Table 3.

Emerging therapies targeting endothelial-podocyte crosstalk in diabetic nephropathy

Therapy Class	Example Agent	Mechanism	Trial Phase	Efficacy (vs. Placebo)
Endothelin blockers	Atrasentan	Inhibits ET-1-induced podocyte apoptosis	Phase III	UACR↓ 38.5% (P = 0.002)
SGLT2 inhibitors	Empagliflozin	Restores endothelial NO bioavailability	Phase IV	eGFR slope +1.2 mL/min/yr (P < 0.01)
Nrf2 activators	Bardoxolone methyl	Reduces oxidative stress in endothelial cells and podocytes	Phase II	eGFR↑ 5.1 mL/min (P = 0.03)