Chronic kidney disease carries a very high mortality risk, in particular from cardiac diseases. Often heart failure and renal failure
coincide, a phenomenon referred to as the cardio renal syndrome. In recent years, it has become clear that not only fibrotic repair but
also restoration of damaged kidney and heart can occur and the use of cell therapy has been advanced as a means to activate endogenous
repair mechanisms or even to re-introduce repairing tissue. In this perspective, mesenchymal stromal cells are of particular interest, since
these cells have both immune modulating and reparative functions and are on the brink of entering the clinical arena. Indeed, MSCs can
trigger numerous therapeutic biologic processes that contribute to both renal and cardiac repair; however exact mechanisms of actions are
largely unknown. In the present review we have made a critical appraisal of the data available with respect to origin and function of
MSCs, and we discuss both preclinical as well as clinical evidence on their therapeutic potential in kidney and heart disease.