Stem cell intervention and eGFR dynamics in chronic kidney disease, tracking renal function improvement: A systematic review and meta-analysis

Abstract

Chronic kidney disease (CKD) poses a significant global health burden with limited therapeutic options to reverse renal function decline. This systematic review and meta-analysis evaluated the effectiveness of mesenchymal stem cell (MSC) interventions in CKD patients by analyzing changes in estimated glomerular filtration rate (eGFR). An electronic search of PubMed, Scopus, EBSCOhost, and ScienceDirect was performed for all articles about MSC therapy for CKD with eGFR as the primary outcome, from January 2015 to March 2025. Data were pooled for analysis with Stata. A total of 13 study groups from ten eligible studies were included, encompassing both controlled and single-arm trials with various MSC sources and dosages. Meta-analysis of controlled studies, which notably all shared the same etiology of diabetic kidney disease, demonstrated a significant improvement in eGFR following MSC therapy compared to controls (mean difference: 10.08 mL/min/1.73 m²; 95% CI: 2.92–17.24; p=0.01), indicating a potential benefit of MSC in enhancing renal function. However, pooled single-arm analyses revealed a non-significant overall eGFR change (mean difference: 1.14 mL/min/1.73 m²; p=0.62) with considerable heterogeneity across studies. MSC therapy shows promise for improving renal function in CKD, particularly in controlled settings with diabetic kidney disease, but further large-scale, standardized randomized trials are necessary to confirm its clinical utility and optimize treatment protocols.