(s) in medicine, serving as effective diagnostic and therapeutic agents (Lee et al.

2015).

NPs can be made to shield the degradative effects before the drug reaches the

target site and escape the body’s defense system when coated with biocompatible

and biodegradable polymers (Kandav et al. 2019). In drug delivery, the most

significant potential of nanomedicine is its ability to control drug pharmacokinetics

(Duncan and Gaspar 2011). This is a major advantage especially with respect to

kidneys where most therapeutic small molecules exhibit poor pharmacokinetics as

their persistence in the kidneys is for a very small period to provide any therapeutic

effect. It is now possible to amplify the potency, acceptability and localization of

nanomedicines by molding them in terms of kidney retention and binding to key

membranes and cell populations associated with renal diseases (Kamaly et al. 2016).

When administered conventionally, the nanomedicines are targeted to specific

tissues, cells and organs in the body which would prevent the off-target side effects

of the drug (Fig. 13.1). Specific targeting of the drug also reduces the amount of the

dose to be administered as most of the drug is available at the disease site rather than

at healthy organs (Wang et al. 2012). Numerous chemistries, materials and fabrica-

tion methods can be employed to design and produce NPs with optimal functions

and characteristics such as application-specific NP size and shape, prolonged half-

lives in circulation, targeting to specific cell types and multiplexing of functions (i.e.,

theranostics; Lee et al. 2012).

Several researchers all over the globe have reported that immobilization of

enzymes on nanomaterials could considerably improve the enzymatic properties

such as their stability, reusability and most importantly their targeting/localization to

specific cell and tissues (Verma et al. 2020). Over the past few decades, ample

amount of nanomaterials has been examined for their therapeutic potential. Techni-

cal approaches that combine different functionalities bring together liposomes,

dendrimers, polymer-drug conjugates, and other NPs (Fig. 13.2) into the province

of nanotechnology as opposed to conventional pharmacology and have been

formulated. There are prominent varieties of organic and inorganic nanocarriers

that can be employed in the development of nanodrugs for kidney stones

(Table 13.1).

Membrane localized NPs

NPs

Cell population associated

with kidney disease

Nanomedicine advantages:

Off-target side effects of the

Nanomedicine properties:

Prolonged half-life

Application-specific size and

drug

Drug dose

Enzyme stability

shape

Cell-specific targeted delivery

Theranostics i.e multiplexing

Fig. 13.1 Advantages of NP-associated anti-nephrolithiasis drugs

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G. Shruti and K. S. Singh