Wearable biosensor can detect impaired kidney drug clearanceDownload PDF Research HighlightPublished: 01 May 2026BiotechnologyMonica Wang1 Nature Reviews Nephrology (2026)Cite this articleSubjectsBiotechnologyChronic kidney diseaseDrug therapyYou have full access to this article via your institution.Download PDF Minimally invasive microneedle-based systems show promise as tools for real-time monitoring of kidney health. Now, Sam Emaminejad and colleagues report on a new microneedle biosensor capable of providing real-time assessment of liver and kidney drug clearance in a rat model.“Continuous glucose monitoring has transformed diabetes care, but this capability cannot be easily extended to other molecules owing to physical and electrochemical challenges at the tissue–sensor interface,” remarks Emaminejad. “These obstacles led us to rethink the microneedle electrode itself, not simply as a passive sensing substrate, but as a structure that could both protect the sensing interface and enhance signal quality.” The team developed a biocompatible microneedle-based resilient nanostructured bioelectrode (RNB) that was stable in rats over 6 days.The alternative text for this image may have been generated using AI.Credit: BlackJack3D/E+/Getty“We paired our nanocavity-textured microneedle electrode with a bioanalytical framework that translates interstitial fluid measurements into blood-equivalent pharmacokinetic parameters,” explains Emaminejad. The potential of this RNB for therapeutic drug monitoring in vivo was confirmed by the concordance between the RNB data and blood levels of the liver-metabolized chemotherapy drug irinotecan in healthy rats; the biosensor data also showed prolonged drug half-life in rats with liver damage. As for kidney drug clearance, the RNB data from vancomycin-treated healthy rats correlated strongly with the dose-dependent changes in drug levels measured in blood. In rats with adenine-induced kidney injury, the biosensor data not only showed lower drug clearance concordant with a reduction in glomerular filtration rate but, when animals were allowed to recover for 2 weeks from the high-adenine diet, it also reflected improvements in kidney function. Of note, early in the disease induction phase, RNB-detectable decreases in drug clearance preceded the increase in blood creatinine levels.“This continuous, longitudinal monitoring of low-concentration therapeutic drugs in vivo not only enabled precision dosing, but also direct inference of kidney and liver function by quantifying drug clearance,” adds Emaminejad. “Our findings show that measurements made just 1 mm beneath the skin can provide clinically actionable insight into the function of organs deep within the body. We plan to expand the range of detectable biomarkers and translate this technology to human studies with the goal of contextualizing drug and biomarker measurements to guide clinical interventions.”ReferencesOriginal articleZhu, J. et al. Resilient nanostructured bioanalytic microneedle longitudinally monitors preclinical renal and hepatic drug clearance and dysfunction. Sci. Transl. Med. 18, eadr5493 (2026)Article PubMed Google Scholar Download referencesAuthor informationAuthors and AffiliationsNature Reviews Nephrology http://www.nature.com/nrnephMonica WangAuthorsMonica WangView author publicationsSearch author on:PubMed Google ScholarCorresponding authorCorrespondence to Monica Wang.Rights and permissionsReprints and permissionsAbout this article