Renal cell therapy is associated with dynamic and individualized responses in patients with acute renal failure.
BACKGROUND
Renal cell therapy in conjunction with continuous hemofiltration techniques may provide important cellular metabolic activities to patients with acute renal failure (ARF) and may thereby change the natural history of this disorder. The development of a tissue-engineered bioartificial kidney consisting of a conventional hemofiltration cartridge in series with a renal tubule assist device (RAD) containing 10(9) human renal proximal tubule cells provides an opportunity to evaluate this form of therapy in patients with ARF in the intensive care unit.


METHODS
Nine patients with ARF and multi-organ systems failure (MOSF) have been treated so far with a tissue-engineered kidney in an FDA-approved Phase I/II clinical study currently underway. Acute physiologic parameters and serum cytokine levels were assessed before, during and after treatment with a bioartificial kidney.


RESULTS
Use of the RAD in this clinical setting demonstrates maintenance of cell viability and functionality. Cardiovascular stability appears to be maintained during RAD treatment. Human tubule cells in the RAD demonstrated differentiated metabolic and endocrinologic activity. Acute physiologic and plasma cytokine data demonstrate that renal cell therapy is associated with rapid and variable responses in patients with ARF and MOSF.


CONCLUSIONS
The initial clinical experience with the bioartificial kidney and the RAD suggests that renal tubule cell therapy may provide a dynamic and individualized treatment program as assessed by acute physiologic and biochemical indices.
Humes
H David
HD
Department of Medicine, University of Michigan Medical Center, Ann Arbor 48109, USA. dhumes@umich.edu
Weitzel
William F
WF
Bartlett
Robert H
RH
Swaniker
Fresca C
FC
Paganini
Emil P
EP
D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D018929:Cell Culture Techniques / Q000379:methods; D002470:Cell Survival; D016207:Cytokines / Q000097:blood; D005260:Female; D006440:Hemofiltration / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007684:Kidney Tubules / Q000166:cytology; D007688:Kidneys, Artificial / Q000592:standards*; D008297:Male; D009102:Multiple Organ Failure / Q000628:therapy; D023822:Tissue Engineering; D016896:Treatment Outcome
D016207:Cytokines