Key result
Endothelin receptor blockade attenuates proteinuria and may provide synergistic renoprotection and vasculoprotection when added to ACE inhibitors or ARBs in diabetes and hypertension.
Why the study?
Do endothelin receptor antagonists provide renoprotection and vasculoprotection in patients with diabetes and chronic kidney disease?
Do endothelin receptor antagonists provide renoprotection and vasculoprotection in patients with diabetes and chronic kidney disease?
Endothelin receptor antagonists, particularly ET(A) blockers, show promise for renoprotection and vasculoprotection in diabetes and CKD when added to standard therapy, though adverse effects remain a challenge.
PURPOSE OF REVIEW: There is increasing evidence that endothelin receptor blockade and, in particular, ET(A) receptor blockade not only confers protection against proteinuric renal disease in diabetes but also confers vasculoprotection. RECENT FINDINGS: Recent clinical trials using ET(A) receptor blockade in treating proteinuria and chronic kidney disease as well as atherosclerosis show great promise; however, adverse effects are still problematic. SUMMARY: Endothelin receptor blockade is associated with a significant attenuation of proteinuria and these effects are mediated in part via inhibition of inflammatory and oxidative stress related pathways as well profibrotic pathways. The addition of ET(A) receptor blockade to currently established therapies such as angiotensin-converting enzyme inhibitors or angiotensin receptor blockers may result in additional or synergistic renoprotection and vasculoprotection in hypertension and, in particular, in the context of diabetes.
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Jandeleit‐Dahm et al. (2011) conducted a review in Proteinuric renal disease, chronic kidney disease, atherosclerosis, hypertension. Endothelin receptor blockade was evaluated. Endothelin receptor blockade attenuates proteinuria and may provide synergistic renoprotection and vasculoprotection when added to ACE inhibitors or ARBs in diabetes and hypertension.
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