Future strategies in the treatment of acute renal failure: growth factors, stem cells, and other novel therapies

PURPOSE OF REVIEW: Acute renal failure remains a significant cause of morbidity and mortality in adults and children. Despite advances in understanding the pathophysiology of acute renal failure, little progress has been made in its treatment. This review assesses the recent data on current and promising new therapies for acute renal failure. RECENT FINDINGS: The first section of the review describes the recent therapies that have been used in humans, all of whom have been adults. The second section evaluates the use of agents given in experimental animal models during or after the onset of acute renal failure. The third section describes the many animal studies using therapies before the onset of experimental renal failure. The final section discusses how the emerging field of stem cell research might be used to treat acute renal failure. SUMMARY: Among the recent studies in humans, the most intriguing have been the use of atrial natriuretic peptide in patients with nonoliguric renal failure and isotonic sodium bicarbonate infusions to prevent radiocontrast medium-induced renal failure. Among the agents used in animal studies, those with the greatest potential were hepatocyte growth factor and ethyl pyruvate, because they seem to protect against or accelerate recovery from acute renal failure after the renal insult. Finally, stem cell therapy may someday offer the best option for recovery from acute renal failure.