Stimuli-responsive nanosystems for precision renal intervention: Microenvironment-responsive strategies in acute kidney injury theranostics

Acute kidney injury (AKI) is defined as a condition of rapid loss of renal function. Now, the standard diagnosis of AKI must be based on the change of serum creatinine(sCr) level and urine volume in a fixed period. There lacks efficient therapy for this disease due to enormous researches without effective ways. For more accurately and timely diagnosis of AKI and ultimately better patient outcomes, different stimulus responsive nanomaterials have been devised and investigated for diagnostic applications and drug delivery to effect targeted early intervention. Herein, we have outlined the common pathophysiological mechanisms among different subtypes of AKI and explained recent progress and trends in responsive nanomaterials aimed at targeting the common mechanisms of pathogenesis. These nanomaterials are triggered in different mechanisms and when combined with imaging techniques they represent very promising tools for earlier diagnosis and efficient therapy. We also describe some outstanding challenges currently faced by the field as well as promising paths to move forward. Overall, this review showcases the ability of responsive nanomaterials as minimally invasive, accurate, and timely diagnosing and treating method for the existing situation in diagnosing and treating AKI.