Células renais epiteliais como terapia celular na doença renal crônica

Abstract

Introduction: Chronic kidney disease is a worldwide growing problem. The kidney has the ability for nearly complete regenerate after ischemia/reperfusion or toxic injury. However, in some injuries the kidney undergoes epithelial-mesenchymal transition and fibrosis with loss of function. The best treatment is transplantation; nevertheless less than one third of patients are able to receive a kidney transplant due to lack of organs. Cell therapy may retard the progression of chronic kidney disease boht in allograft or in native kidney. This study aims to evaluate the feseabilty of a cell therapy. The main objective of this study is to evaluate the cell response to uremic toxins, specially indoxil sulfate. Methods: Human kidney cells were obtained by digestion method from human kidneys discard from Hospital do Rim e Hipertensão, UNIFESP-EPM. Immunofluorescence technique and flow cytometry (FACS) were performed to characterize cells. Indoxil sulfate was used to stimulate injury FACS and immunofluorescence were performed to determine the expression of apha smooth muscle actin. Results: Eight donors were included, only six cultrues were kept. Donors were 46,25 years old on avarage, 100% received vasoactive drugs and 50% received nefrotoxic drugs.Cells were kept for 7 days until confluency were obtain in the passage zero, for the other passages duplication time was 72h.In the primary culture, 3.3% were proximal tubule cells, 1.7% distal tubule cells, 4.6% were EPO producing fibroblasts, 3.6% were mesenchymal cells and 8.9% pluripotente stem cells. There were no changing on cells phenotype while indoxil sulfate were added to the cultures. Conclusions: Primary culture from deceased donors do not change phenotype when exposed to indoxil sulfato.