The human body is a highly sophisticated machine that is not fully understood to date. The body function is highly dependent on the versatile functions performed by different organs, which have their diverse arrangement of cells. Every organ (perhaps every body part) is prone to damage and malfunction because of the topological conditions, lifestyle, habitats, and food chemicals. Helping humans to lead an easy, luxurious, and healthy life are the primary goal of any technology, especially extending human life is the ultimate target of medical instrumentation. The importance of developing innovative techniques for disease diagnosis and treatment are burning topics since the start of the medical and pharmaceutical industry. Kidney failure is one of the common health issues worldwide, which is a slow poison affecting 10% of the world population. The importance of replacing the kidney is essential to extend a patient life. This review focuses on Organ-on-Chip technology with a major focus on Kidney-on-Chip (KOC). The evolution of techniques to diagnose and treat organ failure is elaborately presented. Major emphasis solely on the development of kidney failure causes, diagnostic techniques, replacement techniques are reported with a timeline of developments. The major functions of the kidney that have been achieved artificially so far are reviewed to the deepest level. The future directions in this field are predicted and presented. MEMS and microfluidics allow the design and manufacturing of devices at microscale without compromising the actual functionalities, especially in terms of disease diagnosis and treatment. Microfluidics technology revolutionized the development of artificial organ industry, the chances of realizing an organ substantially improved. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.