Q: Creatinine levels of my wife's uncle have gone very high. He has been undergoing dialysis thrice a day for the past 20 days. My wife is 6 months pregnant. Can her cord cells be used in treating her relative? If so, to what extent would it be useful?

A:Creatinine is a waste product generated by muscles, which is excreted by the kidneys. Its level in blood is a very reliable indicator of kidney function as creatinine levels go up in kidney failure. Most patients with even mildly elevated serum creatinine levels have lost about 50% of their renal function and already have mild to moderate renal insufficiency. These individuals need to be investigated to find the cause (primary kidney disease or secondary to blockage, hypertension, diabetes, reduced blood supply, infections, shock, burns, dehydration etc.), potential for reversibility of the underlying disease, prognostication and to plan therapy. Stem cell work is still quite experimental but is very promising. Clinical efficacy is currently limited to bone marrow transplant, grafting new skin cells to treat burns, regenerating cornea in visually impaired, etc. Its potential use includes cures for cancer, Parkinson's disease, diabetes, kidney disease, multiple sclerosis, macular degeneration, cardiac and neurological disorders. Stem cells or cells quite akin to them have been identified in several tissues including neural, pancreatic, epidermal, mesenchymal, hepatic, bone, muscle, and endothelial tissues and various centres have been reporting their use in Parkinson’s disease, heart disease, endocrine disorders, etc. But this is still not being done routinely or being offered as a therapeutic modality. There are still many difficulties in the routine use of stem cells and they include problem in identifying stem cells in tissue cultures, which contain numerous types of cells; to coax the cell to develop into a desired cell; integrating the new cells into the patient’s own tissue, both structurally and functionally; preventing tissue rejection and the possible risk of cancer. Your wife’s uncle would need dialysis, possibly followed by a renal transplant. Please discuss with the treating doctor as he/she would be best placed to advise you.