at month 12 (P = 0.046). The glomerular filtration rate was not significantly decreased post-infusion of AT-MSCs.
Conclusion: Findings from this pilot study demonstrate that intravenous infusion of autologous expanded AT-MSCs into CKD patients was not associated with adverse effects and could benefit patients already undergoing standard medical treatment.
Keywords: Adipose tissue-derived mesenchymal stromal cells, Chronic kidney disease, Mesenchymal stromal cell transplantation, Proteinuria, Stem cells


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