Applying dendrimer nanoprobes to the diagnosis and evaluation of kidney fibrosis

Renal fibrosis is the central pathological process driving the progression of chronic kidney disease (CKD), representing a major global health burden. Current diagnostics, like biopsy, are invasive and lack the sensitivity for early, repeated monitoring. This creates an urgent need for noninvasive, molecularly specific platforms. While conventional nanoparticles have been explored for imaging, they face critical structural and physiological hurdles, particularly navigating the glomerular filtration barrier (GFB), leading to unpredictable clearance and off-target accumulation. This review highlights the advantageous potential of dendrimers to address these limitations. Their hyperbranched, monodispersed architecture allows for precise size control, enabling predictable renal clearance. The functional multivalent surface of the dendrimer facilitates enhanced targeting avidity toward key myofibroblast markers. We discuss the rational design of dendrimer-based probes for MRI, PET, and near-infrared imaging, synthesizing preclinical evidence of their efficacy. Dendrimer nanotechnology offers a promising path to transform CKD management through early diagnosis and personalized theranostic guidance. [Databases searched: PubMed and Web of Science from 1994 to 2025.].