摘要：There is an urgent need for new ways to treat end-stage renal disease: by promoting regeneration in situ, by repopulating decellularized donor organs with a patient's own stem cells, or by making entirely new kidneys. There are two broad strategies for making new kidneys: precision engineering by positioning everything exactly – for example, by 3D printing – or supporting cells’ self-organizing ability. We describe the latter approach, which begins with a suspension of renogenic stem cells and produces a small kidney with nephrons, a collecting duct system, active transport, and an ability to integrate with host vasculature. Many problems have to be solved before these kidneys are directly clinically useful, including size, maturation, provision of a ureter, and production from human-induced pluripotent stem cells. Even the existing engineered kidneys, if they can be made from human rather than animal cells, may be useful for assays for adverse drug reactions that will be free of the problems of extrapolating from animal tests to predicted human responses.Keywords: kidney; renal; tissue engineering; organogenesis; stem cell; renal replacement(Published: 25 September 2014)Citation: Advances in Regenerative Biology 2014, 1: 24990 - http://dx.doi.org/10.3402/arb.v1.24990Abstract in popular scienceMore people need kidney transplants than there are transplants available. There are two potential solutions to this: to find a way of repairing the patient’s own kidneys, or to make entirely new ones from the patient’s stem cells. This review is about the second approach, and it describes current progress (which is still a long way from clinical application). Methods have been developed that allow kidney-making stem cells isolated from 25 mouse fetuses to organize themselves into small kidneys in culture dishes: these kidneys are anatomically realistic and show physiological functions. They are even capable of connecting to a host blood supply if transplanted. Many things remain to be done, for example, engineering the kidneys from human stem cells, adding a urine drain, and growing the kidneys to a larger size. Even making very small kidneys from human cells would, however, be an advance, because they would be a great help in replacing poorly predictive animal- 30 based tests for testing new drugs for possible toxic side effects against human kidneys.
