Kidney disease affects over 850 million people worldwide and costs the U.S. Medicare system over $81 billion annually. Developing targeted treatments is challenging due to a limited understanding of kidney disease mechanisms and the high failure rate (90%) of drug candidates in human trials. Traditional animal models often fail to predict human toxicity and efficacy accurately.

Innovative ex vivo kidney models, including those derived from induced pluripotent stem (iPS) cells and organ-on-a-chip systems, are gaining attention for their ability to better replicate human kidney functions and responses. This review highlights recent progress in creating kidney organoids and organ-chips using iPS cell technology to model human kidney functions and diseases. It also addresses the challenges in maximizing the potential of these models for personalized medicine and therapeutic discovery, which could revolutionize treatment for kidney disease.