Abstract
Background Renal damage caused by drug toxicity is becoming increasingly common in the clinic. Preventing and treating kidney damage caused by drug toxicity are essential to maintain patient health and reduce the social and economic burden. In this study, we performed a meta-analysis to assess the nephroprotective effect of mesenchymal stem cells (MSCs) in the treatment of kidney disease induced by toxicants. Methods The Cochrane Library, Embase, ISI Web of Science, and PubMed databases were searched up to December 31, 2019, to identify studies and extract data to assess the efficacy of MSCs treatment of kidney disease induced by toxicants using Cochrane Review Manager Version 5.3. A total of 27 studies were eligible and selected for this meta-analysis. Results The results showed that a difference in serum creatinine levels between the MSC treatment group and control group was observed for 2, 4, 5, 6-8, 10-15, 28-30, and ≥42 days (2 days: WMD = −0.88, 95% CI: -1.34, -0.42, P = 0.0002; 4 days: WMD = −0.74, 95% CI: -0.95, -0.54, P < 0.00001; 5 days: WMD = −0.46, 95% CI: -0.67, -0.25, P < 0.0001; 6-8 days: WMD = −0.55, 95% CI: -0.84, -0.26, P = 0.0002; 10-15 days: WMD = −0.37, 95% CI: -0.53, -0.20, P < 0.0001; 28-30 days: WMD = −0.53, 95% CI: -1.04, -0.02, P = 0.04; ≥42 days: WMD = −0.22, 95% CI: -0.39, -0.06, P = 0.007). Furthermore, a difference in blood urea nitrogen levels between the MSC treatment group and control group was observed for 2-3, 4-5, 6-8, and ≥28 days. The results also indicate that MSC treatment alleviated inflammatory cells, necrotic tubules, regenerative tubules, and renal interstitial fibrosis in kidney disease induced by toxicants. Conclusion MSCs may be a promising therapeutic agent for kidney disease induced by toxicants.
Highlights
Kidney injury occurs during acute kidney injury (AKI) and chronic kidney disease (CKD), and it is a common condition associated with the morbidity and mortality of patients
A total of 18 studies [11,12,13,14,15, 17,18,19, 21, 22, 24, 26,27,28,29, 32,33,34, 36, 37] were selected to assess the effect of mesenchymal stem cells (MSCs) on blood urea nitrogen (BUN), and the results indicate that the difference between the MSC treatment and control groups was observed for 2-3, 4-5, 6-8, and ≥28 days (2-3 days: weighted mean differences (WMDs) = −25:08, 95% confidence intervals (95% CI): -37.49, -12.67, P < 0:0001; 4-5 days: WMD = −45:71, 95% CI: -59.36, -32.05, P < 0:00001; 6-8 days: WMD = −57:55, 95% CI: -99.19, -15.91, P = 0:007; ≥28 days: WMD = −23:39, 95% CI: -36.39, -10.40, P = 0:0004; Figure 4 and Table 2)
The results show that the MSC group had a lower urinary albumin excretion (UAE) than the control group (WMD = −22:66, 95% CI: -26.41, -18.90, P < 0:00001; Table 2)
Summary
Kidney injury occurs during acute kidney injury (AKI) and chronic kidney disease (CKD), and it is a common condition associated with the morbidity and mortality of patients. Renal damage caused by drug toxicity is becoming increasingly common in the clinic. Mesenchymal stem cells (MSCs), which are multipotent mesenchymal cells present in various tissues, have multilineage differentiation ability under appropriate conditions and are easy to obtain They are a promising therapeutic option for some diseases because of their unique property of releasing some important bioactive factors [3,4,5]. We performed a meta-analysis to assess the nephroprotective effect of mesenchymal stem cells (MSCs) in the treatment of kidney disease induced by toxicants. The results indicate that MSC treatment alleviated inflammatory cells, necrotic tubules, regenerative tubules, and renal interstitial fibrosis in kidney disease induced by toxicants. MSCs may be a promising therapeutic agent for kidney disease induced by toxicants
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