Selective endothelin A receptor antagonism in patients with proteinuric chronic kidney disease

Area of Science:

• Nephrology
• Pharmacology
• Clinical Trials

Background:

• Selective endothelin-1 receptor antagonists (ERA) have been investigated for chronic kidney disease (CKD).
• The SONAR trial was a pivotal phase 3 study evaluating the long-term impact of ERA on CKD progression.

Purpose of the Study:

• To examine the effects of ERA in patients with proteinuric CKD.
• To discuss findings from major clinical studies on ERA in CKD and provide expert opinion on the SONAR trial.
• To explore future perspectives for ERA in CKD management.

Main Methods:

• Systematic literature search of PubMed and ISI Web of Science databases.
• Inclusion of experimental and clinical studies evaluating ERA in proteinuric CKD.
• Analysis and discussion of results from key clinical trials, including the SONAR study.

Main Results:

• The SONAR study demonstrated that ERA provides protection against the risk of CKD progression.
• ERA has stimulated further clinical research, expanding therapeutic avenues for CKD patients.
• Two new phase 3 studies are underway to test ERA in patients with glomerular diseases.

Conclusions:

• ERA confers protection against CKD progression, as evidenced by the SONAR trial.
• Further research, including trials with novel designs, is needed to identify patient subgroups who benefit most from ERA.
• Personalized medicine approaches evaluating combination therapies, including ERA, are relevant for proteinuric CKD.