Clin Exp Nephrol. 2026 May 18. doi: 10.1007/s10157-026-02891-0. Online ahead of print.
ABSTRACT
Chronic kidney disease (CKD) affects over 800 million individuals globally and is a primary aetiology of premature cardiovascular mortality. Despite advancements in pharmacological therapies, these strategies remain incapable of regenerating nephrons lost due to fibrosis, ischemia, or immunological damage. Renal autologous cell therapy, which includes renal tubular epithelial cells, mesenchymal stromal cells, renal progenitor cells, urine-derived stem cells, endothelial progenitor cells, and induced pluripotent stem cell-derived nephron progenitors, signifies a transformative approach towards authentic nephron rescue and regeneration. Preclinical studies and early clinical trials evaluating selected renal cells (SRCs), including rilparencel (REACT®), suggest that autologous renal cell therapy may stabilize estimated glomerular filtration rate (eGFR) decline in diabetic kidney disease and other forms of CKD. This review consolidates the mechanistic foundations, emerging clinical trial data, and translational challenges associated with each principal autologous cell platform utilized in CKD. It critically evaluates the advantages, such as immunological compatibility, paracrine trophic effects, and utility in disease modelling, alongside significant drawbacks, including senescent cell dysfunction, scalability limitations, and regulatory complexities. Furthermore, a procurement pathway -to-in-clinic framework that incorporates bioengineered scaffolds, extracellular vesicle derivatives, CRISPR-corrected iPSC lines, and kidney-on-a-chip validation systems is discussed in this review, collectively delineating the applicability of regenerative medicine in nephrology.
PMID:42149346 | DOI:10.1007/s10157-026-02891-0