Extracellular vesicles, such as exosomes and microvesicles, are host cell-derived packages of information that allow cell–cell communication and enable cells to rid themselves of unwanted substances. The release and uptake of extracellular vesicles has important physiological functions and may also contribute to the development and propagation of inflammatory, vascular, malignant, infectious and neurodegenerative diseases. This Review describes the different types of extracellular vesicles, how they are detected and the mechanisms by which they communicate with cells and transfer information. We also describe their physiological functions in cellular interactions, such as in thrombosis, immune modulation, cell proliferation, tissue regeneration and matrix modulation, with an emphasis on renal processes. We discuss how the detection of extracellular vesicles could be utilized as biomarkers of renal disease and how they might contribute to disease processes in the kidney, such as in acute kidney injury, chronic kidney disease, renal transplantation, thrombotic microangiopathies, vasculitides, IgA nephropathy, nephrotic syndrome, urinary tract infection, cystic kidney disease and tubulopathies. Finally, we consider how the release or uptake of extracellular vesicles can be blocked, as well as the associated benefits and risks, and how extracellular vesicles might be used to treat renal diseases by delivering therapeutics to specific cells.

细胞外的囊泡，例如外泌体和微囊泡，是宿主细胞衍生的信息包，它允许细胞间的通信并允许细胞摆脱不需要的物质。细胞外囊泡的释放和摄取具有重要的生理功能，并且还可能有助于炎性，血管性，恶性，传染性和神经退行性疾病的发展和传播。这篇综述描述了细胞外囊泡的不同类型，如何检测它们以及它们与细胞通讯并传递信息的机制。我们还描述了它们在细胞相互作用中的生理功能，例如血栓形成，免疫调节，细胞增殖，组织再生和基质调节，重点是肾脏过程。我们讨论了如何将细胞外囊泡的检测用作肾脏疾病的生物标志物，以及它们如何对肾脏的疾病进程做出贡献，例如在急性肾脏损伤，慢性肾脏疾病，肾脏移植，血栓性微血管病，血管炎，IgA肾病，肾病综合征，尿路感染，肾囊性疾病和肾小管病变。最后，我们考虑如何阻止细胞外囊泡的释放或摄取，以及相关的益处和风险，以及如何通过将治疗剂递送至特定细胞来利用细胞外囊泡治疗肾脏疾病。血栓性微血管病，血管炎，IgA肾病，肾病综合征，尿路感染，囊性肾病和肾小管病。最后，我们考虑如何阻止细胞外囊泡的释放或摄取，以及相关的益处和风险，以及如何通过将治疗剂递送至特定细胞来利用细胞外囊泡治疗肾脏疾病。血栓性微血管病，血管炎，IgA肾病，肾病综合征，尿路感染，囊性肾病和肾小管病。最后，我们考虑如何阻止细胞外囊泡的释放或摄取，以及相关的益处和风险，以及如何通过将治疗剂递送至特定细胞来利用细胞外囊泡治疗肾脏疾病。