Engineering Kidney-Targeted Drug Delivery Systems: Principles, Materials, and Emerging Strategies.

Area of Science:

• Biomedical Engineering
• Nanotechnology
• Pharmacology

Background:

• Kidney diseases require targeted drug delivery to minimize systemic toxicity.
• Renal physiological barriers necessitate advanced nanomedicine strategies.
• Current delivery systems face challenges in specificity and controlled release.

Purpose of the Study:

• To review and analyze integrated strategies for kidney-targeted drug delivery.
• To explore fundamental mechanisms of renal targeting (passive, active, combined).
• To deconstruct nanomedicine delivery systems into core components (carriers, functional moieties, cargo).

Main Methods:

• Comprehensive narrative review of existing literature.
• Analysis of carrier platforms: polymeric nanoparticles, liposomes, exosomes.
• Evaluation of functional moieties: peptides, antibodies, biomimetic coatings.
• Discussion of microenvironmental triggers for drug release: pH, ROS, enzymes.

Main Results:

• Functionalized nanoparticles, liposomes, and exosomes demonstrate enhanced renal specificity.
• Biomimetic coatings and specific ligands improve targeting efficiency.
• Microenvironmental triggers enable precise, localized drug release.
• Challenges include hepatic sequestration, biocompatibility, and patient heterogeneity.

Conclusions:

• A rational design framework for intelligent kidney-targeted therapeutics is proposed.
• Multimodal targeting, real-time feedback, and scalable manufacturing are crucial for future advances.
• Optimized nanomedicines hold promise for improved renal disease treatment.