Let’s talk about Kidney Cell-Based Therapy

One of the biggest public health problems at the moment is the increase of the number of patients suffering from kidney disease. It is a sad reality that even preventive treatments and campaigns to reduce the rates each year are not enough to keep numbers in a certain balance. For this reason, dialysis treatments are also on the rise, considering that other options, such as kidney transplantation, are usually complicated.

Likewise, medical science is always in search of alternative therapies, taking into account that dialysis, although it is the best option so far, also represents many problems for patients, starting with the fact that dialysis is essentially a control treatment, not a cure. One of the options that are currently being developed is stem cell therapy. The great genetic discoveries regarding stem cells could be one of the main areas of development in the future of nephrology.

One of the great hopes in this field is cell regeneration. The possibilities offered by this therapy are countless because the renal function is not being carried out by a machine, as in the case of hemodialysis, nor is necessary to transplant an organ from a human being to another, but rather the objective is to regenerate the damaged organ, so that it recovers its functions completely, following a natural process. The idea with this therapy, in a nutshell, is to perform a transplant of renal precursor cells, so that, they become perfectly functional in the kidney tissue, so that a satisfactory recovery is achieved.

This treatment has not been reached yet. It is still in the experimentation stage, despite the fact that great advances have been made in this subject. In ideal conditions, renal precursor cells could be transplanted directly into the renal parenchyma, and this means a great challenge in medical terms. Some think that the precision that must be obtained for this procedure could only be really achieved through the use of robots, which is a strong trend in the research of biomedical engineering right now. Kidneys are very complex organs, which, in addition to the complications they may have – which are innumerable, by the way – have quite solid tissues that make it hard to transplant cells. The kidney is composed of groups of cells called nephrons. The nephrons are organized in clusters, and each of them fulfills a function of filtering the blood.

Read also: An Alternative To Dialysis: The Nanofiber Web, by Joe Cosgrove

Well, what happens when a patient suffers from kidney disease, is that the speed with which these cells die is much faster than the ability of the kidney to recover them. In this way, while the time progresses, kidneys lose the ability to perform their functions, and because they cannot regenerate, the body no longer finds a way to filter the blood and eliminate excess fluid. It is at this point that cell regeneration therapy comes into play. Because hemodialysis and other medical treatments cannot do much to prevent the death of the nephrons, it is necessary to find a way in which the kidney of the same patient recovers effectively.


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Another major challenge with this therapy is that it is not easy to get enough precursor cells for a single treatment. Not only because stem cell treatments have huge policy obstacles in several countries, but it is expensive to isolate these cells for keeping them alive in the lab.

The experiments behind the development of this therapy have been carried out, first of all, in mice. What the researchers have done is to transplant kidney precursor cells at specific points in the kidney tissue. The kidneys of rats are very similar to ours, especially when they suffer from critical kidney damage. What has been seen is that, although the transplanted cells are not fully integrated into the tissues of the kidney, the organs manage to recover the replacement rate of useless nephron cells with new ones somehow. This prevents the occurrence of necrosis, and, therefore, a series of harmful consequences for the organism.

In this regard, one of the fundamental points to develop these therapies is to identify exactly which stem cells are useful for the tissue of the kidneys to regenerate. That is why it is key to know the repair processes that the body carries out naturally, o that researchers can just boost them up.

One of the observations which has drawn the attention of the medical community is that the kidneys of mammals, compared with those of other animals, have a lower regeneration capacity. However, it has been noted that both in mice and in humans, the organism has a small stock of stem cells in case the kidney is not able to balance the loss of nephron cells. To this extent, medical science has focused on enhancing this process in the body. For many people, stem cell treatments are controversial. However, what science has shown in recent years is that it is a natural process that does not interfere with the way in which it works and balances in our body.

Recommended: Challenges and opportunities for stem cell therapy in patients with chronic kidney disease

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Mental health issues in kidney disease patients

Dialysis treatments are hard experiences for both patients and relatives close to them. Since patients depend on a machine from that moment on (or on other devices) to live, dialysis means a very drastic change in their lives. This is not easy mentally speaking. It means adapting to completely unknown conditions, a lot of fear, and, above all, fear to what life will be like from that moment on. Worst of all, the stress, anxiety, and depression may be so severe sometimes, that it may even worsen the current health status of patients. There is an additional problem: many people still underestimate the extent of depression and other mental problems. These people are doctors (sadly) as well as patients and their relatives. It is true that depression is a delicate issue that requires immediate and sufficient answers, and, for this reason, there are social workers and psychologists who are aware of the mental and emotional state of patients with kidney disease in several centers where dialysis treatments are carried out.

The main causes of anxiety, depression, and high levels of stress are fear of death, fear of relying on a machine, fear of suffering, and, especially, fear of change. Many people believe that dialysis means the end of a great cycle. That’s not true at all. Although dialysis does mean a big change in patients’ routines, patients are able to live perfectly normal lives. They can keep pursuing their dreams; they can keep working on their careers and go beyond their limits. In this post, we will talk about depression and anxiety in dialysis patients, as well as some basic tools to combat them.

The first thing to understand is that we all face many changes throughout life. Life, in essence, is about that: a great succession of changes. Some of those changes are more pleasurable than others, and, therefore, it is a so naïve idea to think that things will always stay the same way. This is the first step to face depression in the middle of a dialysis treatment: to take dialysis as one of many great changes in life. One of many limitations that can bring out the best (or the worst) of ourselves.

Read also: What is it like to live with dialysis?, by Joe Cosgrove

Secondly, it is very important to count on the support of professionals. A good psychotherapy, in which, if necessary, the patient receives prescription antidepressants, could be of tremendous help to overcome depression. In addition to the above, it is just key that patients remain active. Performing different activities that make them feel better, besides helping them to significantly increase the level of physical and mental energy, could help them to let go of the negative thoughts of depression, and learn to face them when they arrive. Physical exercise, hobbies, relaxing activities such as meditation, gardening, fishing, volunteer work, etc., may be great alternatives to feel useful and help you understand that dialysis treatment is not the end of anything.

On the other hand, it is very important that therapists help kidney disease patients to increase their self-esteem. Although this may sound hard to believe, self-esteem is a kind of immune system of the mind to resist different mental problems such as anguish, anxiety, existential dread, and fear of the unknown. A fundamental practice for developing self-esteem is to identify and learn to eliminate self-critical thoughts. After all, when it comes to depression, the main antagonist is the patient himself, especially when guilt, and other recurring thoughts, make the patient feel that there are no choices left.

It is also very important to develop assertiveness. Assertiveness is the human capacity to know how to defend oneself in a non-aggressive way in the face of pressure, demands or abuse from others or from oneself. Assertiveness is an intermediate point between aggression and calmness. It is very important to learn to be assertive in the midst of depression; and, to be assertive it is necessary to strengthen self-esteem in the first place. It is very common to find patients with depression, in particular, those who are undergoing dialysis treatment, in whom there is a high level of escape from problematic situations. This is not just a psychological problem that may increase depression and anxiety even more: it could be dangerous. Many patients, due to the fear of dealing with dialysis, avoid going to health centers to undergo dialysis. This behavior, in addition to self-destructive, is absurd from any point of view. It’s understandable, but it does not make any sense.

Finally, patients should not feel guilty for suffering from depression. It is perfectly normal that they are going through that, and it is necessary to call things by their name. Depression is an illness, and nobody decides to suffer from it. There are solutions for this, and it is not the end of the road. It’s just a station.

I hope this post has been useful in some way. Remember to share it with someone who is going through this situation.

Recommended: Depression in dialysis patients

* Featured Image courtesy of Quintin Gellar at Pexels.com

An Alternative To Dialysis: The Nanofiber Web

As per discussed in previous articles by Joe Cosgrove, the main role of the kidneys is to act as a filter capable of separating waste products from the blood, thusly turning them into urine. However, this process, although present in every individual’s daily life, might represent a dreary situation when their kidneys are compromised. Individuals who have kidney failure struggle at getting rid of the accumulation of waste products in the blood.

The process that helps them get rid of this build-up is called dialysis, which has been previously covered in this blog; however, dialysis is also a nagging process, oftentimes rather expensive, which is why not every single individual can access it easily.

Now, after years of research, physicians and researchers have created an alternative. They have come up with a nanofiber that may serve as a cheaper alternative to the process in question, thusly enabling a bigger of portion of individuals to access kidney treatment much easier.

Although kidney dialysis is perhaps the most famous and common treatment for individuals with any degree of kidney failure, it is also known that the very nature of the procedure involves the use of auxiliary machines, either at a medical facility or, in some cases, at home, that serves as an aid filtering the waste and toxins from a person’s blood, thusly mimicking a healthy, normal kidney. However, researchers at the International Center for Materials Nanoarchitectonics say that, given the fact that dialysis as people know it requires electricity for the machines to function properly, it is quite difficult to make it available in poorer locations and areas where electricity fluctuates. Besides, dialysis machines require careful maintenance, and sometimes it is rather impossible to either find someone capable of keeping the machines functioning or have someone commute from far away to do it.

Additionally, areas known for their natural disasters, such as Chile or Japan, require alternatives to the procedure for, in the aftermath of these eventualities, many individuals have to go without treatment until normal medical services are reestablished. Having this in mind, researchers at MANA embarked themselves on the journey to develop a much cheaper, wearable way of filtering toxins in the blood of individuals with any degree of kidney failure. As mentioned above, the result was the creation of a nanofiber web.

During the creation process, physicians and researchers first set out to combine blood-compatible polymers made from EVOH alongside a variety of zeolite and minerals mostly made of oxygen, aluminum, silicon and other materials. The aforementioned zeolites have microscopical structures capable of absorbing the toxins and the waste that accumulates in the blood. Afterwards, researchers put in practice a low-cost method commonly referred to as electrospinning—a method that uses electrical charges to develop the web.

After having tested the web on its ability to absorb several waste products such as creatinine from the blood, researchers and physicians discovered that for the web to properly serve as a reliable alternative, a specific combination of aluminum and silicon within the aforementioned zeolites is necessary for it to absorb the highest amount of waste products from the blood. This composition of fibers and materials have proven to have enough potential to be considered as a new, cheaper way to remove waste products from the bloodstream without the intricacies commonly associated to regular and traditional dialysis, and without the inexorable need of additional equipment and specialized machines.

And even though the web is still in early stages, the findings seem to be promising. Researchers assert that it is possible that the web could be tailored as a blood purification product that would be accessible for a larger portion of individuals suffering from kidney failure and any degree of kidney disease. Additionally, the device has been initially conceived as a wearable, much cheaper alternative, for the idea is to also save people money and time. Moreover, the team at MANA strongly believe this development is quite feasible, and that it would totally change kidney treatment as the world knows it for it would pose a different way to approach kidney failure treatments.

Alongside this web, there are other developments in progress given the complexity of making dialysis less nagging and more accessible for individuals with kidney failure. An artificial kidney, for instance, is in the works. It would be capable to extract waste from the bloodstream just like healthy kidneys do. Other institutions set out to explore other alternatives as the use of pig kidneys as the substrate to develop and build human kidneys by providing them with a shot of stem cells. Theoretically, the stem cells would “colonize” the pig kidney, thusly making it available for human transplant.

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Be that as it may, as dialysis becomes more and more expensive and difficult to access, the scientific community is working hard to come up with an alternative in hopes of making kidney treatments cheaper and less demanding in terms of time, consequences and quality of life.

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