Recent advances in kidney research have yielded dramatic headlines touting scientists' ability to grow kidneys in the lab. But some experts worry that hype about tissue engineering is excessively raising patients' hopes

In 2013, US scientists announced that they had grown kidneys that could process urine in rats. The announcement was hailed as potentially paving the way for artificially creating an endless supply of organs that could be used in humans.

But adapting the technique for humans is enormously complex. Kidney disease is a devious condition because it often lacks symptoms until it has advanced and complications occur.

Obesity, smoking, and diabetes all affect kidney health and with 750 million people worldwide suffering compromised kidney function—and some 70 million of them in Europe—it poses an increasingly large burden on public health.

Between 5 and 10 million people die of kidney disease each year, double the figure for malaria, tuberculosis, and AIDS combined. Professor Giuseppe Remuzzi, director of Italy's Mario Negri Institute for Pharmacological Research, recently led a project called RESET that explored the possibility of using the patient's tissue to repopulate the kidney.

Described by medical journal the Lancet as 'a pioneer in nephrology,' Prof. Remuzzi is now concerned that reports about innovations in stem cell research and tissue engineering overstate their potential and risk misleading patients.

Dialysis

In Europe, Japan and the US, patients with kidney disease can receive dialysis—a daily treatment that artificially removes waste—or goes on a waiting list for a kidney transplant.

In developing countries, only the wealthy have access to these options while 'everyone else dies,' Prof. Remuzzi said. He points out that even if tissue engineering did succeed, it would remain out of reach for many.

As Europe's population ages, chronic kidney disease (CKD) will become an even greater problem and more costly for healthcare systems to cover. The condition spikes in people aged over 75, affecting up to 50% of the population. Older people with CKD are frailer and at greater risk for other ailments and cognitive impairment.

Detecting kidney disease early on makes it possible to avoid end-stage disease and dialysis. But in older people, detection is complicated by the presence of other conditions that can mask symptoms. Also, screening programmes frequently use techniques that do not target older adults specifically as they have been tested on the overall population.

Dr. Fabrizia Lattanzio is a scientific director at the National Institute of Health and Sciences on Ageing in Ancona, Italy, and leads SCOPE, a large-scale observational study of kidney disease in seven countries. The goal is to figure out which indicators of the disease, known as biomarkers, are most accurate for older people.

'The problem is that if we look at the biomarkers that are working on the creatinine-based (a waste product) filtrations, we have a high degree of inaccuracy,' she said. 'As age increases in the 75 plus or the 80 plus age group, we have problems with the protein metabolism that can affect the efficacy and the effective use of this kind of biomarker.'

Profiling

SCOPE researchers are looking at new biomarkers that would be based on proteomic and metabolomic profiling—analyses of the levels of different proteins in a patient's blood. The project is building on information from more than 2,400 people whose average age is 81.

Central to the study is what researchers call a 'comprehensive geriatric assessment' – a bank of different types of information not just about participants' kidney health, but also their other ailments and the medications they take, as well as their overall physical and mental functioning.

The combined data reflects the full complexity of elderly people's health issues and will allow researchers to tease out the different factors affecting their kidneys.

The research is at too early a stage to comment on the new biomarkers' effectiveness, but Dr. Lattanzio says the group hopes to flag up ineffective screening programmes that can be discontinued, and hone a more personalized approach to kidney care for Europe's elderly population.

Better monitoring programmes, along with preventative strategies, are emerging as the preferred public health options to contain CKD. Remission clinics, combining drug treatment and healthier lifestyles clinics, can delay the onset of end-stage renal disease by as long as 21 years.