Abstract
Advances in kidney organoid technologies have expanded opportunities to model human renal development, disease, and therapeutic response. Yet pluripotent stem cell-derived organoids remain limited by cellular heterogeneity, incomplete tubular maturation and low scalability, restricting their translational relevance. Tubular-specific organoids, derived from adult kidney epithelium, address many of these constraints by providing stable, reproducible cultures enriched for functional proximal and distal tubular cells. Their polarized transport, metabolic activity and patient-specific phenotypes enable high-fidelity modeling of acute and chronic tubular disorders, nephrotoxicity, and inherited tubulopathies-areas where conventional animal and cell-line models often fall short. In this Perspective, we outline recent advances that position tubuloids as a versatile platform for drug screening, toxicity testing and personalized disease modeling. We highlight emerging integration with microfluidics, biomaterials, and gene-editing strategies that promise greater physiological realism and precision therapeutics. We also discuss persistent barriers that impede broader adoption and clinical translation. We propose a roadmap for advancing tubuloid technologies toward precision nephrology and their future incorporation into diagnostic, pharmacological and regenerative pipelines.