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Current State of Renal Regenerative Therapies

Shankar, Anusha Shweta, MD1; Hoorn, Ewout J., MD, PhD1; Gribnau, Joost, PhD2; Baan, Carla C., PhD1; Hoogduijn, Martin J., PhD1

doi: 10.1097/TP.0000000000002547

The worldwide increase in the number of patients with end-stage renal disease leads to a growing waiting list for kidney transplantation resulting from the scarcity of kidney donors. Therefore, alternative treatment options for patients with end-stage renal disease are being sought. In vitro differentiation of stem cells into renal tissue is a promising approach to repair nonfunctional kidney tissue. Impressive headway has been made in the use of stem cells with the use of adult renal progenitor cells, embryonic stem cells, and induced pluripotent stem cells for the development toward primitive kidney structures. Currently, efforts are directed at improving long-term maintenance and stability of the cells. This review aims to provide a comprehensive overview of the cell sources used for the generation of kidney cells and strategies used for transplantation in in vivo models. Furthermore, it provides a perspective on stability and safety during future clinical application of in vitro generated kidney cells.

The authors provide a comprehensive guide to the cells, systems and science of regenerating a kidney from scratch. Where has the science got to and where is it leading us?

1 Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

2 Department of Developmental Biology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Received 30 October 2018. Revision received 9 November 2018.

Accepted 10 November 2018.

Disclosure: The authors declare no conflicts of interest.

A.S.S.: concept and design, article writing, final approval of article. E.J.H. and M.H.: concept and design, article writing, final approval of article. J.G. and C.C.B.: final approval of article.

Correspondence: Anusha S. Shankar, Department of Internal Medicine, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, The Netherlands. (

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