Kidney disease affects more than 10% of the global population and is associated with considerable morbidity and mortality, highlighting a need for new therapeutic options. Engineered nanoparticles for the treatment of kidney diseases (renal nanomedicines) represent one such option, enabling the delivery of targeted therapeutics to specific regions of the kidney. Although they are underdeveloped compared with nanomedicines for diseases such as cancer, findings from preclinical studies suggest that renal nanomedicines may hold promise. However, the physiological principles that govern the in vivo transport and interactions of renal nanomedicines differ from those of cancer nanomedicines, and thus a comprehensive understanding of these principles is needed to design nanomedicines that effectively and specifically target the kidney while ensuring biosafety in their future clinical translation. Herein, we summarize the current understanding of factors that influence the glomerular filtration, tubular uptake, tubular secretion and extrusion of nanoparticles, including size and charge dependency, and the role of specific transporters and processes such as endocytosis. We also describe how the transport and uptake of nanoparticles is altered by kidney disease and discuss strategic approaches by which nanoparticles may be harnessed for the detection and treatment of a variety of kidney diseases.

肾脏疾病影响着全球 10% 以上的人口，并且与相当大的发病率和死亡率相关，这凸显了对新治疗选择的需求。用于治疗肾脏疾病的工程纳米颗粒（肾脏纳米药物）代表了一种选择，能够将靶向治疗药物输送到肾脏的特定区域。尽管与治疗癌症等疾病的纳米药物相比，它们还不够成熟，但临床前研究的结果表明，肾脏纳米药物可能有希望。然而，肾脏纳米药物体内转运和相互作用的生理原理与癌症纳米药物不同，因此需要全面了解这些原理，以设计有效、特异性靶向肾脏的纳米药物，同时确保未来临床的生物安全性。翻译。在此，我们总结了目前对影响肾小球滤过、肾小管摄取、肾小管分泌和纳米颗粒挤出的因素的理解，包括尺寸和电荷依赖性，以及特定转运蛋白和过程（如内吞作用）的作用。我们还描述了肾脏疾病如何改变纳米颗粒的运输和摄取，并讨论了利用纳米颗粒检测和治疗各种肾脏疾病的战略方法。