常染色体显性多囊肾病（ADPKD）是导致遗传性肾衰竭的主要病因之一，目前仍缺乏有效的手段来逆转其疾病进展。干细胞疗法因其在组织修复和免疫调节方面的潜力，成为研究的热点领域。本研究系统阐述了造血干细胞（HSCs）通过旁分泌作用、代谢重塑及免疫调控干预ADPKD病理进程的机制，并总结了其在急性肾损伤和慢性肾病中的临床转化证据。此外，文章比较分析了间充质干细胞（MSCs）和诱导多能干细胞（iPSCs）在ADPKD治疗中的独特优势与面临的挑战，为多模态干细胞疗法的开发提供理论支持。

    Autosomal dominant polycystic kidney disease（ADPKD）stands as a leading cause of inherited renal failure，with current therapeutic strategies lacking effective means to reverse disease progression．Stem cell therapy，owing to its potential in tissue repair and immunomodulation，has emerged as a focal point of research．This review systematically elucidates the mechanisms by which hematopoietic stem cells（HSCs）intervene in ADPKD pathology through paracrine effects，metabolic reprogramming，and immune regulation．Furthermore，it summarizes clinical translational evidence of HSCs in both acute kidney injury and chronic kidney disease．This article also comparatively analyzes the unique advantages and challenges of mesenchymal stem cells（MSCs）and induced pluripotent stem cells（iPSCs）in the context of ADPKD treatment，thereby providing theoretical support for the development of multimodal stem cell therapies．

       糖尿病肾病（DKD）是糖尿病首要的微血管并发症，亦是终末期肾病的主要病因，其进行性发展已严重威胁患者生活质量及生存结局。大量蛋白尿是糖尿病肾病的主要临床表现，西医治疗依赖抗炎药、糖皮质激素等，但副作用显著，亟需更安全有效的干预策略。基于《灵枢·阴阳清浊》中的 “清浊相干，命曰乱气”理论，提出DKD蛋白尿的核心病机为浊邪内生、清浊逆乱，从“肺激浊源”致邪气外侵，浊源始生；“脾酿浊邪”致湿邪内蕴，脂浊周流；“肾虚浊陷”致瘀浊损络，封藏失职三个方面阐述DKD的病机，确立“宣肺调水御浊”、“运脾转枢除浊”、“益肾守络绝浊”的治法，凸显中医药调节清浊、保护肾功能的优势，以期为DKD蛋白尿的中西医结合诊疗提供新的思路与方法。

       Diabetic kidney disease（DKD） is a primary microvascular complication of diabetes and a leading cause of end-stage kidney disease．Its progressive development seriously threatens patients’ quality of life and survival outcomes．Massive proteinuria is the main clinical manifestation of DKD．Western medicine treatments rely on anti-inflammatory drugs，glucocorticoids，etc.，but they have significant side effects，highlighting the urgent need for safer and more effective intervention strategies．Based on the theory of “mutual interference of clear and turbid qi” mentioned in Ling Shu：Yin-Yang and Purity-Turbidity，the core pathogenesis of DKD proteinuria is proposed as the internal generation of turbid pathogens and the disordered reversal of clear and turbid．It is elaborated through three aspects：“lung activating turbid sources”，which leads to the external invasion of pathogenic qi and the initial generation of turbid sources；“spleen brewing turbid evil”，which results in internal retention of damp-evil and the circulation of greasy turbid factors；and “kidney deficiency causing turbid stagnation”，which leads to turbidity-induced stasis damaging the collaterals and impairment of storage function．Correspondingly，the treatment principles are established as “disseminate the lung and regulate water to control turbidity”，“transport the spleen to transform and remove turbidity” and “benefit the kidney and protect the collaterals to eliminate turbidity”．This highlights the advantages of traditional Chinese medicine in regulating clear and turbid qi and protecting kidney function，aiming to provide new ideas and methods for the integrated Chinese and Western diagnosis and treatment of DKD proteinuria．

慢性肾脏病是一类具有高发病率、高死亡率的慢性疾病群。临床上一般采用血液透析和肾脏移植治疗终末期的慢性肾脏病。研究表明,小分子药物或核酸类药物在慢性肾脏病治疗中极具潜力,但是缺乏特异性导致肾脏纤维化治疗效果有限,亟需开发新的治疗策略。纳米载体因具有良好的理化性质,被广泛应用于生物医学领域。本文综述了近年来纳米载体递送小分子或核酸类药物在慢性肾脏病中的研究进展。

Chronic kidney disease (CKD) is a series of chronic disease groups associated with high morbidity and mortality. Hemodialysis and kidney transplantation are the only choices for end-stage renal disease. According to the literature report, it is shown that small molecule and nucleic acid drugs have great potential in CKD treatments with an unsatisfied therapeutic efficacy because of the lack of specific targeting. Thus, it is necessary to develop a new strategy. Nanocarriers have been widely used in biomedical fields due to their excellent physical and chemical properties. In this review, we have summarized the recent advances in applying functional nanocarriers to deliver the small molecules and nucleic acid drugs in the treatment of CKD.