2nd Edition of International Conference on Tissue Engineering and Regenerative Medicine

September 16-17, 2022 (Online Event)

September 16 -17, 2022 | Online Event
TERMC 2020

Cyclic high hydrostatic pressure treatment to degenerate renal fibrosis in CKD

Shrikant L Kulkarni, Speaker at Regenerative Medicine Conference
Kulkarni Clinic, India
Title : Cyclic high hydrostatic pressure treatment to degenerate renal fibrosis in CKD


Today the chronic kidney diseases (CKD) or end stage renal diseases (ESRD) patients are increasing day by day. Kidney organ  allograft  transplant  or  dialysis  effective  treatment  of  choice  under  current  circumstances.  But  because  of  the limitation of the transplant treatment and complications there is an urgent need to investigate alternative new therapeutic reliable techniques. The main cause for CKD is the presence of fibrosis in renal parenchyma producing a toxic and hostile environment  i.e.  prevents  the  regenerative  process.  Therefore  the  priority  to  treat  CKD  is  to  dissolve  the  fibrosis  and  restore the circulation and elasticity of the arteries  which makes the environment friendly to the regeneration of the damaged tissues. Biomechanical microenvironment plays an important role in tissue development and pathogenesis. Accumulation of  excessive  extracellular  matrix (ECM)  alters tissue  mechanical  properties  which  leads  to  organ failure Forces  potentially operate in fibrosis include hydrostatic osmotic and stretch pressure. Failure to resolve injury and restore haemostasis gives progressive fibrosis which alters the mechanical environment that is matrix deposition and stiffness. A potential regenerative approach is an in-situ repair which is an attractive strategy to tackle this problem. T he physical environment has a key role to play in regulating both cells and the organs’ ability to regenerate and repair tissues in  response  to injury  via  mechanical  factors  which  often   is overlooked in  regenerative medicine. Hydrostatic pressure is  the most fundamental and common mechanical stimuli in the body playing a critical role in hemostasis of the organ system. Mechanical environment that operates organ function which is a physiological system. Injury alters mechanical hemostasis and initiates reparative processes. Fibrosis represents failure to re-establishment of mechanical hemostasis and mechanical stresses that alter structural and functional properties of cells. After injury tissue rapidly changes in size, shape, composition and their mechanical characteristics. Cells are continuously exposed to a range of mechanical stresses due to the biological environment in which they reside; they play an important role in the process of constructing and modifying organs and tissues. High hydrostatic pressure has potential to disrupt structure of ECM through protein denaturation. It achieves devitalisation without damaging biomechanical properties. Intra luminal hydrostatic pressure elevation over 20-30 cms. H2O causes degenerative changes in tissues, and fibrosis. When high pressure (HP) is applied by use of a hydrostatic fluid column, a hypoxic  condition is  created  that  alters  cell function,  inhibits  collagen  matrix  production  and  suppresses  the  differentiation of fibroblast to myofibroblast phenotype. Therefore, the priority to treat CKD is  to therapeutically manipulate fibrosis and restore its micro vascular circulation T he fibrotic cells mechanically compressed between strong renal capsule and elevated intraluminal hydrostatic pressure by artificial obstruction created at pelvi- ureteric junction will act like closed chamber pressure. The effect of cyclic high hydrostatic pressure over renal fibrosis causes first softening of the fibrosis, seperting collagen fibres, then breaking of fibres, thinning and then eliminating the renal fibrosis. In the proposed therapy hypothesis, excessive elevation of intraluminal hydrostatic pressure will degenerate renal fibrosis and restore microcirculation functionality to eventually help to rebuild a healthy kidney from native stem cells. regeneration.


Dr. Shrikant L. Kulkarni completed his M.S. (General Surgery) in 1975 from B.J.Medical College Pune, Maharashtra India. The bachelor’s degree M.B.B.S. completed from Miraj Medical College. Since 1971 he has worked at several government hospitals like the Wanless Hospital Miraj, Sangli General Hospital Sangli, Sassoon Hospital Pune and multispecialty hospitals like Ruby Hall Clinic, Pune and Jahangir Nursing Home, Pune. For the last 40 plus years he has been working at his own hospital at Chinchwad, Pune Maharashtra India.