Vigezzi Andrea, Brani Paola, Dalla Gasperina Daniela, Azzi Lorenzo, Giaroni Cristina, Inversini Davide, Pettinato Giuseppe, Massaad Matthew, Carcano Giulio, Ietto Giuseppe, Baj Andreina
Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy.
Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
Front Endocrinol (Lausanne). 2025 Jul 18;16:1549744. doi: 10.3389/fendo.2025.1549744. eCollection 2025.
A scoping review was conducted to systematically assess the current evidence and emerging applications of regenerative medicine in the treatment of End Stage Renal Disease (ERSD), aiming to map existing knowledge and identify key research gaps. ESRD represents a major global health burden, and despite being managed primarily through dialysis and kidney transplantation, both approaches are limited by morbidity, mortality, and organ donor shortages. Regenerative medicine emerged as a promising alternative, leveraging stem cells technologies and tissue engineering to develop functional renal tissues with the potential to restore or replace damaged kidney structures. Our review protocol was developed in accordance with the PRISMA-ScR guidelines and was prospectively registered on Figshare. Inclusion criteria comprised peer-reviewed articles published between 2004 and 2024, focusing on bioengineering strategies relevant to kidney regeneration and ESRD, with no restrictions on language or geographic origin. Editorials, letters, and non-peer-reviewed sources were excluded. A comprehensive literature search was performed in Medline, Scopus, and Web of Science using pre-defined search terms. Screening and selection were conducted independently by four reviewers working in pairs selected with discrepancies resolved through consensus. A standardized data extraction form was iteratively developed and piloted to collect relevant information on study characteristics and experimental models. Of the 5,869 records initially identified, 111 studies met the inclusion criteria. The findings underscore the therapeutic potential of regenerative medicine in ESRD, with kidney organoids and organ-on-a-chip platforms representing two of the most advanced and translationally relevant approaches currently under investigation. These technologies are increasingly recognized not only for their role in disease modeling and drug screening, but also as potential precursors to fully bioengineered renal replacement therapies.
进行了一项范围综述，以系统评估再生医学在终末期肾病（ESRD）治疗中的现有证据和新兴应用，旨在梳理现有知识并识别关键研究空白。ESRD是一项重大的全球健康负担，尽管主要通过透析和肾移植进行管理，但这两种方法都受到发病率、死亡率和器官供体短缺的限制。再生医学作为一种有前景的替代方法出现，利用干细胞技术和组织工程来开发具有恢复或替代受损肾脏结构潜力的功能性肾组织。我们的综述方案是根据PRISMA-ScR指南制定的，并在Figshare上进行了前瞻性注册。纳入标准包括2004年至2024年发表的同行评审文章，重点关注与肾脏再生和ESRD相关的生物工程策略，对语言或地理来源没有限制。社论、信件和非同行评审来源被排除。使用预定义的搜索词在Medline、Scopus和科学网进行了全面的文献检索。筛选和选择由四名成对工作的评审员独立进行，如有差异通过共识解决。反复开发并试用了标准化的数据提取表，以收集有关研究特征和实验模型的相关信息。在最初识别的5869条记录中，111项研究符合纳入标准。研究结果强调了再生医学在ESRD中的治疗潜力，肾脏类器官和芯片上器官平台是目前正在研究的两种最先进且与转化相关的方法。这些技术不仅因其在疾病建模和药物筛选中的作用而越来越受到认可，而且还被视为完全生物工程化肾脏替代疗法的潜在前身。
