# Therapeutic Potential of Mesenchymal Stem Cells in Pediatric Kidney Disorders: A Comprehensive Review

## TL;DR

This review explores how mesenchymal stem cells may help treat kidney diseases in children, highlighting their potential and the need for further research.

## Contribution

The paper provides a comprehensive review of MSC therapy in pediatric kidney disorders, comparing pediatric and adult applications.

## Key findings

- MSCs improve renal function in pediatric AKI, CKD, and nephrotic syndrome.
- Intravenous MSC delivery is less effective than local infusion for targeting the kidneys.
- Pediatric MSC therapy requires tailored approaches due to differences in disease and physiology.

## Abstract

Kidney diseases in children present significant health challenges, often leading to complications and reduced quality of life. Mesenchymal stem cell (MSC) therapy shows promise for pediatric kidney disorders. This review evaluates current evidence on MSC applications in pediatric nephrology, focusing on mechanisms, delivery methods, and outcomes.

We analyzed preclinical and clinical studies of MSC therapy for pediatric acute kidney injury (AKI), chronic kidney disease (CKD), glomerular disorders, and Congenital Anomalies of the Kidney and Urinary Tract (CAKUT), comparing pediatric and adult applications.

MSCs exert therapeutic effects through immunomodulation, tissue regeneration, anti‐fibrotic activity, and paracrine mechanisms. Different sources (bone marrow, umbilical cord, adipose) show varying efficacy. Delivery methods significantly impact outcomes: intravenous administration is well‐tolerated but limited (2%–5% kidney delivery), while local infusion enhances targeting (10%–20%). Clinical studies show improved renal function: decreased creatinine in AKI, reduced albumin‐to‐creatinine ratio in CKD, and decreased proteinuria in nephrotic syndrome. Pediatric applications differ from adult ones in disease etiology, physiological considerations, therapeutic goals, and safety requirements.

MSC therapy shows promising potential for pediatric kidney disorders, with preliminary evidence supporting safety and efficacy. Challenges remain in optimizing cell sources, standardizing protocols, and establishing long‐term safety. Future research should focus on biomarker identification, pediatric‐specific models, and protocol standardization.