Mesenchymal stem cell transplantation may provide a new therapy for ultrafiltration failure in chronic peritoneal dialysis

Nephrol Dial Transplant. 2013 Oct;28(10):2493-501. doi: 10.1093/ndt/gft089. Epub 2013 Jul 22.

Abstract

Background: The purpose of this study was to investigate possible healing effects of intraperitoneal (IP) mesenchymal stem cell (MSC) transplantation on ultrafiltration failure (UFF) in a chronic rat model of peritoneal dialysis (PD).

Methods: Rats were initially divided into two groups. The APUF group received once-daily IP injections of 20 mL of 3.86% glucose PD solution for 6 weeks to stimulate the development of UFF and a control group received noinjections. The PUF group was sub-divided into three groups: a PUF-C group, an MSC group and a Placebo (P) group. Peritoneal equilibration tests (PETs) and peritoneal biopsies were performed in the control and PUF-C groups. MSCs were administered by IP injection in the MSC group and the PUF-C and P groups received IP injection of placebo. PETs and peritoneal biopsies were performed in the MSC and P groups at the first [P-1 (and MSC-1 groups] and second [P-2 and MSC-2 groups] week after receiving MSCs or placebo.

Results: When compared with the control group, ultrafiltration capacity significantly decreased and the submesothelial thickness increased in the PUF-C and P groups (P-1, P-2) (P < 0.05), but there were no differences between the control and MSC groups (MSC-1, MSC-2). The rate of glucose transport was high in the PUF-C and P-2 groups compared with the control group, and D/PCr rates in the PUF-C and P-2 groups were lower than in the control group (P < 0.05). However, D/D0(glucose) was higher and D/P(Cr)was lower in the MSC-2 group than in the PUF-C and P-2 groups (P < 0.05). Transforming growth factor-β (TGF-β) levels were lower in the MSC groups than in the P and PUF-C groups (P < 0.05).

Conclusion: The PUF-C group had a high permeability UFF. These results showed that MSC transplantation exerted positive effects on UFF in a chronic rat model of PD. MSC transplantation may provide new options for the renewal of the peritoneum in chronic PD patients with UFF.

Keywords: chronic peritoneal dialysis; mesenchymal stem cell transplantation; ultrafiltration failure.

MeSH terms

  • Animals
  • Biological Transport
  • Cell Membrane Permeability*
  • Chronic Disease
  • Dialysis Solutions
  • Kidney Failure, Chronic / therapy*
  • Male
  • Mesenchymal Stem Cell Transplantation*
  • Peritoneal Dialysis / adverse effects*
  • Peritoneum / metabolism
  • Rats
  • Rats, Wistar
  • Transforming Growth Factor beta / metabolism
  • Treatment Failure
  • Ultrafiltration / adverse effects*

Substances

  • Dialysis Solutions
  • Transforming Growth Factor beta