Regeneration and replacement of endothelial cells and renal vascular repair

Abstract Given the strong association between impaired renal microcirculation and disease states, significant attention has been directed toward understanding renal vascular repair. Endothelial progenitor cells (EPCs) have been studied in different cardiovascular models, including preclinical models of kidney disease. However, as this field of study has evolved over the last 20 years, it has been hampered by inconsistent definitions surrounding the term EPC. This chapter attempts to provide relevant background regarding vascular injury and impaired regenerative responses in the setting of either acute kidney injury (AKI) or chronic kidney disease (CKD). We provide an updated discussion on different types of cells previously classified broadly as EPCs and discuss potential interactions of these cells in vascular repair. Using this framework, we present a hypothesis by which the activity of intrinsic vascular progenitors represents a central element of disease progression. Finally, we summarize evidence that cells with vasculoreparative properties may represent potential therapies in disease states.