Nephrotoxicity, a chronic renal disease that results from the accumulation of endogenous and exogenous toxins in the kidney, disturbs the excretion and detoxification function of the kidney. Metal-mediated nephrotoxicity is induced by toxic metals/metalloids such as mercury, lead, arsenic, chromate, uranium, and cadmium. These materials become concentrated in the kidneys and injure the nephrons. Developing strategies to detect these metal ions will enable the earlier identification of kidney damage. An aptamer, an artificial antibody generated against a wide range of targets including metal ions, may be the right tool for the detection of metal ions associated with renal injury. The use of a detection system consisting of an aptamer and metallic nanoparticles is a potential way to overcome nephrotoxicity. Here, we discuss the detection of metal-mediated nephrotoxicity caused by metals/metalloids using the aptamer and nanomaterial-conjugated system. © 2019 Bentham Science Publishers.