Efficacy and safety of endothelin receptor antagonists in non-diabetic kidney nephropathy

Recent evidence increasingly confirms the therapeutic potential of endothelin receptor antagonists (ERA) in treating non-diabetic kidney nephropathy. However, clinical data in this area remain limited. Therefore, we conducted this meta-analysis to investigate the efficacy and safety of ERAs in the treatment of non-diabetic kidney nephropathy.

Randomized controlled trials were identified through PubMed, WOS, Embase, Cochrane Library and Google scholar. The initial participant characteristics and primary outcome measures were gathered, followed by the calculation of risk ratios (RR) and 95% confidence intervals (CI). Additionally, subgroup analyses were conducted to investigate the sources of heterogeneity.

In this study, seven randomized, controlled trials (RCT) were included. The results indicated that patients in the ERAs group exhibited a greater mean reduction in the urinary protein to creatinine ratio (UPCR) (standardized mean difference, MD −28.08, 95% CI −33.59 to −22.57, p < 0.001). The number of patients experiencing either complete or partial remission from proteinuria notably increased when treated with ERAs (complete remission: odds ratio, OR = 3.14, 95% CI 2.23–4.42, p < 0.001; partial remission: OR = 3.03, 95% CI 2.33–3.96, p < 0.001). Furthermore, ERAs delayed the decline in the estimated glomerular filtration rate (eGFR, MD = 3.81, 95% CI 1.71–5.90, p < 0.001). However, the incidence of edema events slightly increased in the ERA group (OR = 1.42, 95% CI 1.04–1.93, p = 0.03).

The use of ERAs is more effective than regimens without ERAs in slowing the progression of non-diabetic nephropathy.