Kidneys are a major organ for blood filtration and waste elimination and thus play a key role in the transport and clearance of nanoparticles in vivo. The interactions of nanoparticles with different kidney compartments can be precisely regulated by modulating their size, shape and surface chemistry. The quantitative understanding of nanoparticle–kidney interactions at the molecular level is important for improving disease targeting, precisely controlling nanoparticle transport and clearance, and minimizing the potential health hazards of nanomedicines. In this Review, we summarize the glomerular filtration of macromolecules and nanoparticles in the kidney and survey kidney imaging techniques for the study of nanoparticle–kidney interactions ex vivo and in vivo. We investigate the different transport mechanisms of nanoparticles in the kidneys and discuss size, charge and shape dependencies in renal clearance. Nanoparticles are then investigated for the preclinical and clinical detection and treatment of diseases such as kidney dysfunction and cancer. Finally, challenges and opportunities for renal-clearable nanoparticles are highlighted.

肾脏是血液过滤和废物消除的主要器官，因此在体内纳米颗粒的运输和清除中起着关键作用。纳米颗粒与不同肾区室的相互作用可以通过调节其大小，形状和表面化学来精确调节。在分子水平上对纳米颗粒-肾脏相互作用的定量理解对于提高疾病靶向性，精确控制纳米颗粒的运输和清除以及最小化纳米药物的潜在健康危害非常重要。在这篇综述中，我们总结了肾脏中大分子和纳米颗粒的肾小球滤过，并调查了肾脏成像技术以研究离体和体内的纳米颗粒与肾脏的相互作用。我们研究了肾脏中纳米颗粒的不同转运机制，并讨论了肾脏清除率的大小，电荷和形状依赖性。然后研究纳米颗粒用于诸如肾功能不全和癌症的疾病的临床前和临床检测和治疗。最后，强调了肾脏可清除纳米颗粒的挑战和机遇。