الفهرس 
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Abstract
Chronic kidney disease is a major public health problem worldwide; the present work was conducted to investigate the possible protective effects of darbepoietin alpha and mesenchymal stem cells on chronic adriamycin nephropathy model in rats
Methods: 80 male Sprague Dwaley rats which were divided into 4 groups (20 rats in each group); (Group I): negative control group which received saline. (Group II): positive control group (received only twice injection of ADR via penile vein at 14 days interval ).(Group III): which received twice injection of ADR plus darbepoietin alpha (Aranesp) administrated s.c once weekly for 12 weeks from the first day of adriamycin injection. (Group IV): which received twice injection of ADR plus twice injection of MSCs each one was administrated 5 days after each adriamycin injections. After 12 weeks,body weight, survival rate beside blood hemoglobin, serum creatinine, BUN, serum triglycerides and cholesterol, urine protein and serum albumin, Kim-1 in urine. Also level of MDA, GSH and caspase-3.Also, histopathological examination by H&E, MT.
Results:Concomitant administration of darbepoietin alpha with adriamycin treatment from the first day has a protective effect manifested by improvement in both biochemical and histopathological parameters.The protective effect of darbepoietin is mediated by anemia correction, mitogenic effect , antioxidant and antiapoptotic actions,while MSCs injection significantly produces histological protection of the kidney accompanied by an antioxidant and antiapoptotic effect but couldn’t modify clinical parameters as (animal mortality , anemia ,proteinuria and hypoalbuminemia) .
Conclusion: Darbepoietin alpha with adriamycin treatment from the first day has a protective effect manifested by improvement in both biochemical and histopathological parameters ,while MSCs only provide partial protection that did not modify outcome of adriamycin nephrosis. This effect may be due to the absence of anemia correction or lower number engrafted of MSCs in the kidney after intravenous injection,so, Strategies to deliver the optimal number of the right type of stem cell that stays in injured tissue for the longest duration possible must be optimized.