Efficacy and safety of endothelin receptor antagonists in non-diabetic kidney nephropathy : A systematic review and meta-analysis.

IF 1.9 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Wiener Klinische Wochenschrift Pub Date : 2025-04-22 DOI:10.1007/s00508-025-02528-4

Jiamei Xu, Congyuan Ma, Xuanwei Li, Meng Zhang, Ping Zhu

{"title":"Efficacy and safety of endothelin receptor antagonists in non-diabetic kidney nephropathy : A systematic review and meta-analysis.","authors":"Jiamei Xu, Congyuan Ma, Xuanwei Li, Meng Zhang, Ping Zhu","doi":"10.1007/s00508-025-02528-4","DOIUrl":null,"url":null,"abstract":"Background: 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.Methods: 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.Result: 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).Conclusion: The use of ERAs is more effective than regimens without ERAs in slowing the progression of non-diabetic nephropathy.","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wiener Klinische Wochenschrift","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00508-025-02528-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background: 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.

Methods: 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.

Result: 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).

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

查看原文本刊更多论文

内皮素受体拮抗剂治疗非糖尿病肾病的疗效和安全性：系统回顾和荟萃分析。

背景：最近越来越多的证据证实内皮素受体拮抗剂（ERA）治疗非糖尿病肾病的治疗潜力。然而，这一领域的临床数据仍然有限。因此，我们进行了这项荟萃分析，以调查ERAs治疗非糖尿病肾病的疗效和安全性。方法：通过PubMed、WOS、Embase、Cochrane Library和谷歌scholar进行随机对照研究。收集初始受试者特征和主要结局指标，然后计算风险比（RR）和95%置信区间（CI）。此外，进行亚组分析以调查异质性的来源。结果：本研究纳入7项随机对照试验（RCT）。结果显示，ERAs组患者尿蛋白与肌酐比值（UPCR）的平均降低幅度更大（标准化平均差，MD为-28.08,95% CI为-33.59至-22.57,p ）。结论：ERAs在减缓非糖尿病肾病进展方面比不使用ERAs的方案更有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Wiener Klinische Wochenschrift 医学-医学：内科

CiteScore

4.70

自引率

3.80%

发文量

110

审稿时长

4-8 weeks

期刊介绍： The Wiener klinische Wochenschrift - The Central European Journal of Medicine - is an international scientific medical journal covering the entire spectrum of clinical medicine and related areas such as ethics in medicine, public health and the history of medicine. In addition to original articles, the Journal features editorials and leading articles on newly emerging topics, review articles, case reports and a broad range of special articles. Experimental material will be considered for publication if it is directly relevant to clinical medicine. The number of international contributions has been steadily increasing. Consequently, the international reputation of the journal has grown in the past several years. Founded in 1888, the Wiener klinische Wochenschrift - The Central European Journal of Medicine - is certainly one of the most prestigious medical journals in the world and takes pride in having been the first publisher of landmarks in medicine.