SynthesisClinical journal of the American Society of Nephrology : CJASN2026
Meta-Analysis of Randomized Controlled Trials Assessing the Efficacy and Safety of Endothelin Receptor Antagonists in CKD.
Synthesis in Clinical journal of the American Society of Nephrology : CJASN, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- A novel TRPC6 variant (c.131C>T, p.(Pro44Leu)) associated with focal segmental glomerulosclerosis: a case report.Frontiers in genetics · 2026Article
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Authors and funding
4 authors.
Funding
Abstract
key pointsEndothelin receptor antagonists should be applied for patients with CKD whose proteinuria and high risk of kidney function decline remains insufficiently controlled. We recommend that endothelin A receptor-selective endothelin receptor antagonists should be preferable for patients with CKD with consideration for combination therapy with sodium-glucose cotransporter-2 inhibitors.
backgroundEndothelin receptor antagonists (ERAs) are considered a potential effective treatment to reduce proteinuria and protect kidney function for patients with CKD; however, they may cause fluid retention. We conducted this meta-analysis to quantify the efficacy and safety of ERAs in CKD.
methodsWe searched Cochrane Library, Ovid Medline, and Ovid Embase for randomized controlled trials up to January 2025. Continuous and dichotomous data were reported as standardized mean differences (SMDs) with 95% confidence intervals (CIs) and risk ratios (RRs) with 95% CIs, respectively.
resultsFourteen trials enrolling 6412 patients were included. Compared with the control group, ERAs decreased the risk of ESKD (RR=0.76, 95% CI [0.61 to 0.96]), reduced the urine protein-to-creatinine ratio (SMD=-0.56, 95% CI [-0.78 to -0.35]) and urine albumin-to-creatinine ratio (SMD=-0.64, 95% CI [-0.75 to -0.53]), achieved more frequent complete proteinuria remission (RR=2.61, 95% CI [1.84 to 3.71]) and partial proteinuria remission (RR=1.51, 95% CI [1.32 to 1.73]), slowed the decline of eGFR in the subgroup with a follow-up duration of at least 1 year (SMD=0.18, 95% CI [0.04 to 0.32]), improved the chronic eGFR slope (SMD=0.15, 95% CI [0.01 to 0.30]), and decreased systolic BP (SMD=-0.53, 95% CI [-0.76 to -0.30]) and diastolic BP (SMD=-0.78, 95% CI [-1.18 to -0.38]). Although the risk was increased in B-type natriuretic peptide (SMD=0.08, 95% CI [0.01 to 0.16]) and body weight (SMD=0.15, 95% CI [0.01 to 0.29]), ERAs did not increase the incidence of edema, fluid retention, or heart failure. The risk of hypotension was higher with ERAs compared with the control group (RR=1.92, 95% CI [1.36 to 2.70]).
conclusionThese findings suggest that ERAs may reduce proteinuria, prevent kidney disease progression, and lower BP in individuals with CKD.
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