Drug-delivery systems for local drug delivery to kidneys and associated systems and methods are disclosed herein. One aspect of the present technology is directed to drug-delivery systems that include a physiological sensor, an implantable medical device, and a control module configured to communicate with the physiological sensor and to control delivery of a drug in response to a physiological parameter measured by the physiological sensor. The implantable medical device can be configured to be surgically implanted in a patient with a delivery opening at or near a renal capsule of a kidney of the patient. Suitable drugs for local delivery to a kidney can include diuretics, aldosterone antagonists, vasodilators, renin inhibitors, and combinations thereof. In some embodiments, local drug delivery to a kidney can be used to treat hypertension, heart failure, or another condition associated with renal activity.
