Nanomaterial-Based Precision Drug Delivery for Advanced Nephrology Therapy: A Systematic Review.

Kidney disease represents a serious global health challenge. Current therapeutic strategies often lack the precision to deliver drugs specifically to the kidneys, potentially leading to systemic side effects. Nanomaterials offer a promising alternative, as their size and surface properties can be engineered to facilitate renal accumulation and retention. This systematic review summarizes recent advances in four primary nanomaterial platforms for nephrology therapy, namely lipid nanoparticles, polymeric nanoparticles, inorganic nanoparticles, and exosome delivery system. It focuses on how these rationally designed nanomaterials overcome inherent physiological barriers of the kidney (eg, the glomerular filtration barrier) and how their surface modification with targeting ligands enables response to pathological microenvironments to achieve controlled drug release. Furthermore, the theranostic potential of nanomaterials in kidney disease diagnosis, such as in advanced imaging and disease monitoring, is also discussed. Finally, this review identifies key challenges to the clinical translation of renal nanomedicines, including biosafety, limitations of murine models, insufficient long-term safety, suboptimal targeting accuracy, and scalable manufacturing hurdles, and suggests potential strategies to facilitate their bench-to-bedside translation and improve kidney disease management. In conclusion, this review provides a comprehensive overview of nanomaterial applications in nephrology, clarifying their potential and challenges to lay a foundation for promoting clinical translation and improving kidney disease care.