Chronic Renal Failure (CRF)

Chronic renal failure (CRF, or "chronic kidney failure", CKF, or "chronic kidney disease", CKD) is a slowly progressive loss of renal function over a period of months or years and defined as an abnormally low glomerular filtration rate, which is usually determined indirectly by the creatinine level in blood serum.

Chronic renal failure is an important clinical problem with significant socioeconomic impact worldwide. CRF that leads to severe illness and requires some form of renal replacement therapy (such as dialysis) is called end-stage renal disease (ESRD). Despite advances in renal replacement therapies and organ transplantation, poor quality of life for dialysis patients and long transplant waiting lists remain major concerns for nephrologists treating this condition. Renal transplantation increases the survival of patients with stage 5 CKD significantly when compared to other therapeutic options; however, it is associated with an increased short-term mortality (due to complications of the surgery).

There is therefore a pressing need for novel therapies to promote renal cellular repair and tissue remodelling. Over the past decade, advances in the field of regenerative medicine allowed development of cell therapies suitable for kidney repair.

The rising concept of cell-based therapeutics has provided a framework around which new approaches are being generated, and its combination with advances in stem cell research stands to bring both fields to clinical fruition. Since CRF affects a large number of these patients who will lose their productive life, stem cell implantation can offer some promise of improved health.

A number of different types of cells from the bone marrow have been tested in animals and in clinical studies for potential use in kidney disease. Amongst all the cells under investigation, mesenchymal stem cells have shown the most promising results to date. Studies suggest that MSCs may be able to enhance the intrinsic ability of the kidney to repair itself.

Mesenchymal stem cells (MSCs) are undifferentiated cells that possess immunomodulatory and tissue trophic properties and the ability to differentiate into multiple cell types. Studies in animal models of chronic renal failure have uncovered a unique potential of these cells for improving function and regenerating the damaged kidney. Most studies indicate a remarkable capability of MSCs to achieve kidney repair.

MSCs of the bone marrow can differentiate to produce specialized bone, fat and cartilage cells. Researchers investigating the therapeutic effects of these MSCs within the kidney have suggested these cells may release proteins that can help kidney cells to grow, inhibit cell death and that could encourage the kidney’s own stem cells to repair kidney damage. MSCs could have the ability to regenerate glomerulus, interstitium, blood vessels and tubules, the four essential components of the renal matrix and in-turn potentially reverses symptoms of CKD. They secrete protecti
ve and nourished factors that can prevent progressive apoptosis of functional cells and stimulate replication of host cells.

Further research is needed to establish whether these ideas are correct and if so, how this could lead to a treatment for patients.

In our present study, we want to evaluate the safety and efficacy of autologous bone marrow derived stem cells injected into the Renal Artery in patients with Chronic Renal Failure. The improvement can be depicted by a gradual decrease in BUN, creatinine, and uric acid levels. Overtime GFR and urine output should also improve substantially with regeneration of the kidney tissue.

We will be treating your renal failure with autologous mononuclear fraction of bone marrow derived stem cells for studies conducted in India and Umbilical cord mesenchymal stem cells for treatment done in Trinidad.

We will be doing femoral catheterization and super selective intra-arterial injection of bone marrow derived mononuclear cells in renal artery. Treatment can be either done in India or Trinidad.

The treatment length would be as follows: Intra-arterial injection of bone marrow derived stem cells once with follow-up of another 7 days as direct observation before the discharge.

Our staff members will follow you up in accordance to the study protocols. Our medical staff will be monitoring your BUN, creatinine and uric acid levels at 1, 3, 6 and 12 months after treatment. We will also collaborate with your nephrologist after monitoring your BUN, creatinine, and uric acid levels and titrate your dialysis requirement to ensure optimal renal function.