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Review
. 2022 Jul 22:10:953408.
doi: 10.3389/fcell.2022.953408. eCollection 2022.

Approaches to kidney replacement therapies-opportunities and challenges

Biao Huang  1   2 , Zipeng Zeng  1   2 , Chennan C Zhang  1   2 , Megan E Schreiber  1   2 , Zhongwei Li  1   2
Affiliations
Review

Approaches to kidney replacement therapies-opportunities and challenges

Biao Huang et al. Front Cell Dev Biol. .

Abstract

One out of seven people develop chronic kidney disease (CKD). When kidney function continues to decline, CKD patients may develop end-stage renal disease (ESRD, or kidney failure). More than 2 out of 1,000 adults develop ESRD and these patients must live on dialysis or get a kidney transplant to survive. Each year, more than $51 billion is spent to treat patients with ESRD in the United States. In addition, ESRD greatly reduces longevity and quality of life for patients. Compared to dialysis, kidney transplant offers the best chance of survival, but few donor organs are available. Thus, there is an urgent need for innovative solutions that address the shortage of kidneys available for transplantation. Here we summarize the status of current approaches that are being developed to solve the shortage of donor kidneys. These include the bioartificial kidney approach which aims to make a portable dialysis device, the recellularization approach which utilizes native kidney scaffold to make an engineered kidney, the stem cell-based approach which aims to generate a kidney de novo by recapitulating normal kidney organogenesis, the xenotransplantation approach which has the goal to make immunocompatible pig kidneys for transplantation, and the interspecies chimera approach which has potential to generate a human kidney in a host animal. We also discuss the interconnections among the different approaches, and the remaining challenges of translating these approaches into novel therapies.

Keywords: bioartificial kidney; bioengineering (general); decellularizalion; genome editing; interspecies chimera; kidney organoid; pluripotent stem cells; xenotransplant.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Summary of different kidney replacement approaches.
See this image and copyright information in PMC

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References

    1. Abolbashari M., Agcaoili S. M., Lee M. K., Ko I. K., Aboushwareb T., Jackson J. D., et al. (2016). Repopulation of porcine kidney scaffold using porcine primary renal cells. Acta Biomater. 29, 52–61. 10.1016/j.actbio.2015.11.026 PubMed Abstract | 10.1016/j.actbio.2015.11.026 | Google Scholar - DOI - DOI - PubMed
    1. Brown A. C., Muthukrishnan S. D., Oxburgh L. (2015). A synthetic niche for nephron progenitor cells. Dev. Cell 34, 229–241. 10.1016/j.devcel.2015.06.021 PubMed Abstract | 10.1016/j.devcel.2015.06.021 | Google Scholar - DOI - DOI - PMC - PubMed
    1. Buffington D. A., Pino C. J., Chen L., Westover A. J., Hageman G., Humes H. D. (2012). Bioartificial renal epithelial cell system (BRECS): A compact, cryopreservable extracorporeal renal replacement device. Cell Med. 4, 33–43. 10.3727/215517912X653328 PubMed Abstract | 10.3727/215517912X653328 | Google Scholar - DOI - DOI - PMC - PubMed
    1. Cacalano G., FarInas I., Wang L. C., Hagler K., Forgie A., MooreM., et al. (1998). GFRalpha1 is an essential receptor component for GDNF in the developing nervous system and kidney. Neuron 21, 53–62. 10.1016/s0896-6273(00)80514-0 PubMed Abstract | 10.1016/s0896-6273(00)80514-0 | Google Scholar - DOI - DOI - PMC - PubMed
    1. Caralt M., Uzarski J. S., Iacob S., Obergfell K. P., BergN., Bijonowski B. M., et al. (2015). Optimization and critical evaluation of decellularization strategies to develop renal extracellular matrix scaffolds as biological templates for organ engineering and transplantation. Am. J. Transpl. 15, 64–75. 10.1111/ajt.12999 10.1111/ajt.12999 | Google Scholar - DOI - DOI - PMC - PubMed

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