We are extremely grateful to all Mao and Hu Lab members, past and present, for the interesting discussions and great contributions to the project. We thank the National Clinical Research Center for Child Health for the great support. This study was financially supported by the National Natural Science Foundation of China (U20A20351 to Jianhua Mao, 82200784 to Lidan Hu), the Natural Science Foundation of Zhejiang Province of China (No. LQ22C070004 to Lidan Hu), and the Natural Science Foundation of Jiangsu Province (Grants No. BK20210150 to Gang Wang).

The iPSCs used for the present study were obtained from a commercial source. The cells were maintained with mTeSR medium on commercially available basement membrane matrix-coated plates (see Table of Materials). Table 1 contains all the medium compositions utilized in the study.
1. Plating iPSCs for differentiation and inducing posterior primitive streak (PS)
<ol>
	<li>Wash iPSCs on the membrane matrix-coated 6-well plate with 2 mL DPBS. Asp...

Using Induced Pluripotent Stem Cell Suspension for Kidney Organoid Production

<ol>
	<li>Tekguc, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Kidney+organoids:+a+pioneering+model+for+kidney+diseases.">Kidney organoids: a pioneering model for kidney diseases.</a> Translational Research. 250, 1-17 (2022).</li><li>Hill, N. R., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Global+prevalence+of+chronic+kidney+disease+-+a+systematic+review+and+meta-analysis.">Global prevalence of chronic kidney disease - a systematic review and meta-analysis.</a> PLOS ONE. 11 (7), 0158765 (2016).</li><li>Rossi, G., Manfrin, A., Lutolf, M. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Progress+and+potential+in+organoid+research.">Progress and potential in organoid research.</a> Nature Reviews Genetics. 19 (11), 671-687 (2018).</li><li>Takasato, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Directing+human+embryonic+stem+cell+differentiation+towards+a+renal+lineage+generates+a+self-organizing+kidney.">Directing human embryonic stem cell differentiation towards a renal lineage generates a self-organizing kidney.</a> Nature Cell Biology. 16 (1), 118-126 (2014).</li><li>Morizane, R., Lam, A. Q., Freedman, B. S., Kishi, S., Valerius, M. T., Bonventre, J. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nephron+organoids+derived+from+human+pluripotent+stem+cells+model+kidney+development+and+injury.">Nephron organoids derived from human pluripotent stem cells model kidney development and injury.</a> Nature Biotechnology. 33 (11), 1193-1200 (2015).</li><li>Freedman, B. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modelling+kidney+disease+with+CRISPR-mutant+kidney+organoids+derived+from+human+pluripotent+epiblast+spheroids.">Modelling kidney disease with CRISPR-mutant kidney organoids derived from human pluripotent epiblast spheroids.</a> Nature Communications. 6 (1), 8715 (2015).</li><li>Takasato, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Kidney+organoids+from+human+iPS+cells+contain+multiple+lineages+and+model+human+nephrogenesis.">Kidney organoids from human iPS cells contain multiple lineages and model human nephrogenesis.</a> Nature. 526 (7574), 564-568 (2015).</li><li>Mugford, J. W., Sipil&#228;, P., McMahon, J. A., McMahon, A. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Osr1+expression+demarcates+a+multi-potent+population+of+intermediate+mesoderm+that+undergoes+progressive+restriction+to+an+Osr1-dependent+nephron+progenitor+compartment+within+the+mammalian+kidney.">Osr1 expression demarcates a multi-potent population of intermediate mesoderm that undergoes progressive restriction to an Osr1-dependent nephron progenitor compartment within the mammalian kidney.</a> Developmental biology. 324 (1), 88-98 (2008).</li><li>SaxOn, L., Sariola, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Early+organogenesis+of+the+kidney.">Early organogenesis of the kidney.</a> Pediatric Nephrology. 1, 385-392 (1987).</li><li>Kobayashi, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Six2+defines+and+regulates+a+multipotent+self-renewing+nephron+progenitor+population+throughout+mammalian+kidney+development.">Six2 defines and regulates a multipotent self-renewing nephron progenitor population throughout mammalian kidney development.</a> Cell Stem Cell. 3 (2), 169-181 (2008).</li><li>Boyle, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fate+mapping+using+Cited1-CreERT2+mice+demonstrates+that+the+cap+mesenchyme+contains+self-renewing+progenitor+cells+and+gives+rise+exclusively+to+nephronic+epithelia.">Fate mapping using Cited1-CreERT2 mice demonstrates that the cap mesenchyme contains self-renewing progenitor cells and gives rise exclusively to nephronic epithelia.</a> Developmental Biology. 313 (1), 234-245 (2008).</li><li>Nishinakamura, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Human+kidney+organoids:+progress+and+remaining+challenges.">Human kidney organoids: progress and remaining challenges.</a> Nature Reviews Nephrology. 15 (10), 613-624 (2019).</li><li>Kumar, S. V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Kidney+micro-organoids+in+suspension+culture+as+a+scalable+source+of+human+pluripotent+stem+cell-derived+kidney+cells.">Kidney micro-organoids in suspension culture as a scalable source of human pluripotent stem cell-derived kidney cells.</a> Development. 146 (5), 172361 (2019).</li><li>Takasato, M., Er, P. X., Chiu, H. S., Little, M. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Generation+of+kidney+organoids+from+human+pluripotent+stem+cells.">Generation of kidney organoids from human pluripotent stem cells.</a> Nature Protocols. 11 (9), 1681-1692 (2016).</li></ol>

A detailed protocol has been described for generating kidney organoids from iPSCs, involving minor modifications to the basal medium, initial cell density, and concentration of CHIR99021. In various experiments, the critical factors for successful kidney organoid generation were found to be the initial differentiation of the intermediate mesoderm (IM) and the cell state on Day 7. Moreover, different iPSC lines exhibited variations in cell proliferation and differentiation potential, resulting in varying optimal cell dens...

The kidney plays a critical role in maintaining physiological homeostasis, depending on its functional unit. Nephrons, which excrete waste products, can regulate the composition of body fluids. Chronic kidney disease (CKD), caused by hereditary mutations or other high-risk factors, will eventually progress to end-stage kidney disease (ESKD)1,2. ESKD is apparently due to the limited regeneration capacity of nephrons. Thus, renal replacement therapy is required. Directed differentiation of human iPSCs enables the in vitro generation of patient-specific 3D kidney organoids, which can be used to study kidney development, model patient-specific diseases, and perform nephrotoxic drug screening3,4.
During embryonic development, kidneys originate from the intermediate mesoderm (IM), which differentiates from the primitive streak (PS). The classical WNT signaling pathway may induce additional differentiation of IM with the coordinated participation of FGF (FGF9, FGF20) and BMP (Bmp7 signaling through JNK)5,6,7. They produce two important cell populations of nephric progenitor cells (NPC): the ureteral bud (UB), and the metanephric mesenchyme (MM), forming the collecting ducts and the nephron, respectively8,9. Each nephron consists of glomerular and tubular segments, such as the proximal and distal tubules, and the loop of Henle10,11. According to the theory mentioned above, currently published protocols mimic the signal cascades and growth factor stimulation to induce kidney organoids5,12.
Over the past several years, many protocols have been developed to differentiate human iPSCs into kidney organoids5,6,7,12. Takasato et al.7 optimized the duration of CHIR (WNT agonist) treatment before replacement by FGF9. According to their protocol, CHIR exposure for 4 days, followed by FGF9 for 3 days, is the most effective way to induce IM from iPSCs. Transwell filters were utilized as the culture format in their procedure; however, this method is difficult for beginners. Therefore, Kumar et al.13 tried to change the culture format and chose to suspend the culture. They dissociated the adherent cells on Day 7 for seeding in low adherent plates to help them assemble into embryoid bodies (EBs) that contain nephron-like structures. However, the batch effect of these methods was apparent, especially in different iPSCs. Additionally, different literature reported that the concentration of CHIR varied from 7 &#181;M to 12 &#181;M5,13,14.
We speculated that the concentration of cell density and the CHIR might affect the generation of organoids in different iPSCs, and this has been verified numerous times in our experiments. The present protocol has slightly modified the study method of Kumar et al.13 and provided users with a step-by-step procedure. The schedule and schematic of the approach are shown in Figure 1.

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			<td>96 Well Cell Culture Plate, Flat-Bottom</td>
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			<td>Sigma-Aldrich</td>
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			<td>Benzyl benzoate</td>
			<td>Sigma-Aldrich</td>
			<td>Cat #120-51-4</td>
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			<td>Biological Safety Cabinet</td>
			<td>Haier</td>
			<td>Cat #HR40&#160;<img alt="Equation 1" src="/files/ftp_upload/65698/65698eq01.jpg" style="margin: auto;" />&#160;A2</td>
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			<td>Biotin anti-human LTL (1:300)</td>
			<td>Vector Laboratories</td>
			<td>Cat #B-1325</td>
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			<td>Blood mononuclear cells hiPS-B1 (iPSc, female)</td>
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			<td>N/A</td>
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			<td>Chemicals, peptides, and recombinant proteins</td>
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			<td>STEMCELL Technologies</td>
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			<td>Corning</td>
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			<td>Costar Ultra-Low Attachment 6 Well Plate</td>
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			<td>Cat #3471</td>
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			<td>STEMCELL Technologies</td>
			<td>Cat #07930</td>
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			<td>Coolaber</td>
			<td>Cat #SL7102</td>
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			<td>Dextran, Alexa Fluor 647</td>
			<td>Thermo SCIENTIFIC</td>
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			<td>Servicebio</td>
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			<td>Donkey Anti-Sheep IgG H&#38;L (Alexa Fluor 647)</td>
			<td>Abcam</td>
			<td>Cat #ab150179</td>
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			<td>Meilunbio</td>
			<td>Cat #MB4516-1</td>
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			<td>D-PBS (without calcium, magnesium, phenol red)</td>
			<td>Solarbio Life Science</td>
			<td>Cat #D1040</td>
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			<td>Dry Bath Incubator</td>
			<td>Shanghai Jingxin</td>
			<td>Cat #JX-10</td>
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			<td>Earthox</td>
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			<td>Dylight 488-Goat Anti-Rabbit IgG (1:400)</td>
			<td>Earthox</td>
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			<td>Earthox</td>
			<td>Cat #E032310</td>
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			<td>Dylight 549-Goat Anti-Rabbit IgG (1:400)</td>
			<td>Earthox</td>
			<td>Cat #E032320</td>
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			<td>Dylight 649-Goat Anti-Rabbit IgG (1:400)</td>
			<td>Earthox</td>
			<td>Cat #E032620</td>
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			<td>Experimental models: Cell Lines</td>
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			<td>Forma Steri-Cycle CO2 Incubator</td>
			<td>Thermo SCIENTIFIC</td>
			<td>Cat #370</td>
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			<td>Geltre LDEV-Free</td>
			<td>Gibco</td>
			<td>Cat #A1413202</td>
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			<td>Glass Bottom Culture Dishes</td>
			<td>NEST</td>
			<td>Cat #801002</td>
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			<td>Goat anti-human CUBN (1:300)</td>
			<td>Santa Cruz Biotechnology</td>
			<td>Cat #sc-20607</td>
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			<td>Heparin Solution (Cell culture supplement)</td>
			<td>STEMCELL Technologies</td>
			<td>Cat #07980</td>
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			<td>Human Recombinant FGF-9</td>
			<td>STEMCELL Technologies</td>
			<td>Cat #78161</td>
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			<td>Inverted Microscope</td>
			<td>OLYMPUS</td>
			<td>Cat #CKX53</td>
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			<td>Laser Scanning Confocal Microscope</td>
			<td>OLYMPUS</td>
			<td>Cat #FV3000</td>
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			<td>Methyl cellulose</td>
			<td>Sigma-Aldrich</td>
			<td>Cat #M7027</td>
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			<td>Micro Centrifuge</td>
			<td>HENGNUO</td>
			<td>Cat #2-4B</td>
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			<td>Mouse anti-human CD31 (1:300)</td>
			<td>BD Biosciences</td>
			<td>Cat #555444</td>
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		<tr>
			<td>Mouse anti-human ECAD (1:300)</td>
			<td>BD Biosciences</td>
			<td>Cat #610182</td>
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		<tr>
			<td>Mouse anti-human Integrin beta 1 (1:300)</td>
			<td>Abcam</td>
			<td>Cat #ab30394</td>
			<td></td>
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		<tr>
			<td>Mouse anti-human MEIS 1/2/3 (1:300)</td>
			<td>Thermo SCIENTIFIC</td>
			<td>Cat #39795</td>
			<td></td>
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			<td>Mowiol 4-88 (Polyvinylalcohol 4-88)</td>
			<td>Sigma-Aldrich</td>
			<td>Cat #81381</td>
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			<td>mTeSR1 5X Supplement</td>
			<td>STEMCELL Technologies</td>
			<td>Cat #85852</td>
			<td></td>
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		<tr>
			<td>mTeSR1 Basal Medium</td>
			<td>STEMCELL Technologies</td>
			<td>Cat #85851</td>
			<td></td>
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			<td>Nunc CryoTube Vials</td>
			<td>Thermo SCIENTIFIC</td>
			<td>Cat #377267</td>
			<td></td>
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			<td>Others</td>
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			<td></td>
			<td></td>
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			<td>Rabbit anti-human GATA3 (1:300)</td>
			<td>Cell Signaling Technology</td>
			<td>Cat #5852S</td>
			<td></td>
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			<td>Rabbit anti-human LRP2 (1:300)</td>
			<td>Sapphire Bioscience</td>
			<td>Cat #NBP2-39033</td>
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			<td>Rabbit anti-human Synaptopodin (1:300)</td>
			<td>Abcam</td>
			<td>Cat #ab224491</td>
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			<td>Rabbit anti-human WT1 (1:300)</td>
			<td>Abcam</td>
			<td>Cat #ab89901</td>
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			<td>Rabbit anti-mouse PDGFR (1:300)</td>
			<td>Abcam</td>
			<td>Cat #ab32570</td>
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			<td>Recombinant Human Serum Albumin (rHSA)</td>
			<td>YEASEN</td>
			<td>Cat #20901ES03</td>
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			<td>Sheep anti-human NPHS1 (1:300)</td>
			<td>R&#38;D Systems</td>
			<td>Cat #AF4269</td>
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			<td>STEMdiff APEL 2 Medium</td>
			<td>STEMCELL Technologies</td>
			<td>Cat #05275</td>
			<td></td>
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			<td>Streptavidin Cy3 (1:400)</td>
			<td>Gene Tex</td>
			<td>Cat #GTX85902</td>
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			<td>Versene (1X)</td>
			<td>Gibco</td>
			<td>Cat #15040066</td>
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			<td>Y-27632 (Dihydrochloride)</td>
			<td>STEMCELL Technologies</td>
			<td>Cat #72304</td>
			<td></td>
		</tr>
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</table>

generating kidney organoids in suspension from induced pluripotent stem cells

Kidney organoids can be generated from induced pluripotent stem cells (iPSCs) through various approaches. These organoids hold great promise for disease modeling, drug screening, and potential therapeutic applications. This article presents a step-by-step procedure to create kidney organoids from iPSCs, starting from the posterior primitive streak (PS) to the intermediate mesoderm (IM). The approach relies on the APEL 2 medium, which is a defined, animal component-free medium. It is supplemented with a high concentration of WNT agonist (CHIR99021) for a duration of 4 days, followed by fibroblast growth factor 9 (FGF9)/heparin and a low concentration of CHIR99021 for an additional 3 days. During this process, emphasis is given to selecting the optimal cell density and CHIR99021 concentration at the start of iPSCs, as these factors are critical for successful kidney organoid generation. An important aspect of this protocol is the suspension culture in a low adherent plate, allowing the IM to gradually develop into nephron structures, encompassing glomerular, proximal tubular, and distal tubular structures, all presented in a visually comprehensible format. Overall, this detailed protocol offers an efficient and specific technique to produce kidney organoids from diverse iPSCs, ensuring successful and consistent results.

Author Spotlight: Optimizing iPSC Differentiation for Efficient Production to Generate Kidney Organoids 

Generating Kidney Organoids in Suspension from Induced Pluripotent Stem Cells

Our research presents a comprehensive and efficient method for producing kidney organoids from induced pluripotent stem cells, using suspension cultural conditions. We emphasize the importance of initial cell density and WNT agonist concentration during the inducing phase, which will educate new organoid researchers. Currently, it is difficult to obtain a single high-density cell line for iPSCs.The batch impact was noticeable, particularly in various iPSC lines. Each batch's kidney organoids, may have a varied form and size. Several attempts are necessary to get the best initial cell density and concentration of CHIR for one iPSC line.We have established that the initial differentiation of the intermediary method is important for successful kidney organoid formation. Our protocol describes in detail, how to choose the optimal cell densities and CHIR concentrations during the process because different iPSC lines showed variances in cell proliferation and differentiation ability. Researchers can quickly generate the specific kidney organoids from their iPSCs.According to our protocol, by adjusting the cell density and the concentration of CHIR, it's undoubtedly beneficial for all our researchers to focus on their kidney disease. Our lab future research has to optimize the method of the protocol in disease models, regenerate new medicine and the drug screening. In recent five years, our lab will focus on the epigenetics and the cell topic drug development of various hereditary kidney disease, based on patient development, iPSC and the kidney organized disease models.

The production of IM is achieved by activating canonical WNT signaling using the GSK3 inhibitor CHIR99021, followed by FGF9/heparin. From Day 0 to Day 4, iPSCs rapidly expand and take on rhomboid or triangular shapes. The confluence reaches 90%-100% and accumulates evenly until Day 7. Upon suspension culture, the aggregates spontaneously form nephron structures after dissociating on Day 7. The kidney organoids created through suspension culture display tubular-like structures and are easily observed in bright field image...

Watch this Scientific Journal Video about Optimizing iPSC Differentiation for Efficient Production to Generate Kidney Organoids at JoVE.com

This protocol presents a comprehensive and efficient method for producing kidney organoids from induced pluripotent stem cells (iPSCs) using suspension culture conditions. The primary emphasis of this study lies in the determination of the initial cell density and the WNT agonist concentration, thereby benefiting investigators interested in kidney organoid research.

Kidney organoids can be generated from induced pluripotent stem cells (iPSCs) through various approaches. These organoids hold great promise for disease ...

generating-kidney-organoids-suspension-from-induced-pluripotent-stem