Artificial organs: Kidney

This article provides an overview of the development of hemodialysis, the principles of modern dialysis, and current efforts to improve outcomes of renal replacement therapy using approaches rooted in miniaturization, stem cell technology, and bioengineering. Current dialysis therapy requires strict dietary and lifestyle regimens, while having high rates of cardiovascular mortality and poor quality-of-life outcomes. Proposed methods for improving dialysis through altering dialyzer membrane composition, incorporation of living renal cells to assume active transport functions, and use of micro- and nanofabrication as tools for novel scaffolds are being developed. Several improved dialysis devices have undergone clinical testing; however, their utility has been only demonstrated in instances of acute renal failure, due to limitations in device design and performance. A completely implantable and living artificial kidney has the potential to relieve the immense healthcare burden associated with dialysis as a treatment modality for renal disease. Emerging technologies in tissue engineering and regenerative medicine have stimulated development of novel techniques and animal models for generation of living kidney tissues, primordia, and whole organs. The continued development of such approaches indicates that the prospect for development of a living, implantable artificial kidney remains just beyond the horizon.