Targeted nanotherapy for kidney diseases: a comprehensive review

Abstract

Kidney diseases represent a major public health problem, affecting millions of people worldwide. Moreover, the treatment of kidney diseases is burdened by the problematic effects of conventional drug delivery, such as systemic drug toxicity, rapid drug clearance, and the absence of precise targeting of the kidney. Although the use of nanotechnology in medicine is in its early stage and lacks robust translational studies, nanomedicines have already shown great promise as novel drug-delivery systems for the treatment of kidney disease. On the basis of our current knowledge of renal anatomy and physiology, pathophysiology of kidney diseases, and physicochemical characteristics of nanoparticles, an expansive repertoire and wide use of nanomedicines could be developed for kidney diseases in the near future. Some limitations have slowed the transition of these agents from preclinical studies to clinical trials, however. In this review, we summarize the current knowledge on renal drug-delivery systems and recent advances in renal cell targeting; we also demonstrate their important potential as future paradigm-shifting therapies for kidney diseases.

Keywords: drug delivery; nanomedicine; nanoparticles; renal drug delivery; target therapy.

Figure 1:

NP clearance and accumulation. In health condition, positively charged NPs with a diameter <5.5 nm freely filter through the glomerular barrier, while negatively charged NPs do not pass the endothelial layer. In the same condition, positively charged NPs with a diameter of 5.5 to 150 nm may accumulate in the negatively charged GBM. When the glomerular barrier is damaged, negatively charged and bigger NPs can either accumulate in glomerular structures or reach the urinary space of the Bowman's capsule. (Created with BioRender.)