{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:24:03Z","timestamp":1789147443125,"version":"build-2803163510"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","funder":[{"name":"Beijing Anzhen Hospital High Level Research Funding","award":["2025AZD2002"],"award-info":[{"award-number":["2025AZD2002"]}]},{"name":"Beijing Municipal Hospital Scientific Research Cultivation Plan","award":["PX2022024"],"award-info":[{"award-number":["PX2022024"]}]},{"name":"Beijing Hospital Management Center's Youth Talent Training \u201cYoung Seedlings\u201d Program","award":["QML20230601"],"award-info":[{"award-number":["QML20230601"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2026,3]]},"abstract":"\n Key Points<\/jats:title>\n \n \n \n Endothelin receptor antagonists should be applied for patients with CKD whose proteinuria and high risk of kidney function decline remains insufficiently controlled.<\/jats:p>\n <\/jats:list-item>\n \n 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.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Endothelin 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.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Fourteen 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=\u22120.56, 95% CI [\u22120.78 to \u22120.35]) and urine albumin-to-creatinine ratio (SMD=\u22120.64, 95% CI [\u22120.75 to \u22120.53]), 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=\u22120.53, 95% CI [\u22120.76 to \u22120.30]) and diastolic BP (SMD=\u22120.78, 95% CI [\u22121.18 to \u22120.38]). 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]).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n These findings suggest that ERAs may reduce proteinuria, prevent kidney disease progression, and lower BP in individuals with CKD.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.0000000928","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T17:00:20Z","timestamp":1768237220000},"page":"401-413","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Meta-Analysis of Randomized Controlled Trials Assessing the Efficacy and Safety of Endothelin Receptor Antagonists in CKD"],"prefix":"10.2215","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4156-8470","authenticated-orcid":false,"given":"Yunqi","family":"Shi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9339-9361","authenticated-orcid":false,"given":"Nan","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7288-6830","authenticated-orcid":false,"given":"Guoqin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7908-3333","authenticated-orcid":false,"given":"Hong","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"issue":"10225","key":"B1-20260416","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","article-title":"Global, 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