Endothelin Receptor Antagonists (ERA) in Hypertension and ChronicKidney Disease: a Rose with Many Thorns

摘要

The discovery of endothelin created a lot of enthusiasm and paved new therapeutic avenues for the treatmentof arterial hypertension. Endothelin plays a significant role in blood pressure regulation through pronounced vasoconstrictionand modulation of sodium and water reabsorption in the kidneys. Endothelin receptor antagonists have been tested inmany clinical trials in patients with arterial hypertension, heart failure, pulmonary arterial hypertension, systemic sclerosis,chronic kidney disease, and diabetic nephropathy. However, the results were usually disappointing, except in pulmonaryhypertension and scleroderma digital ulcers. The future of ERAs for the treatment of arterial hypertension andchronic kidney disease does not seem bright, and only the combination with other classes of antihypertensive drugs mightoffer a way out.