Engineered renal tissue as a potential platform for pharmacokinetic and nephrotoxicity testing

• There is an urgent need for better in vitro nephrotoxicity screens.
• 2D cell proximal cell cultures exist but are imperfect.
• A new 3D kidney tissue engineering technique has potential to deliver more realistic assays.

Pharmacology and regenerative medicine interact in two ways. One is the use of drugs to promote tissue regeneration. The other, less obvious but with great potential, is the use of techniques developed for regenerative medicine to engineer realistic human organoids for drug screening. This review focuses on testing for nephrotoxicity, often a problem with drugs and poorly predicted in animals. Current human-based screens mainly use proximal tubule cells growing in 2D monolayers. Realism might be improved by collagen-based culture systems that encourage proximal tubule cells to grow as tubules. More realistic would be a recently developed technique for engineering functioning ‘mini-kidneys’ from suspensions of stem cells, a technique that works in mouse but that could also be applied to humans.