Advances and perspectives of functional nanomaterials in scavenging reactive oxygen species for acute kidney injury.

Abstract

Acute kidney injury (AKI) is characterized by a rapid decline in renal function with diverse etiologies, leading to high morbidity and mortality. Its pathophysiology involves the interwoven processes of oxidative stress, inflammation, ferroptosis, and mitochondrial dysfunction. Conventional treatments have issues such as low bioavailability, inadequate renal targeting, and systemic toxicity, leaving clinical needs unmet. Nanotechnology addresses these bottlenecks via rational engineering and surface modification, endowing nanomaterials with enhanced stability, precise targeting, and multifunctional therapeutic potential. Herein, we systematically review reactive oxygen species (ROS)-scavenging nanomaterials for AKI therapy, categorized into inorganic, organic, organic-inorganic hybrid, and biological nanomaterials. The article focuses on the subtype-specific design, targeting strategies, and multi-functional integration principles for different AKI pathological mechanisms, and explores the oxidative stress-mediated toxicity mechanisms of nanomaterials as well as relief strategies based on degradable and surface-modified approaches. Finally, we highlight critical translational challenges and propose pathology-responsive and preclinical evaluation-oriented solutions. This review provides a mechanism-integrated, translation-oriented perspective on ROS-scavenging nanomaterials for AKI therapy, guiding the development of precise, safe, and clinically viable next-generation nanotherapeutics.