Stem cell-based solutions for kidney failure

On World Kidney Day, March 14, we aim to raise awareness on the importance of our kidneys and reduce the impact of kidney disease and its associated health problems. Worldwide, there are 850 million people that have some degree of kidney disease and are at risk of progressing to end-stage kidney failure. This number is growing globally, driven by hypertension, diabetes, obesity and aging.

Once kidney function is lost and patients have end stage renal disease, the only current solution is transplant which is limited by the low number of donor organs available. Many will not receive a transplant at all and will spend the rest of their life on dialysis.

Professors Melissa Little and Ton Rabelink from the Novo Nordisk Foundation Center for Stem Cell Medicine, reNEW, are collaborating towards a potential alternative solution, called an auxiliary kidney. The auxiliary kidney, a stem cell-based technology, may one day allow new tissue to be delivered to patients to increase their kidney function.

The kidney is one of the most complex organs in our bodies. It contains more than 25 distinct cell types and helps establish the correct balance of salts and minerals in our blood by filtering out toxins. Developing kidney tissue from stem cells in the lab was a challenge but one that was overcome in 2013 by Professor Melissa Little, reNEW CEO, who grew the first model of kidney tissue from stem cells.

From here, Professor Little, who is also a principal investigator at reNEW Melbourne and Copenhagen, and her teams are working on ways to improve this kidney tissue so that it better matches the complexity and functionality of the human kidney.

In parallel, the work of Professor Rabelink, node director at reNEW Leiden, and his team is focused on the formation of blood vessels in the kidney, called vascularisation. Since one of the most important tasks of the kidney is to filter the blood, good vascularisation is essential for the kidney to function.

For this, Rabelink’s team make use of stem cell derived kidney tissue and study how they become vascularized after transplanting them into animal models. Knowledge obtained on this process is paramount to generating auxiliary kidney tissues that can connect to the bloodstream and fulfil the filter function of a real kidney.

Together, Little and Rabelink aim to progress the development of an auxiliary kidney tissue within reNEW that can support the failing kidney. However, several challenges need to be overcome before these can be used in the clinic, including the large variety of cell types in the kidney, the complex structure of the organ and the scale of production required.

Ongoing research within the labs of Little and Rabelink aims to overcome these challenges and the teams hope that their research could contribute to an alternative treatment strategy for end stage kidney failure in the future.

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