Abstract
BACKGROUND: Chronic kidney disease (CKD) is largely driven by inflammation. Mesenchymal stem cells (MSCs) show therapeutic potential; however, their efficacy across CKD etiologies remains unclear. METHODS: Comprehensive searches were conducted in PubMed, Cochrane, ScienceDirect, Scopus and Google Scholar. Effect sizes for inflammation and renal function outcomes were meta-analyzed. RESULTS: Of 2514 studies screened, 52 met inclusion criteria (49 animal studies, 3 randomized controlled trials). In animal models, MSCs significantly reduced interleukin-6 (mean difference [MD] = -155.80; 95% CI: -249.10, -62.51; p = 0.001) and tumor necrosis factor-α (TNF-α) (MD = -35.53; 95% CI: -52.75, -18.30; p < 0.0001). In patients, TNF-α reduction was not significant (MD = -0.74; 95% CI: -2.20, 0.73; p = 0.32). Serum creatinine decreased in animals (MD = -0.38; 95% CI: -0.46, -0.29; p < 0.00001), but not in patients (MD = -0.59; 95% CI: -1.92, 0.74; p = 0.39). Blood urea nitrogen decreased in animals (MD = -19.27; 95% CI: -23.50, -15.04; p < 0.00001), and glomerular filtration rate improved (standardized MD = 1.83; 95% CI: 0.51, 3.15; p = 0.007), with no change in patients. CONCLUSION: MSCs improve inflammation and renal function in CKD animal models; however, evidence in patients remains inconclusive.