Bio-artificial Kidney: A Silver Bullet in Kidney Transplant and Kidney Diseases

Chronic Kidney Disease (CKD) is a serious health condition that affects millions of people worldwide. Dialysis is the most common treatment for kidney failure, but it has significant drawbacks, including limited effectiveness, frequent sessions, and various complications. Bio-artificial kidney technology has brought new hope to the field of kidney transplantation. This cutting-edge technology aims to revolutionize kidney health by providing a viable solution for individuals suffering from End-stage Renal Disease (ESRD) and reducing their dependence on traditional dialysis methods. This innovative treatment option has the potential to transform the field and improve patient outcomes on a global scale. Moreover, this innovative technology can lead to cost savings, improved patient outcomes, and enhanced healthcare efficiency. In this review, we summarize the current state of the art of kidney disease management and discuss the development and widespread implementation of this innovative treatment technology.

Overview of Chronic Kidney Disease (CKD)

Of Chronic Kidney Disease (CKD) and the Rising Incidence of It. A dangerous medical condition known as Chronic Kidney Disease (CKD) affects millions of people worldwide. It is characterized by the gradual loss of kidney function over time [1], leading to complications such as high blood pressure, anaemia, and bone disease [2]. The frequency of CKD has increased. Steadily increasing in recent years, with lifestyle elements like poor diet, sedentary lifestyle, and obesity contributing to its rise [3].

Conventional treatment modalities

Dialysis and Kidney Transplantation Currently, the two primary methods of treatment for end-stage CKD are dialysis and kidney transplantation. Dialysis involves the application of a machine to filter waste products and excess fluid from the blood [4], while kidney transplantation entails replacing a diseased kidney with a healthy one from a living or deceased donor. Although these treatments have been life-saving for many patients, they come with their own set of challenges and limitations [5].

Emergence and potential of the bio-artificial kidney

The emergence of bio-artificial kidney technology has brought new hope to the domain of kidney transplantation. A bio-artificial kidney is a device that combines the principles of both dialysis and transplantation [6], aiming to provide A more productive and efficient long-lasting solution for individuals who have CKD. This innovative approach involves the use of living cells and advanced biotechnology to create a device that closely mimics the functions of a natural kidney [7].

Core concepts behind the bio-artificial kidney

The core concepts behind the bio-artificial kidney lie in its design and biotechnological innovations. The device is composed of a bioreactor, which houses a combination of living cells and synthetic membranes [8]. These cells are carefully selected and engineered to perform the essential functions of the kidneys, including filtration, reabsorption, and secretion. The synthetic membranes act as barriers, allowing the selective passage of molecules while preventing the loss of important substances [9]. The bioreactor is intended to be implanted within the patient’s body, eliminating the need for external dialysis machines or long waiting lists for kidney transplantation [10]. This not only provides better convenience for the patient but also lowers the chance of complications and infections associated with traditional treatments.

Design and biotechnological innovations

Bio Artificial Kidney (BAK) is a bio-hybrid device that combines biological and synthetic components. The BAK combines a silicon nanomembrane hem filter with a bioreactor containing human kidney cells [11]. The bioreactor replicates key functions of the renal tubule, such as delivering nutrients and oxygen to kidney cells and protecting them from recipient immune cells.

Some characteristics of an ideal artificial kidney include

1. Size: The device should be small enough to be wearable or implantable.
2. Ergonomics: The equipment should be discreet and able to be worn under the patient's clothes.
3. Weight: The device must be in a manageable weight and size range

Some innovative dialysis technologies being developed include

Portable wearable and implanted kidney substitute systems. The iRAD (Implantable renal assist device), which couples a durable, long-life hem filter equipped with a kidney bioreactor tubule cell. A portable, totally man-made artificial kidney that is small enough to fit inside a backpack.

Replicating the natural kidney functions

One of the key goals of the bio-artificial kidney is to replicate the natural functions of the kidney as closely as possible. This includes the capacity to filter waste products, regulate electrolyte balance, and produce hormones that play an important part in maintaining overall health. By replicating these functions, the bio-artificial kidney aims to restore normal kidney function and enhance the standard of living for individuals with end-stage CKD [12].

Current investigation and practice applications

Pre-clinical studies and results: In the last few years: There has been significant progress in the evolution of Bio-artificial kidney technology, a groundbreaking innovation that possesses the potential to revolutionize kidney health [13]. Pre-clinical studies have demonstrated encouraging outcomes. Paving the way for further research as well as clinical studies. These studies have focused on demonstrating the safety and efficacy of bio-artificial kidneys in animal models, offering insightful information about their possible uses in Human patients [14]. One such research carried out by A team of researchers at a leading medical institution explored the application of Bio-artificial kidneys in a rat model. The results were remarkable, with the bio-artificial kidneys effectively mimicking the purposes of a Natural kidney [15]. The rats exhibited improved renal function, reduced levels of poisons, and enhanced overall health. These findings provide a solid base for the development of Bio-artificial kidney technology and its capacity to change the lives of millions suffering from kidney disease [16]. Another pre-clinical study investigated the long-term viability of bio-artificial kidneys. By implanting bio-engineered kidney structures into pigs, researchers observed the integration and functionality of these artificial organs over an extended period. The results indicated that the bio-artificial kidneys remained functional, demonstrating the possibility of Long-term durability and effectiveness [17]. This study brings us one step closer to the realization of bio-artificial kidneys as a viable option for kidney disease treatment. The Success of these pre-clinical studies highlights the immense potential of bioartificial kidney technology. The positive outcomes observed in animal models provide a solid foundation for further research and the transition to human clinical trials [16].

Clinical trials, findings and patient outcomes

Clinical trials are a critical phase in the development of any medical technology, and bio-artificial kidneys are no exception. These trials aim to assess the Safety, efficacy, and potential benefits of bio-artificial kidneys in human patients [18]. The findings from these trials play a crucial role in determining the viability and future implementation of this groundbreaking technology. Preliminary results from early-stage Clinical trials have yielded positive results. Outcomes. End-stage renal disease patients who received bio-artificial kidneys experienced significant improvements in their overall health as well as quality. These patients demonstrated enhanced renal function, reduced reliance on dialysis, and improved management of complications associated with kidney disease [19]. One clinical trial focused on those suffering from long-term renal illness that was not eligible for a kidney replacement. The trial assessed the safety and effectiveness of bioartificial kidneys in providing long-term renal support. The results indicated that the bio-artificial kidneys effectively maintained stable renal function, lessening the requirement for dialysis and improving the overall well-being among the patients [20]. These initial findings are highly encouraging and provide a glimpse into the possibility of bio-artificial kidney technology to transform the lives of patients suffering from kidney disease. But it’s crucial to remember that further research and larger-scale clinical trials are necessary to validate these results and ensure the widespread effectiveness of bio-artificial kidneys [19].

Comparisons with traditional treatments

When exploring the possibility of bio-artificial kidney technology, it is essential to compare its advantages and limitations with traditional treatments like kidney transplants and dialysis. Dialysis is frequently used as treatment for renal failure; nonetheless, it has significant drawbacks, including limited effectiveness, frequent sessions, and various complications. Kidney transplantation, although more effective in the long term, faces challenges such as organ shortage, immunosuppressive medications, and rejection risks [21]. Bio-artificial kidneys offer a promising alternative to these traditional treatments. Unlike dialysis, which only partially replaces kidney function, bio-artificial kidneys strive to completely replicate the complex functions of an organic kidney. This comprehensive approach could result in better patient outcomes. Reduced reliance on dialysis and enhanced overall quality of life [22]. Furthermore, bio-artificial kidneys possess the capacity to address the difficulties related to kidney transplantation The lack of available donors organs could be mitigated by the ability to bio-engineer kidneys using a patient’s own cells, removing the requirement for immunosuppressive medications, and reducing the possibility of being turned down This customized strategy could revolutionize the domain of transplantation and provide a viable solution for patients in need of kidney replacement [19].

While bio-artificial kidney technology shows immense promise, it’s critical to acknowledge that further investigations and clinical trials are necessary to fully understand its comparative advantages and limitations. Nevertheless, the possibility of bio-artificial kidneys to enhance patient outcomes and revolutionize the kidney disease is undeniable [21].

Advantages of the bio-artificial kidney in medical treatment

The advantages of bio-artificial kidney technology extend beyond its potential to replicate natural kidney function. This innovative approach to kidney health offers several benefits that can significantly impact patient care. Among the essential advantages of bio-artificial kidneys is their potential for long-term durability. Unlike dialysis, which requires frequent sessions, bio-artificial kidneys possess the capacity to provide continuous renal assistance, lowering the burden on patients and improving their quality. This continuous support may also contribute to better management of complications associated with kidney disease, resulting in enhanced patient outcomes and decreased healthcare costs [23]. Another advantage resides in the personalized nature of bio-artificial kidneys. Traditional treatments like kidney transplants and dialysis often involve a one-size-fits-all approach, whereas bio-artificial kidneys may be specifically tailored to an individual’s unique needs. By utilizing a patient’s own cells, these artificial organs possess the capacity to reduce the likelihood of rejection, improve compatibility, and offer a more personalized treatment option. Additionally, bio-artificial kidney technology has the ability to alleviate kidney disease’s worldwide burden. With millions of people worldwide suffering from kidney-related conditions, the development and implementation of bio-artificial kidneys could significantly alleviate the strain on healthcare systems. By providing an effective individualized and reachable treatment option, bio-artificial kidneys possess the capacity to enhance the overall management and outcomes of kidney disease worldwide [19].

Potential risks, restrictions, and difficulties

While bio-artificial kidney technology has enormous potential, it’s crucial to acknowledge the potential risks, constraints, and difficulties related to its development and implementation. Understanding these factors is essential in ensuring the safe and efficient application of this groundbreaking technology.

The main danger is the possibility of immune rejection. Although bio-artificial kidneys may be personalized using a patient’s own cells, there is still a risk of immune response and rejection. Researchers are actively exploring strategies to minimize this risk, such as developing immune-modulating techniques and utilizing biomaterials that promote integration and reduce the likelihood of rejection [16]. Another limitation and challenge lies in the scalability and affordability of bio-artificial kidney technology. The production and implementation of these complex organs, broadly speaking, present logistical and economic hurdles. Researchers & medical professionals are working to optimize the manufacturing processes, cut expenses, and develop sustainable models for widespread adoption. Additionally, the regulatory as well as moral issues surrounding bio-artificial kidney technology require careful attention. Ensuring the safety, efficacy, and ethical consequences for ethics of this technology are of paramount importance. Regulatory bodies and research institutions must collaborate to establish robust rules and structures for the development, testing, and implementation of bio-artificial kidneys [24].

Overcoming barriers to implementation

Effective use of bio-artificial kidney technology requires overcoming various barriers and challenges. Researchers, healthcare providers, and policymakers are actively working towards addressing these hurdles in order to guarantee the widespread acceptance and incorporation of this groundbreaking technology.

One key aspect is the collaboration between multidisciplinary teams. The evolution of bio-artificial kidneys necessitates the expertise of scientists, engineers, clinicians, and regulatory experts. By fostering collaboration and knowledge-sharing across these disciplines, researchers can leverage their collective expertise to deal with the intricacies of bio-artificial kidney technology [25]. Another essential component in overcoming barriers is securing adequate funding and resources. The development, clinical investigations, and implementation of bio-artificial kidneys require substantial financial investment. Governments, philanthropic organizations, and private entities need to recognize the likelihood of this technology and provide the necessary support for further investigation and creation efforts. Education and awareness play a vital role in the effective use of bioartificial kidney technology. Healthcare professionals, patients, and the public must be informed about the potential benefits, risks, and limitations of this innovative treatment option. By fostering a deeper comprehension, we can enable the acceptance and adoption of bio-artificial kidneys in the context of clinical practice [26].

Technological advancements and potential modifications

As Technology keeps evolving. Advancing at an unprecedented pace, bio-artificial kidney technology is poised to benefit from these advancements. Researchers are exploring various avenues to further enhance the capabilities and efficiency of bio-artificial kidneys. One area of focus is the combination of Artificial Intelligence (AI) and machine learning algorithms. By analysing enormous volumes of patient data, AI systems can optimize the performance and functionality of bio-artificial kidneys. This integration has the capacity to enhance patient results, personalize treatment approaches, and strengthen the overall efficiency of bio-artificial kidney technology [25].

Additionally, researchers are investigating the application of 3D printing technology in the production of bio-artificial kidneys. 3D printing allows for precise and customized creation of intricate structures, which can be tailored to an individual’s specific needs. This technology possesses the capacity to streamline the manufacturing process, increase scalability, and cut expenses associated with bio-artificial kidney production. Furthermore, advancements in nanotechnology hold promise for the prospects of bioartificial kidneys. By leveraging nonmaterial, researchers can improve the biocompatibility, durability, and functionality of these artificial organs. Nanotechnology also enables targeted drug delivery and improved monitoring of patient health, further enhancing the possibility of bio-artificial kidney technology [28].

Implications for global kidney disease management

The evolution and widespread implementation of bio-artificial kidney technology have significant implications for global kidney disease management. With millions of people worldwide suffering from kidney-related conditions, this innovative treatment option has to possess the capacity to revolutionize the industry and enhance patient outcomes globally. Bio-artificial kidneys offer a personalized, comprehensive, and potentially long-term solution for individuals with kidney disease. By replicating the functions of an organic kidney, these artificial organs can improve renal function, reduce the reliance on dialysis, and enhance overall patient well-being. This customized strategy has the ability to completely transform the field of kidney disease management and provide a viable treatment option for those in need [29]. Furthermore, the scalability and affordability of bio-artificial kidney technology could have a profound effect on medical treatment systems globally. By providing an accessible and efficient medical care option, bio-artificial kidneys can alleviate the cost of healthcare resources and improve the overall management of kidney disease. This, in turn, can result in significant cost savings, enhanced quality of life, and better patient outcomes for individuals affected by kidney disease [30].

Economic and healthcare impacts

The introduction of bio-artificial kidney technology has the capacity to have a significant economic and healthcare impact. By revolutionizing the kidney field disease, this innovative technology can result in lower expenses, better patient outcomes, and enhanced healthcare efficiency.

Among the primary economic impacts is the reduction of healthcare costs associated with kidney disease. Traditional therapies like dialysis and kidney transplantation are expensive and require ongoing medical interventions. Bio-artificial kidneys, with their potential for long-term durability and reduced reliance on dialysis, can significantly reduce the economic strain on medical systems [29]. Moreover, bio-artificial kidney technology possesses the capacity to enhance patient outcomes, resulting in an elevated standard of living and increased productivity. Individuals receiving bio-artificial may experience fewer complications, require fewer hospitalizations, and have improved overall health. This can result in reduced healthcare expenditure and increased economic productivity for individuals and society. Furthermore, the evolution and implementation of bio-artificial kidney technology can stimulate research, innovation, and job creation. This groundbreaking technology requires collaboration between various scientific disciplines, leading to advancements in bioengineering, nanotechnology, and artificial intelligence. The growth of these fields can foster economic development and create new employment opportunities within the medical field and biomedical industries.

Summarization of key findings and insights

Throughout the years, advancements in medical research have led to groundbreaking innovations within the domain of renal therapy. One such innovation that has enormous potential is bio-artificial kidney technology. This cutting-edge technology aims to revolutionize kidney health by offering a viable solution for individuals suffering from End-stage kidney illness (ESRD) and reducing their dependence on traditional dialysis methods. The bio-artificial kidney combines the principles of both biological and engineering sciences to replicate the operations of a natural kidney. It includes a filtration system that removes waste and excess fluids from the blood, and additionally, a cellular component that helps in the reintegration of essential substances. This integration of biology and engineering offers a potential breakthrough in the manner in which kidney diseases are treated, providing patients with a more efficient and sustainable therapy option. The primary objective of developing bio-artificial kidney technology is in order to enhance patient outcomes and improve their quality. Traditional dialysis methods, although life-saving, have several limitations and can be burdensome for patients. These limitations include the requirement for frequent visits to dialysis centres, limitations on diet, and the possibility of infection. By leveraging bio-artificial kidney technology, patients can experience a more customized and convenient treatment approach that closely resembles the natural roles that a healthy kidney.

The function of the bio-artificial kidney in revolutionizing renal therapy

The bio-artificial kidney has the capacity to transform renal therapy by addressing the shortcomings of current treatment methods. Unlike traditional dialysis, which only filters excess and waste fluids, the bio-artificial kidney offers a more comprehensive approach. It not only filters the blood but also performs vital functions such as pH regulation, hormone production, and the absorption of nutrients. By integrating living cells into the filtration system, the bio-artificial kidney can mimic the complex biological processes of a natural kidney. This allows for more efficient removal of waste products, while simultaneously reabsorbing essential substances that would otherwise be lost during traditional dialysis. As a result, patients may experience improved overall health, reduced complications, as well as enhanced life quality. Furthermore, the bio-artificial kidney technology has the ability to reduce the requirement for immunosuppressive medications. Currently, kidney transplant recipients are required to take immunosuppressive drugs to prevent organ rejection. However, with the bio-artificial kidney, the possibility of rejection is significantly reduced as the device utilizes the patient’s own cells. This not only eliminates the requirement for lifelong medication but also reduces the possibility of associated side effects, thereby improving patient security as well as long-term outcomes.

Areas earmarked for continued research

While bio-artificial kidney technology shows great promise, there are still several areas that require further research and production. One key area of focus is the long-term viability and functionality of the bio-artificial kidney. As the device utilizes living cells, it’s crucial to ensure their survival, functionality, and immune compatibility over an extended period. Ongoing research aims to optimize the design and materials used in the bio-artificial kidney to enhance cell viability and longevity. Another critical aspect of research is the scalability and affordability of bio-artificial kidney technology. To make this innovation accessible to a broader population, efforts are underway to develop cost-effective manufacturing processes and optimize the production of bio-artificial kidneys. Additionally, research is being conducted to explore alternative cell sources, such as stem cells, that could potentially overcome the limitations associated with the availability of donor cells. Collaboration between multidisciplinary teams is also crucial for the continued advancement of bio-artificial kidney technology. By bringing together experts from a range of fields, such a nephrology, bioengineering, and regenerative medicine, researchers can pool their knowledge and expertise to address the complex difficulties related to developing a fully functional and clinically viable bio-artificial kidney.

Suggestions for technological and clinical refinements

As bio-artificial kidney technology progresses, there are several suggestions for technological and clinical refinements that could further enhance its effectiveness and applicability. Firstly, the development of advanced biomaterials that facilitate improved cell integration and function is essential. These biomaterials should not only provide an atmosphere that is favourable for cell proliferation and differentiation but also possess the necessary mechanical properties for optimal filtration and reabsorption. Additionally, the incorporation of smart sensors and monitoring systems within the bio-artificial kidney could provide real-time feedback on its performance. This would enable medical experts to closely monitor patient response and make necessary adjustments to optimize treatment outcomes. Furthermore, the incorporation of telemedicine and remote monitoring capabilities would allow patients to receive personalized care from the comfort of their homes, decreasing the requirement for frequent hospital visits. More research is required to make clinical modifications. Assess the long-term safety and efficacy of bio-artificial kidney technology. Clinical trials involving a larger patient population and longer follow-up periods are necessary to determine the device’s effectiveness in enhancing patient results and reducing mortality rates. Additionally, comparative studies that directly evaluate the bio-artificial kidney against traditional dialysis methods would offer insightful information about its superiority and potential cost savings. In conclusion, bio-artificial kidney technology holds tremendous potential in revolutionizing renal therapy and improving the lives of millions of individuals suffering from kidney diseases. With ongoing research, technological advancements, and clinical refinements, we are inching closer to a future where bio-artificial kidneys become a standard treatment option. By investing in this innovative technology, we can bring about a paradigm shift in kidney health, offering patients a more efficient and personalized, and sustainable therapy approach.

1. Kakitapalli Y, Ampolu J, Madasu SD, Sai Kumar MLS. Detailed review of chronic kidney disease. Kidney Dis (Basel). 2020;6(2):85–91. Available from: https://doi.org/10.1159/000504622
2. Stevens LA, Viswanathan G, Weiner DE. CKD and ESRD in the elderly: current prevalence, future projections, and clinical significance. Adv Chronic Kidney Dis. 2010;17(4):293–301. Available from: https://doi.org/10.1053/j.ackd.2010.03.010
3. Ojo A. Addressing the global burden of chronic kidney disease through clinical and translational research. Trans Am Clin Climatol Assoc. 2014;125:229–46. Available from: https://pubmed.ncbi.nlm.nih.gov/25125737/
4. Murabito S, Hallmark BF. Complications of kidney disease. Nurs Clin North Am. 2018;53(4):579–88. Available from: https://doi.org/10.1016/j.cnur.2018.07.010
5. Hunter DJ, Reddy KS. Noncommunicable diseases. N Engl J Med. 2013;369(14):1336–43. Available from: https://doi.org/10.1056/nejmra1109345
6. National Kidney Foundation. Global Facts: About Kidney Disease [Internet]. 2015–2016. Available from: https://www.kidney.org/kidneydisease/global-facts-about-kidney-disease
7. Abecassis M, Bartlett ST, Collins AJ, Davis CL, Delmonico FL, Friedewald JJ, et al. Kidney transplantation as primary therapy for end-stage renal disease: a National Kidney Foundation/Kidney Disease Outcomes Quality Initiative (NKF/KDOQI™) conference. Clin J Am Soc Nephrol. 2008;3(2):471–80. Available from: https://doi.org/10.2215/cjn.05021107
8. Corstorphine L, Sefton MV. Effectiveness factor and diffusion limitations in collagen gel modules containing HepG2 cells. J Tissue Eng Regen Med. 2011;5(2):119–29. Available from: https://doi.org/10.1002/term.296
9. Cooper TP, Sefton MV. Fibronectin coating of collagen modules increases in vivo HUVEC survival and vessel formation in SCID mice. Acta Biomater. 2011;7(3):1072–83. Available from: https://doi.org/10.1016/j.actbio.2010.11.008
10. Arenas-Herrera JE, Ko IK, Atala A, Yoo JJ. Decellularization for whole organ bioengineering. Biomed Mater. 2013;8(1):014106. Available from: https://doi.org/10.1088/1748-6041/8/1/014106
11. Bach LA, Hale LJ. Insulin-like growth factors and kidney disease. Am J Kidney Dis. 2015 Feb;65(2):327–36. Available from: https://doi.org/10.1053/j.ajkd.2014.05.024
12. Corridon P, Rhodes G, Zhang S, Bready D, Xu W, Witzmann F, et al. Hydrodynamic delivery of mitochondrial genes in vivo protects against moderate ischemia-reperfusion injury in the rat kidney (690.17). FASEB J. 2014;28(1 Suppl):690.17. Available from: http://dx.doi.org/10.1096/fasebj.28.1_supplement.690.17
13. Ichishita R, Matsuda T, Kawakami S, Kiyonaga A, Tanaka H, Morito N, et al. The accumulation of healthy lifestyle behaviors prevents the incidence of chronic kidney disease (CKD) in middle-aged and older males. Environ Health Prev Med. 2016;21:129–37. Available from: https://doi.org/10.1007/s12199-016-0506-6
14. Reddenna L, Basha SA, Reddy KSK. Dialysis treatment: a comprehensive description. Int J Pharm Res Allied Sci. 2014;3(1). Available from: https://www.scirp.org/reference/referencespapers?referenceid=1705519
15. Venkat KK, Eshelman AK. The evolving approach to ethical issues in living donor kidney transplantation: A review based on illustrative case vignettes. Transpl Rev (Orlando). 2014;28(3):134–9. Available from: https://doi.org/10.1016/j.trre.2014.04.001
16. Basile A, Annesini MC, Piemonte V, Charcosset C, editors. Current Trends and Future Developments on (Bio-) Membranes: Membrane Applications in Artificial Organs and Tissue Engineering. 2019. Available from: https://shop.elsevier.com/books/current-trends-and-future-developments-on-bio-membranes/basile/978-0-12-814225-7
17. Attanasio C, Latancia MT, Otterbein LE, Netti PA. Update on renal replacement therapy: implantable artificial devices and bioengineered organs. Tissue Eng Part B Rev. 2016;22(4):330–40. Available from: https://doi.org/10.1089/ten.teb.2015.0467
18. Chevtchik NV, Pinto PC, Masereeuw R, Stamatialis D. Membranes for bioartificial kidney devices. World Sci Ser Membr Sci Technol. 2018;2. Available from: https://research.utwente.nl/en/publications/membranes-for-bioartificial-kidney-devices
19. Peloso A, Katari R, Murphy SV, Zambon JP, DeFrancesco A, Farney AC, et al. Prospect for kidney bioengineering: shortcomings of the status quo. Expert Opin Biol Ther. 2015;15(4):547–58. Available from: https://doi.org/10.1517/14712598.2015.993376
20. Duy Nguyen BT, Nguyen Thi HY, Nguyen Thi BP, Kang DK, Kim JF. The roles of membrane technology in artificial organs: current challenges and perspectives. Membranes (Basel). 2021;11(4):239. Available from: https://doi.org/10.3390/membranes11040239
21. Ostadfar A. Design and experimental proof of selected functions in implantable artificial kidney [dissertation]. 2013. Available from: https://summit.sfu.ca/item/13866
22. Jansen J, Fedecostante M, Wilmer MJ, van den Heuvel LP, Hoenderop JG, Masereeuw R. Biotechnological challenges of bioartificial kidney engineering. Biotechnol Adv. 2014;32(7):1317–27. Available from: https://doi.org/10.1016/j.biotechadv.2014.08.001
23. Kellum JA, Bellomo R, Ronco C, editors. Continuous renal replacement therapy. Oxford: Oxford University Press; 2016. Available from: https://academic.oup.com/book/24475
24. Marques AP. Prospects of tissue engineering in wound management. 2019;3:15. Available from: https://repositorium.uminho.pt/handle/1822/75134
25. Holmberg JA, Henry SM, Burnouf T, Devine D, Marschner S, Boothby TC, et al. National Blood Foundation 2021 Research and Development summit: Discovery, innovation, and challenges in advancing blood and biotherapies. Transfusion. 2022;62(11):2391–404. Available from: https://doi.org/10.1111/trf.17092
26. Loai S, Kingston BR, Wang Z, Philpott DN, Tao M, Cheng HLM. Clinical perspectives on 3D bioprinting paradigms for regenerative medicine. Regen Med Front. 2019;1(1):e190004. Available from: https://doi.org/10.20900/rmf20190004
27. Shapira A, Noor N, Oved H, Dvir T. Transparent support media for high resolution 3D printing of volumetric cell-containing ECM structures. Biomed Mater. 2020;15(4):045018. Available from: https://doi.org/10.1088/1748-605x/ab809f
28. Himmelfarb J, Vanholder R, Mehrotra R, Tonelli M. The current and future landscape of dialysis. Nat Rev Nephrol. 2020;16(10):573–85. Available from: https://doi.org/10.1038/s41581-020-0315-4
29. Nagasubramanian S. The future of the artificial kidney. Indian J Urol. 2021;37(4):310–7. Available from: https://doi.org/10.4103/iju.iju_273_21
30. Bonventre JV, Hurst FP, West M, Wu I, Roy-Chaudhury P, Sheldon M. A technology roadmap for innovative approaches to kidney replacement therapies: a catalyst for change. Clin J Am Soc Nephrol. 2019;14(10):1539–47. Available from: https://doi.org/10.2215/cjn.02570319