{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:17:26Z","timestamp":1787804246589,"version":"build-2784847793"},"reference-count":44,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This narrative review examines how endothelin receptor antagonists (ERAs) can be used at the intersection of difficult\u2010to\u2010control hypertension, chronic kidney disease (CKD), and albuminuria or proteinuria. For clinicians, the central question is not receptor selectivity alone, but whether a specific agent, indication, dose, background therapy, and monitoring plan can deliver meaningful blood\u2010pressure or kidney benefit without unacceptable fluid retention. Pulmonary arterial hypertension established the pharmacology and major safety liabilities of the class; the current implementation questions for hypertension and kidney specialists arise in systemic hypertension and proteinuric kidney disease. Aprocitentan is the first and only ERA approved for hypertension; in PRECISION, the approved 12.5\u2010mg once\u2010daily dose reduced placebo\u2010corrected 24\u2010h ambulatory systolic blood pressure by 4.2\u00a0mm Hg, with reductions of 4.2 to 5.9\u00a0mm Hg across the studied doses. In IgA nephropathy (IgAN), sparsentan reduces proteinuria and slows estimated glomerular filtration rate (eGFR) decline. Atrasentan has an established antiproteinuric effect and a favorable eGFR slope, although the prespecified week\u2010136 eGFR contrast in the final ALIGN analysis did not reach statistical significance. Zibotentan plus dapagliflozin remains investigational. Across these settings, successful ERA use depends on careful patient selection, indication\u2010specific interpretation of the evidence, optimized diuretic and cardiorenal therapy, and early surveillance for edema, anemia, liver\u2010test abnormalities, and pregnancy risk, with treatment interruption or discontinuation when clinically significant volume expansion or other serious safety signals occur.<\/jats:p>","DOI":"10.1111\/jch.70353","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:40:10Z","timestamp":1787755210000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endothelin Receptor Antagonists in Resistant Hypertension and Proteinuric Kidney Disease: Receptor Strategy and Volume Management"],"prefix":"10.1111","volume":"28","author":[{"given":"Corey Keith","family":"Goldman","sequence":"first","affiliation":[{"name":"NYU Langone Health MedAlliance Medical Health Centers  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse M.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Clinical Professor of Medicine Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/332411a0"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1124\/pr.115.011833"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00060.2009"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2005121256"},{"issue":"10","key":"e_1_2_13_6_1","first-page":"1010","article-title":"Endothelin and endothelin Antagonists in Chronic Kidney Disease","volume":"79","author":"Kohan D. 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