In nephrology, differential diagnosis or assessment of disease activity largely relies on the analysis of glomerular filtration rate, urinary sediment, proteinuria and tissue obtained through invasive kidney biopsies. However, currently available non-invasive functional parameters, and most serum and urine biomarkers, cannot capture intrarenal molecular disease processes specifically. Moreover, although histopathological analyses of kidney biopsy samples enable the visualization of pathological morphological and molecular alterations, they only provide information about a small part of the kidney and do not allow longitudinal monitoring. These limitations not only hinder understanding of the dynamics of specific disease processes in the kidney, but also limit the targeting of treatments to active phases of disease and the development of novel targeted therapies. Molecular imaging enables non-invasive and quantitative assessment of physiological or pathological processes by combining imaging technologies with specific molecular probes. Here, we discuss current preclinical and clinical molecular imaging approaches in nephrology. Non-invasive visualization of the kidneys through molecular imaging can be used to detect and longitudinally monitor disease activity and can therefore provide companion diagnostics to guide clinical trials, as well as the safe and effective use of drugs.

在肾脏病学中，疾病活动性的鉴别诊断或评估在很大程度上依赖于通过侵入性肾活检获得的肾小球滤过率、尿沉渣、蛋白尿和组织的分析。然而，目前可用的非侵入性功能参数，以及大多数血清和尿液生物标志物，无法具体捕捉肾内分子疾病过程。此外，虽然肾活检样本的组织病理学分析能够可视化病理形态学和分子改变，但它们仅提供有关肾脏一小部分的信息，并且不允许纵向监测。这些局限性不仅阻碍了对肾脏特定疾病过程动力学的理解，但也将治疗的目标限制在疾病的活动阶段和新型靶向疗法的开发。分子成像通过将成像技术与特定分子探针相结合，能够对生理或病理过程进行非侵入性和定量评估。在这里，我们讨论了肾脏病学中当前的临床前和临床分子成像方法。通过分子成像对肾脏进行非侵入性可视化可用于检测和纵向监测疾病活动，因此可以提供伴随诊断以指导临床试验以及安全有效地使用药物。我们讨论了肾脏病学中当前的临床前和临床分子成像方法。通过分子成像对肾脏进行非侵入性可视化可用于检测和纵向监测疾病活动，因此可以提供伴随诊断以指导临床试验以及安全有效地使用药物。我们讨论了肾脏病学中当前的临床前和临床分子成像方法。通过分子成像对肾脏进行非侵入性可视化可用于检测和纵向监测疾病活动，因此可以提供伴随诊断以指导临床试验以及安全有效地使用药物。