Nanomedicine for Acute Kidney Injury: Precision Delivery Strategies, Therapeutic Breakthroughs, Challenges, and Future Perspectives.

Acute kidney injury (AKI) is a critical condition associated with high mortality rates, currently lacking effective early diagnostic methods and targeted therapeutics. Nanomaterials, due to their unique size effects and modifiability, offer breakthrough strategies for AKI management. This review systematically explores the advancements in the use of nanomaterials for the diagnosis and treatment of AKI: in the diagnostic realm, quantum dot biosensors and ultrasmall contrast agents significantly enhance the sensitivity of early biomarker detection (eg, KIM-1/NGAL); in the therapeutic domain, cerium oxide nanocatalysts (antioxidant), targeted liposomes (anti-inflammatory), and exosome-delivered miRNA (regenerative repair) demonstrate superior renal protection compared to traditional drugs by modulating oxidative stress, inflammation, and apoptosis pathways in animal models. The article emphasizes the design principles of nanomaterials (size <10 nm for renal clearance, cationic surfaces to enhance tubular uptake) and targeting mechanisms. Despite the promising outlook, the clinical translation of nanomaterials faces challenges related to biosafety (long-term retention toxicity) and large-scale production. This review critically evaluates key studies from recent years, providing a theoretical basis and technical roadmap for the development of next-generation nanomedicine platforms for AKI.