Human Kidney Proximal Tubule‐Microvascular Model Facilitates High‐Throughput Analyses of Structural and Functional Effects of Ischemia‐Reperfusion Injury

Abstract Kidney ischemia reperfusion injury (IRI) poses a major global healthcare burden, but effective treatments remain elusive. IRI involves a complex interplay of tissue‐level structural and functional changes caused by interruptions in blood and filtrate flow and reduced oxygenation. Existing in vitro models poorly replicate the in vivo injury environment and lack means of monitoring tissue function during the injury process. Here, a high‐throughput human primary kidney proximal tubule (PT)‐microvascular model is described, which facilitates in‐depth structural and rapid functional characterization of IRI‐induced changes in the tissue barrier. The PREDICT96 (P96) microfluidic platform's user‐controlled fluid flow can mimic the conditions of IR to induce pronounced changes in cell structure that resemble clinical and in vivo phenotypes. High‐throughput trans‐epi/endo‐thelial electrical resistance (TEER) sensing is applied to non‐invasively track functional changes in the PT‐microvascular barrier during the two‐stage injury process and over repeated episodes of injury. Notably, ischemia causes an initial increase in tissue TEER followed by a sudden increase in permeability upon reperfusion, and this biphasic response occurs only with the loss of both fluid flow and oxygenation. This study demonstrates the potential of the P96 kidney IRI model to enhance understanding of IRI and fuel therapeutic development.