Chronic kidney disease (CKD), particularly in patients with persistent proteinuria, is associated with a high risk of kidney function decline, yet the effectiveness of endothelin receptor antagonists remains uncertain due to safety concerns such as fluid retention and limited consolidated evidence. To address this gap, a meta-analysis evaluated the efficacy and safety of endothelin receptor antagonists (ERAs), with emphasis on endothelin A–selective agents and potential combination with sodium–glucose cotransporter-2 inhibitors, in 6,412 patients with CKD.
The study found that endothelin receptor antagonists reduced the risk of end-stage kidney disease (relative ratio (RR) 0.76) and significantly lowered proteinuria, with decreases in urine protein-to-creatinine ratio (standardized mean differences (SMDs) −0.56) and albumin-to-creatinine ratio (SMD −0.64), while increasing complete (RR…
