Puerarin, a natural isoflavone derived from the roots of kudzu vine, has shown promising protective effects against kidney diseases. It exerts antioxidative, anti-inflammatory, antifibrotic, and antiapoptotic effects that collectively reduce renal injury and slow disease progression. Despite these pharmacological benefits, the therapeutic potential of puerarin is limited by extremely poor solubility, low oral bioavailability, and rapid metabolism. Advances in nanodelivery have provided innovative strategies to address these barriers, including nanoparticles, hydrogels, liposomes, micelles, and dendrimers. Although the applications of puerarin nanodelivery in kidney diseases remain limited, evidence from other pathological models provides valuable guidance for designing kidney-specific approaches. In this review, existing studies on the therapeutic effects of puerarin in renal disorders are integrated with recent progress in puerarin nanodelivery technologies, and the prospects of puerarin-based nanodelivery systems for kidney diseases are discussed.