- Research Article
- 10.1093/ndt/gfaf116.0135
#1531 Hydrogel embedding of iPSC-derived kidney organoids to enable imaging-based high-throughput screening
- Oct 21, 2025
- Nephrology Dialysis Transplantation
- Roelof Dinkelberg + 1 more +1
Background and Aims Induced pluripotent stem cell (iPSC)-derived human kidney organoids have enabled novel capacity to interrogate the mechanisms of kidney disease and screen for screen for new therapeutic strategies in vitro. However, current high-throughput (HT) protocols often rely on specialized equipment, are incompatible with imaging assays, or compromise on the cellular complexity of the organoid. The incompatibility with imaging in particular hinders robust analysis of how perturbations to the culture conditions alter organoid composition. This study aimed to develop a HT kidney organoid protocol that retains tissue complexity and compatibility with imaging to comprehensively assess cellular and molecular phenotypes. Methods iPSCs were differentiated to nephron and stromal precursor cell types for 7 days according to the Takasato protocol then dissociated into single cells and mixed with a hydrogel. Droplets of cell-hydrogel mix were deposited on the bottom of an imaging-compatible 96 or 384-well plate and cultured for an additional two weeks. Hydrogel composition, cell seeding density, medium additives, and differentiation timelines were optimized and evaluated by brightfield and high-content confocal imaging. Molecular and cell type markers were quantified within and between replicate organoids to define the area stained by a molecular marker, as a percentage of total organoid area. Hydrogel-embedded organoids were subjected to hypoxia (1% atmospheric O2 for 48 h) +/− experimental compounds to suppress hypoxia-induced acute kidney injury (HI-AKI), in comparison to vehicle and normoxic (21% O2) controls. Organoids were also augmented by integration of primary human endothelial cells and macrophages at the time of organoid formation and assessed by brightfield and confocal imaging. Results Hydrogel-embedded kidney precursor cell types successfully formed kidney organoids in 96 and 384-well imaging plates. Cell seeding density and hydrogel stiffness influenced the cellular composition of kidney organoids, with stiffer hydrogels producing more podocyte and vascular cell types and softer favouring proximal and distal tubule formation. Hydrogel composition was optimized to generate kidney organoids with balanced proportions of podocyte, proximal tubule, distal tubule, vasculature, and fibroblast cell types, with low inter-organoid variation. Importantly, hydrogel embedding enabled generation of a full 96-well plate of organoids in just 15 minutes, did not require specialized equipment, and enabled high resolution imaging on standard inverted microscopes. To evaluate drug screening in this protocol, hydrogel-embedded organoids were exposed to hypoxia +/− experimental compounds that targeted pathways associated with the occurrence of HI-AKI and vehicle controls. Hypoxic injury was characterized by loss of proximal tubule (9.3% decrease, P = 0.0199) and podocyte (29.9% decrease, P = 0.011) stainings in vehicle controls. Inhibiting the HIF-1α pathway was acutely toxic to the organoids, whereas the antioxidant N-acetyl cysteine (NAC) reduced proximal tubule loss. We next leveraged the ease of use and scalability of this protocol to improve the cellular composition and accuracy of kidney organoids by integrating primary human endothelial cells and macrophages, which are under-represented or absent in most kidney organoid models. Successful integration without an adverse effect on nephrogenesis was dependent on the ratio of these cell types relative to differentiated iPSCs and supplementations of key cytokines and growth factors. Conclusion We report a novel HT protocol to generate kidney organoids in hydrogel droplets with improved scale, imaging compatibility, and comparable cellular complexity to traditional methods. Our results identify NAC as a candidate agent to protect against ischemic AKI, while integration of vascular and immune cell types provides new possibilities to model human vascular and immune cell interactions in kidney disease. Ultimately, this new high-throughput method holds great promise to improve the biomedical and translational impact of human kidney organoids.
Read more