Endothelin receptor antagonists for the treatment of diabetic and nondiabetic chronic kidney disease.
Journal
Current opinion in nephrology and hypertension
ISSN: 1473-6543
Titre abrégé: Curr Opin Nephrol Hypertens
Pays: England
ID NLM: 9303753
Informations de publication
Date de publication:
01 07 2021
01 07 2021
Historique:
pubmed:
16
5
2021
medline:
26
11
2021
entrez:
15
5
2021
Statut:
ppublish
Résumé
To summarize new clinical findings of endothelin receptor antagonists (ERA) in various etiologies of kidney disease targeted in clinical trials. Endothelin-1 is a multifunctional peptide with potential relevance to glomerular and tubulointerstitial kidney diseases. The phase 3 SONAR trial demonstrated a significant reduction in clinically relevant kidney outcomes for patients with diabetic kidney disease (DKD) after long-term treatment with the ERA, atrasentan, in addition to blockade of the renin-angiotensin-aldosterone system. Promising preclinical disease models and small clinical trials in non-DKD resulted in the initiation of phase 3 trials investigating the effects of long-term treatment with ERA in patients with immunoglobulin A (IgA) nephropathy and focal segmental glomeruloscelerosis (FSGS). The mechanisms by which ERA protects the kidneys have been extensively studied with evidence for the protection of tubule cells, podocytes, mesangial cells, the endothelial glycocalyx, and a reduction in glomerular perfusion pressure. The occurrence of fluid retention during ERA treatment, particularly in susceptible populations, necessitates strategies to support safe and effective treatment. Treatment with ERA induces long-term kidney protection in DKD. Phase 3 trials are underway to investigate ERA effects in patients with IgA nephropathy and FSGS.
Identifiants
pubmed: 33990507
doi: 10.1097/MNH.0000000000000716
pii: 00041552-202107000-00013
doi:
Substances chimiques
Endothelin Receptor Antagonists
0
Atrasentan
V6D7VK2215
Banques de données
ClinicalTrials.gov
['NCT04724837']
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
456-465Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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