Stem cells in kidney development and regeneration

K. McCracken,J. Bonventre

Published 2020 in Principles of Tissue Engineering

ABSTRACT

Abstract The kidneys are a pair of complex organs that are widely known for their role in urine production and waste elimination, but they also have numerous other responsibilities and are key regulators of normal physiologic processes, including electrolyte homeostasis, acid–base balance, blood pressure control, maintenance of bone health, and erythropoiesis. These functions are executed by the collective activity of an array of individual units called nephrons, which are epithelial structures comprising a set of highly specialized segments. Renal failure develops when a significant number of nephrons are injured or lost, which results from a wide variety of acute and chronic etiologies in the clinical setting. Irreversible and progressive diminution of kidney function commonly leads to end-stage kidney disease necessitating renal replacement therapy (e.g., dialysis or transplantation), and this condition is increasing in worldwide prevalence. While dialysis is a reliable method to achieve fluid balance and solute clearance, it is associated with substantial morbidity and mortality, and it can only replace a small fraction of normal kidney functions. Renal transplantation, on the other hand, is significantly limited by donor organ availability. As a result, there is an obvious need for novel approaches to the prevention and treatment of kidney disease, including tissue engineering and other potential regenerative therapies. One prominent strategy toward this objective is the use of stem cells to generate renal tissues, a field that has progressed considerably in recent years. These efforts have been grounded in an advanced understanding of the basic principles of kidney development, during which stem and progenitor cell types predominate. This chapter will provide a discussion of developmental mechanisms of renal embryology and stem cell biology, and we will review recent advances in regenerative technologies relating to the kidney.

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