The critical role of genetic and epigenetic factors in the pathogenesis of kidney disorders is gradually becoming clear, and the need for disease models that recapitulate human kidney disorders in a personalized manner is paramount. In this study, we describe a method to select and amplify renal progenitor cultures from the urine of patients with kidney disorders. Urine-derived human renal progenitors exhibited phenotype and functional properties identical to those purified from kidney tissue, including the capacity to differentiate into tubular cells and podocytes, as demonstrated by confocal microscopy, Western blot analysis of podocyte-specific proteins, and scanning electron microscopy. Lineage tracing studies performed with conditional transgenic mice, in which podocytes are irreversibly tagged upon tamoxifen treatment (NPHS2.iCreER;mT/mG), that were subjected to doxorubicin nephropathy demonstrated that renal progenitors are the only urinary cell population that can be amplified in longterm culture. To validate the use of these cells for personalized modeling of kidney disorders, renal progenitors were obtained from (1) the urine of children with nephrotic syndrome and carrying potentially pathogenic mutations in genes encoding for podocyte proteins and (2) the urine of children without genetic alterations, as validated by next-generation sequencing. Renal progenitors obtained from patients carrying pathogenic mutations generated podocytes that exhibited an abnormal cytoskeleton structure and functional abnormalities compared with those obtained from patients with proteinuria but without genetic mutations. The results of this study demonstrate that urine-derived patient-specific renal progenitor cultures may be an innovative research tool for modeling of genetic kidney disorders. 26: 196126: -197426: , 201526: . doi: 10.1681 The incidence of AKI and CKD is rising and reaching epidemic proportions. 1 In patients with CKD, the progressive decline in renal function is multifactorial and attributable to a variety of mechanisms. 2 In particular, the critical role of genetic factors in the etiology, pathogenesis, and progression of many renal disorders is gradually becoming clear, especially in children. 3 Indeed, the advent of high-throughput sequencing techniques has fostered the identification of novel causative genes and allows the continuous discovery of genetic variants of unknown clinical significance, often raising the problem of the functional testing of their pathogenic role. 4 However, emerging evidence suggests that influence of the
J Am Soc Nephrol