Shedding Light on the Role of Extracellular Vesicles in Renal Fibrosis

Renal fibrosis is the final common pathway of chronic kidney disease (CKD); thus, preventing the fibrotic process is essential to retarding CKD progression. Extracellular vesicles (EVs) are cell-derived membranous particles comprising exosomes and microvesicles. They carry unique biomolecular cargo from donor to recipient cells and are recognized as a novel mechanism for intercellular communication. There is evidence that EV-mediated cellular crosstalk across the glomerular and tubulointerstitial regions potently participates in the pathogenesis of renal fibrosis. Moreover, due to their outstanding stability and delivery capacity in the body, EVs also show tremendous promise in the diagnosis and treatment of kidney diseases, ushering in a new era of precision theranostics. In this Review, we discuss the pathological functions of EVs and highlight the applications of EVs as biomarkers, standalone therapeutics, and novel drug delivery systems for renal fibrosis.