Present status and perspectives of bioartificial kidneys

Area of Science:

• Biomedical Engineering
• Nephrology
• Regenerative Medicine

Background:

• Hemodialysis is inadequate as renal replacement therapy due to intermittent treatment and lack of tubular metabolic function.
• Next-generation artificial kidneys require continuous hemofiltration and full renal tubule metabolic capabilities.

Purpose of the Study:

• To review the development and potential of bioartificial kidneys.
• To highlight advancements in artificial kidney technology for improved renal replacement therapy.

Main Methods:

• Development of bioartificial kidneys using artificial membranes and renal tubular epithelial cells.
• Confirmation of active transport and metabolic functions in tubular cells on artificial membranes.
• Genetic engineering of renal tubule cells to enhance transport and metabolic functions.

Main Results:

• Bioartificial kidneys have shown success in improving prognosis for patients with multiple organ dysfunction, likely by reducing plasma cytokine levels.
• Active transport and metabolic functions were confirmed in tubular cells cultured on artificial membranes.
• Functional protein gene transfection enhanced bioartificial tubule transport and metabolic capabilities.

Conclusions:

• Bioartificial kidneys represent a promising advancement over intermittent hemodialysis for renal replacement therapy.
• Overcoming technical challenges, including antithrombogenic membranes and prolonged cell function, is crucial for clinical application.
• Further development, including wearable pumps, is essential for the widespread clinical use of continuous bioartificial kidney systems.