{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:01:07Z","timestamp":1789959667878,"version":"4.0.1"},"reference-count":107,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease necessitates safer, more continuous kidney replacement therapies (KRT), yet current dialysis and transplantation are constrained by intermittent treatment, organ scarcity, and immunosuppression\u2010related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This conceptual narrative review examines the potential integration of synthetic biology and soft robotics within a biohybrid KRT framework. We define a cyborg nephron as an engineered functional unit coupling living renal\/vascular cells with compliant mechanical and fluidic interfaces, organized as a Modular Renal Assist Device (MRAD) with separable filtration, tubular transport, endocrine support, and control modules. Technology readiness levels (TRL) were applied to distinguish established, preclinical, and conceptual components.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Available evidence supports several individual components including cell\u2010based renal bioreactors, microphysiological models, endothelialized blood\u2010contacting surfaces, passive membranes, soft micropumps, and wireless sensing (TRL 3\u20135). Conversely, autonomous renal gene circuits, active immunoisolation, durable vascular integration, and fully implanted closed\u2010loop control remain predominantly preclinical or conceptual (TRL 1\u20132). Major barriers include thrombosis, oxygen delivery, cell maturation, genetic stability, mechanical fatigue, power demands, cybersecurity, and regulation of combined living\u2010device products.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The cyborg nephron represents a hypothesis\u2010generating research framework rather than a near\u2010term clinical solution. Staged validation through modular development, conservative safety design, and comparison with simpler alternatives is essential before integrated preclinical testing can be justified.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.70242","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T02:16:59Z","timestamp":1789957019000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Synthetic Biology and Soft Robotics in Biohybrid Kidney Replacement: A Conceptual Framework and Translational Roadmap"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5481-5617","authenticated-orcid":false,"given":"Amr Ali Mohamed Abdelgawwad","family":"El\u2010Sehrawy","sequence":"first","affiliation":[{"name":"Internal Medicine, Diabetes, Endocrinology and Metabolism Mansoura University  Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeina T.","family":"Khaleel","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Al\u2010Mustafa University  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rushen","family":"Gafarov","sequence":"additional","affiliation":[{"name":"Department of Urology Samarkand State Medical University  Samarkand Uzbekistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisar Ahmad","family":"Koka","sequence":"additional","affiliation":[{"name":"Department of English, College of Languages and Translation King Khalid University  Abha Kingdom of Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4146-6101","authenticated-orcid":false,"given":"Mirza R.","family":"Baig","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy Dubai Medical University  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrey Kumar","family":"Srivastav","sequence":"additional","affiliation":[{"name":"Department of General Medicine Sharda University  Greater Noida India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarmad S.","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Al\u2010Mustafa University  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0759-8298","authenticated-orcid":false,"given":"Majid S.","family":"Jabir","sequence":"additional","affiliation":[{"name":"College of Applied Sciences University of Technology  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj","family":"Bainsal","sequence":"additional","affiliation":[{"name":"University Institute of Pharma Sciences, Chandigarh University  Mohali Punjab India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4600-509X","authenticated-orcid":false,"given":"Aseel","family":"Smerat","sequence":"additional","affiliation":[{"name":"Hourani Center for Applied Scientific Research Al\u2010Ahliyya Amman University  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,20]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2025.1526482","article-title":"Global, Regional, and National Burden of Chronic Kidney Disease, 1990\u20132021: A Systematic Analysis for the Global Burden of Disease Study 2021","volume":"16","author":"Xie K.","year":"2025","journal-title":"Frontiers in Endocrinology"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2304820"},{"issue":"1","key":"e_1_2_14_4_1","doi-asserted-by":"crossref","DOI":"10.3390\/medicina60010144","article-title":"Cardiovascular Events and Mortality in Patients on Hemodialysis: The Prognostic Value of the CHA(2)DS(2)\u2010VASc Score","volume":"60","author":"Tourountzis T.","year":"2024","journal-title":"Medicina (Kaunas, Lithuania)"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.15040920"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000005124"},{"issue":"6","key":"e_1_2_14_7_1","first-page":"611","article-title":"Renal Assist Device Therapy for Acute Renal Failure","volume":"30","author":"Dirkes S. 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