Acute renal failure and tubular cell loss as a result of ischemia constitute major challenges in renal pathophysiology. Increasing evidence suggests important roles for bone marrow stem cells in the regeneration of renal tissue after injury. This study investigated whether the enhanced availability of hematopoietic stem cells, induced by stem cell factor and granulocyte colony-stimulating factor, to the injured kidney provides an adequate strategy for stem cell-based therapy to counteract renal ischemia/reperfusion injury. It is interesting that cytokine treatment before injury resulted in significant enhancement of function recovery of the kidney. This, however, was not due to increased incorporation of tubular epithelial cells from bone marrow origin. Importantly, cytokine treatment resulted in impaired influx of granulocytes into the injured kidney. Although cytokine treatment improved renal function rapidly after ischemic injury, the results show that the underlying mechanism likely is not based on stem cell transdifferentiation but rather on altered inflammatory kinetics.J Am Soc Nephrol 16: 1684 -1692 , 2005 . doi: 10.1681 A cute renal failure is a major clinical problem that affects up to 5% of all hospitalized patients (1). The major cause is tubular necrosis as a consequence of ischemic injury after episodes of hypotension or surgical vascular clamping. Moreover, renal transplantation is always associated with some degree of ischemia/reperfusion (I/R) injury. The development of specific therapies for I/R injury has proved problematic; therefore, therapy remains largely supportive.Recent studies suggested the involvement of bone marrow (BM)-derived stem cells in the regeneration of nonhematopoietic tissues. BM-derived cells with an endothelial (2), epithelial (3,4), or mesangial (5) phenotype were detected in murine kidneys after injury. Case studies have described the presence of Y chromosome-containing tubular epithelial cells (TEC) in kidneys from female donors that were transplanted into male recipients (6,7). These observations have led to the hypothesis that aside from intrinsic cellular proliferation, BM-derived cells contribute to kidney healing or maintenance.Experimental studies have provided evidence for a limited contribution of BM-derived cells to the injured kidney, perhaps as a direct consequence of the low circulating levels of BMderived stem cells. A study by Orlic et al. (8) demonstrated that cytokine-induced mobilization of BM hematopoietic stem cells (HSC) before the induction of myocardial infarction increased heart function significantly. On the basis of the study by Orlic et al., we mobilized HSC with stem cell factor (SCF) combined with granulocyte colony-stimulating factor (G-CSF), which operate synergistically in inducing egress of HSC from the BM compared with G-CSF alone (9).Here we report that cytokine treatment before renal I/R in mice accelerates renal function recovery compared with controls. The underlying mechanism does not depend on a biologically significant contribu...