Bioengineering a new kidney 

A vital step in the development of improved treatments for chronic kidney disease has been made with the characterisation of a set of genes that reprogram adult kidney cells to progenitor cells.

Chronic kidney disease has a large impact on health, accounting for 15% of all hospitalisations in Australia.

Treatments for end-stage kidney disease include transplantation or dialysis. The cost of treating end-stage kidney disease from 2009-2020 was estimated to be around $12 billion to the Australian Government.

Professor Melissa Little and her team from the University of Queensland’s Institute for Molecular Bioscience (IMB) have identified a set of key genes that can be used to transform adult kidney cells.

“We determined that six key genes can prompt some types of adult kidney cells to regress to an earlier stage of development and act like the precursors to the cells of the nephron,” Little said.

Nephrons filter the blood as it passes through the kidneys and damage to these functional units of the adult kidney causes kidney disease. The kidney stem cell population, which is responsible for giving rise to the nephrons, only exists in the embryo.

“All the nephrons are formed before birth and people with fewer nephrons are at higher risk of kidney disease.

“By forcing adult cells to act like early nephron cells, we have potentially found a way to trigger the growth of new filters,” she said.

The forced expression of key transcription factors facilitates the conversion of the differentiated kidney cells to progenitor cells.

Although there is still more work to be done to encourage these reprogrammed early nephron cells to function and integrate, the research shows it is feasible to reinitiate kidney development from an adult cell population.

“While this is a beginning, we hope it will inspire industry leaders and researchers around the world to invest further in cellular and bioengineering approaches to kidney repair and regeneration,” Little said.

The research was published in the Journal of the American Society of Nephrology.