- 267 Downloads
Purpose of Review
Historically, there have been many advances in the ways in which we treat kidney diseases. In particular, hemodialysis has set the standard for treatment since the early 1960s and continues today as the most common form of treatment for acute, chronic, and end-stage conditions. However, the rising global prevalence of kidney diseases and our limited understanding of their etiologies have placed significant burdens on current clinical management regimens. This has resulted in a desperate need to improve the ways in which we treat the underlying and ensuing causes of kidney diseases for those who are unable to receive transplants.
One way of possibly addressing these issues is through the use of improved bioartificial kidneys. Bioartificial kidneys provide an extension to conventional artificial kidneys and dialysis systems, by incorporating aspects of living cellular and tissue function, in an attempt to better mimic normal kidneys. Recent advancements in genomic, cellular, and tissue engineering technologies are facilitating the improved design of these systems.
In this review, we outline various research efforts that have focused on the development of regenerated organs, implantable constructs, and whole bioengineered kidneys, as well as the transitions from conventional dialysis to these novel alternatives. As a result, we envision that these pioneering efforts can one day produce bioartificial renal technologies that can either perform or reintroduce essential function, and thus provide practical options to treat and potentially prevent kidney diseases.
KeywordsBioratificial kidney Regenerative medicine Bioengineering Dialysis Cell therapy and gene therapy
Compliance with Ethical Standards
Conflict of Interest
Peter R. Corridon has a patent pending on hydrodynamic methods for delivering fluids to kidney tissues and related materials and methods.
In Kap Ko, James J. Yoo, and Anthony Atala declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 4.Global Facts: About Kidney Disease [Internet]. The National Kidney Foundation. 2015 2016. Available from: https://www.kidney.org/kidneydisease/global-facts-about-kidney-disease.
- 5.Kidney Disease Statistics for the United States [Internet]. 2016. Available from: https://www.niddk.nih.gov/health-information/health-statistics/Pages/kidney-disease-statistics-united-states.aspx.
- 6.Ethiopia KP. Acute kidney injury: an overview [Internet]. 2016. Available from: https://www.uspharmacist.com/article/acute-kidney-injury-an-overview.
- 7.Abecassis M, Bartlett ST, Collins AJ, Davis CL, Delmonico FL, Friedewald JJ, et al. Kidney transplantation as primary therapy for end-stage renal disease: a National Kidney Foundation/Kidney Disease Outcomes Quality Initiative (NKF/KDOQI™) conference. Clin J Am Soc Nephrol CJASN. 2008;3(2):471–80.CrossRefPubMedGoogle Scholar
- 12.Martin AB, Hartman M, Washington B, Catlin A, Team the NHEA. National Health Spending: Faster Growth In 2015 As Coverage Expands And Utilization Increases. Health Aff (Millwood). 2016 Dec 2; 10.1377/hlthaff.2016.1330.
- 17.Gura V, Rivara MB, Bieber S, Munshi R, Smith NC, Linke L, et al. A wearable artificial kidney for patients with end-stage renal disease. JCI Insight [Internet]. 2016. Fast Track, Breakthrough Therapy, Accelerated. 2016;1(8). Available from: https://insight.jci.org/articles/view/86397.
- 23.Aebischer P, Ip TK, Panol G, Galletti PM. The bioartificial kidney: progress towards an ultrafiltration device with renal epithelial cells processing. Life Support Syst J Eur Soc Artif Organs. 1987;5(2):159–68.Google Scholar
- 26.Commissioner O of the. Fast Track, Breakthrough Therapy, Accelerated Approval, Priority Review [Internet]. 2017. Available from: http://www.fda.gov/ForPatients/Approvals/Fast/default.htm.
- 27.McCoy L. Artificial kidneys may start saving lives soon MedCareer News [Internet]. MedCareer News. 2015. 2016. Available from: https://www.medcareernews.com/artificial-kidneys-may-start-saving-lives-soon/.
- 28.Beltz AD. Wearable, portable, light-weight artificial kidney [Internet]. US5284470 A, 1994 2017. Available from: http://www.google.com/patents/US5284470.
- 38.Serum and urinary insulin-like growth factor-1 and tumor necrosis factor in neonates with and without acute renal failure—ProQuest [Internet]. 2016. Available from: http://search.proquest.com/openview/90ca0b91ceba92d1e5ee4b64828a894f/1?pq-origsite=gscholar.
- 40.Kopple JD, Massry SG. Kopple and Massry’s Nutritional Management of Renal Disease. Lippincott Williams & Wilkins; 2004. 712 p.Google Scholar
- 41.•• Corridon PR, Rhodes GJ, Leonard EC, Basile DP, Gattone VH, Bacallao RL, et al. A method to facilitate and monitor expression of exogenous genes in the rat kidney using plasmid and viral vectors. Am J Physiol Renal Physiol. 2013;304(9):F1217–29. This method can serve to reduce the barriers to preclinical assessments of clinical interventions related to the kidney.CrossRefPubMedPubMedCentralGoogle Scholar
- 42.Wynn R. Stem cell transplantation in inherited metabolic disorders. Hematol Educ Program Am Soc Hematol Am Soc Hematol Educ Program. 2011;2011:285–91.Google Scholar
- 43.Corridon P, Rhodes G, Zhang S, Bready D, Xu W, Witzmann F, et al. Hydrodynamic delivery of mitochondrial genes in vivo protects against moderate ischemia-reperfusion injury in the rat kidney (690.17). FASEB J. 28(1 Supplement):690.17.Google Scholar
- 47.Huang JL, Woolf AS, Kolatsi-Joannou M, Baluk P, Sandford RN, Peters DJM, et al. Vascular endothelial growth factor C for polycystic kidney diseases. J Am Soc Nephrol. 2015 ;ASN.2014090856.Google Scholar
- 48.Systemic administration of naked plasmid encoding hepatocyte growth factor ameliorates chronic renal fibrosis in mice. Publ Online 21 Sept 2001 Doi101038sjgt3301545 [Internet]. 2001 21 [cited 2016 Oct 10];8(19). Available from: http://www.nature.com/gt/journal/v8/n19/full/3301545a.html.
- 51.Maeshima A, Nakasatomi M, Nojima Y. Regenerative medicine for the kidney: renotropic factors, renal stem/progenitor cells, and stem cell therapy. BioMed Res Int [Internet]. 2014 [cited 2016 10];2014. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034406/.
- 61.Scarritt ME, Pashos NC, Bunnell BA. A review of cellularization strategies for tissue engineering of whole organs. Front Bioeng Biotechnol [Internet]. 2015 30 [cited 2016 Sep 30];3. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378188/.