Imagine that for whatever reason—diseases, toxins, drugs, genetic disorders—that your kidneys no longer work.

Your doctor says that you’ll have to go to dialysis a few times a week—where you sit in a room and get your blood filtered by a machine for hours because your kidneys no longer can do it. In the meantime, your physician puts you on a kidney transplant list, which has an average waiting time of 3-5 years in the United States [1].

Dialysis can be a grueling process for patients who have lost most of their normal kidney function (between 85 and 90 percent). These patients usually have end-stage kidney failure and some won’t have the ability to survive without dialysis treatments [2].

Fortunately, new research from Harvard is showing promise for one day regenerating or replacing damaged kidneys and therefore eliminating the need for dialysis altogether. 

Replicating Kidney Structures with Stem Cells Could Lead to Tissue Regeneration

Researchers at Harvard University (specifically its School of Engineering and Applied Sciences) have published promising research that could one day lead to not just kidney repair and potentially even replacement, but a better understanding of and therefore prevention of kidney damage [3].

The team has been working on replicating specific kidney structures (we’ll talk about which ones in a minute) in a lab to better understand how the kidneys work. In addition to helping researchers simulate the effects of certain diseases or drugs (all without human or animal studies), these replications could eventually form the foundation for kidney replacements.

The crew invented a method of 3D bioprinting, allowing them to replicate complex living tissue from the kidneys with human stem cells. These models could potentially be implanted in patients who have kidney disease or kidney failure so they wouldn’t need dialysis. The technology could even one day be used to create new kidneys.

How Do Our Kidneys Work (and What Causes Kidney Dysfunction)?

Your kidneys—two organs about the size of a fist on either side of your spine—filter about a half of cup of your blood every minute [4].

The kidneys essentially clean the blood, removing waste, eliminated through urine. The kidneys are an essential part of removing acid from the blood to maintain an essential balance of electrolytes and water. They not only remove the bad stuff but isolate beneficial compounds and reintroduce them into the bloodstream— like a smart filter. 

But how does this happen, exactly?

Without getting too technical, kidneys have about one million filtration units called glomeruli to help remove waste from the blood. Then, proximal tubules, which are structures that reabsorb the good stuff, return helpful vitamins, electrolytes, and amino acids back into the blood.

For some people who have compromised kidney function, the kidneys’ proximal tubules don’t work correctly, meaning they can’t reintroduce these beneficial elements back into the blood. This can happen due to pharmaceutical drugs, chemicals, and specific diseases.

The consequences of the kidneys not being able to return vitamins, amino acids, and even glucose to the blood can lead to health complications and deficiencies down the line—including anemia and vitamin D deficiency—as the body needs these vital nutrients to perform many of its functions [5].

Although we don’t yet fully understand how different toxic substances or diseases can affect the kidneys in this way, the new 3D model created by Harvard researchers is showing a promising path to a better understanding.

How a 3D Model Offers Hope for Alternative Therapies (and for Ending Animal Experiments)

The researchers at Harvard actually “printed” living proximal tubules just like the ones in our kidneys in their experiment. The living 3D model allows them to understand how the kidney functions—without using human or animal test subjects.

Not using animals in experimentation is not only, some would argue, more ethical, but provides a more accurate model for research. This new method of 3D bioprinting is an instrumental step towards eliminating animal research altogether.

Co-author of the study Annie Moisan said that these replications can help not only better understand renal (kidney) toxicity but reduce animal experiments (which most people acknowledge are ineffective and cruel) [6]. Yay! 

In the 3D model, proximal tubules show how fluids are filtered through the kidneys, complete with blood vessels and everything. Experts can now see how different elements damage kidneys.

The authors of the study say the 3D model is an exciting advance, not only because it can help us understand the toxicity of drugs and even model disease, but because this new development could one day translate to living devices that can be used in patients needing dialysis.

Could a Kidney Replacement or Regenerative Therapy Be Available One Day?

The new 3D models could one day lead to improved therapies for replacing kidneys. The authors of the study note that the model is a big step towards engineering human kidney tissue that allows research on diseases and drugs to be conducted over a long period of time, all without human or animal participants.

The research shows that doctors have the potential to repair kidneys, regenerate new tissue, or even create an entirely new kidney to eliminate the need for dialysis [7]. While we’re still a while away from constructing these specific therapies, it’s promising to know that we won’t always be reliant on drugs to fix our health issues and that there’s a better way to conduct research that can benefit all life forms on this planet.

According to the team at Harvard, the engineered tissue accurately functions in a way that hasn’t yet been achieved. Who knows what the future will hold? The researchers seem to think that new kidneys or regenerative tissue could make the kidney transplant list—and maybe even other transplant lists as well—unnecessary one day.

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