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Endothelin receptor antagonists in kidney protection for diabetic kidney disease and beyond?

Edmund Y M Chung1, Sunil V Badve2,3, Hiddo J L Heerspink2,4

  • 1Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.

Nephrology (Carlton, Vic.)
|November 9, 2022
PubMed

Insights

Endothelin receptor antagonists show promise for protecting kidneys and reducing proteinuria in chronic kidney disease. Further research is needed to establish their role alongside existing treatments for diabetic and non-diabetic kidney disease.

Area of Science:

  • Nephrology
  • Pharmacology
  • Cardiovascular Medicine

Background:

  • Chronic kidney disease (CKD) burden is rising globally, driven by diabetes and hypertension.
  • Current treatments like renin angiotensin system inhibitors and SGLT2 inhibitors offer partial protection against CKD progression.
  • Novel therapeutic strategies are essential to prevent kidney failure.

Purpose of the Study:

  • To review the biological mechanisms of endothelin receptor antagonists (ERAs) in kidney protection.
  • To evaluate the efficacy and safety of ERAs in randomized controlled trials for kidney outcomes.
  • To explore the potential future applications of ERAs in both diabetic and non-diabetic kidney disease.

Main Methods:

  • Literature review of randomized controlled trials (RCTs) on ERAs.
  • Analysis of studies investigating ERA mechanisms in kidney disease pathophysiology.
  • Synthesis of data on proteinuria reduction and kidney outcomes associated with ERA use.

Main Results:

  • ERAs demonstrate beneficial effects on pathophysiological processes in progressive kidney disease.
  • Proteinuria reduction by ERAs is a key indicator of potential kidney protection.
  • Evidence from RCTs suggests a role for ERAs in managing kidney disease, with a focus on safety and efficacy.

Conclusions:

  • Endothelin receptor antagonism presents a potential therapeutic option for CKD.
  • ERAs may offer additional benefits beyond current standard-of-care treatments.
  • Further investigation into ERA use in diabetic and non-diabetic kidney disease is warranted.

Keywords:
chronic kidney diseaseendothelinfluid retentionkidney failureproteinuria

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