Treatment of patients with diabetes mellitus complicated with diabetic glomerulosclerosis and chronic renal insufficiency by fetal stem cells
Smikodoub Alexander, Novytskaja Alla
Cell Therapy Clinic of National Medical University and Embryonic Tissue Center EmCell
In order to reconstitute the erythropoiesis, the transplantations of fetal stem cells were made to 11 patients suffering from diabetes mellitus complicated with diabetic glomerulosclerosis and chronic renal insufficiency.
The indication for the transplantation was anemia of different range, resistant to conventional hemostimulating therapy (iron preparations, ziankobalomine, folic acid). The group consisted of patients of 25 to 46 years old (average age 33.5 years old). 6 patients had chronic renal insufficiency of the I stage (creatinine – 0.175±0.019 mmol/l, urea – 10.13 mmol/l, bulb filtration reaction speed – 56.17±3.69 ml/min; erythrocytes of peripheral blood – 2.94±0.12x1012
/l, hemoglobin – 92.5±5.4 g/l). 5 patients had chronic renal insufficiency of II stage (creatinine – 0.326±0.066 mmol/l, urea – 15.97±0.68 mmol/l, bulb filtration reaction speed – 34.2±3.34 ml/min; erythrocytes of peripheral blood – 2.26±0.10x1012
/l, hemoglobin – 75.6±1.91 g/l).
Сells suspensions with the following parameters were administered intravenously dropwise:
- age of 5-12 weeks of gestation;
- suspension volume 1 to 4 ml;
- CD34 number 0.3–2.9x106/ml;
- number of CFU-GEMM 2.6–23x103/ml.
After the transplantation, we observed:
- gradual rising of hemoglobin and erythrocytes level, starting from 5–7 day, with the maximum in 1–1.5 month (erythrocytes 3.84±0.12x1012/l and 3.38±0.21x1012/l; hemoglobin – 118.8±4.76 g/l and 103.6±4.4 g/l in the I and II groups respectively ). The effect lasted from 5 to 11 months in the I group, and from 2 to 5 months in the II group;
- functional kidney state improvement: daily proteinuria reduction, urea sediment improvement, moderate rising of bulb filtration speed;
- arterial pressure level reduction during 4–6 months with the simultaneous reduction of hypotensive medication dose;
- recipients' immune reactivity parameters reconstitution, that was clinically manifested in the reduction of frequency and expressiveness of viral infections, complications of chronic inflammatory diseases (chronic pyelonephritis, chronic bronchitis, etc.).