Achievements and challenges in bioartificial kidney development

Abstract

Bioartificial kidneys (BAKs) combine a conventional hemofilter in series with a bioreactor unit containing renal epithelial cells. The epithelial cells derived from the renal tubule should provide transport, metabolic, endocrinologic and immunomodulatory functions. Currently, primary human renal proximal tubule cells are most relevant for clinical applications. However, the use of human primary cells is associated with many obstacles, and the development of alternatives and an unlimited cell source is one of the most urgent challenges. BAKs have been applied in Phase I/II and Phase II clinical trials for the treatment of critically ill patients with acute renal failure. Significant effects on cytokine concentrations and long-term survival were observed. A subsequent Phase IIb clinical trial was discontinued after an interim analysis, and these results showed that further intense research on BAK-based therapies for acute renal failure was required. Development of BAK-based therapies for the treatment of patients suffering from end-stage renal disease is even more challenging, and related problems and research approaches are discussed herein, along with the development of mobile, portable, wearable and implantable devices.

Basic Structure and Cell Culture Condition of a Bioartificial Renal Tubule on Chip towards a Cell-based Separation Microdevice

“…This separation microdevice could be applied as a miniaturized RAD 30 in renal disease therapy combined with a conventional portable hemodialysis device, 31 and also an in vitro research platform for renal tubule cell biology.…”

Prospect for kidney bioengineering: shortcomings of the status quo

“…As discussed previously, BAKs exemplify one approach that combines hemofiltration used in conventional dialysis machines with a bioreactor unit containing human primary renal proximal tubule cells [116]. This would represent a novel modality of renal replacement that recaptures the resorptive, metabolic and endocrine functions of the kidney in addition to volumetric filtration.…”

Proteomics analysis of potential biomarkers of acute kidney injury in urine from patients receiving vancomycin

“…Proučavane HK-2 stanice bile su tretirane vankomicinom tijekom 24 sata, što je dovelo do smanjenja razine keratina 1 u tretiranim u odnosu na netretirane stanice. Kako je otprije poznato da stanice HK-2 imaju neke funkcije primarnih epitelnih stanica proksimalnih kanalića iz organizma, no one funkcionalno i morfološki ipak nisu potpuno jednake 41 , za identifikaciju potencijalnih novih biomarkera akutne ozljede bubrega uzrokovane lijekovima analiza urina smatra se pouzdanijim pristupom. U najnovijem istraživanju iz 2016. godine Djudjaj i suradnici proučavali su uzorke tkiva mišjih i ljudskih bubrega te uzorke ljudskog urina kako bi istražili promjene u ekspresiji keratina kod akutne ozljede bubrega 35 .…”