Table 5.

Summaries of landmark trials with endothelin receptor blockers.

Trial	Year	Kidney Outcomes	Findings	Notes
ASCEND [71]	2010	Doubling of serum creatinine, ESKD, death	No significant change in primary outcome composite	Trial ended early due to safety concerns related to volume overload and CHF
SONAR [72]	2019	Doubling of serum creatinine, ESKD	HR 0.65 (CI 95% 0.49–0.88)	Trial included and “enrichment period” to determine who can tolerate endothelin antagonist prior to randomization

ASCEND = A randomized, double-blind, placebo-controlled, parallel group study to assess the effect of the endothelin receptor antagonist avosentan on time to doubling of serum creatinine, end-stage renal disease, or death, in patients with type 2 diabetes mellitus and diabetic nephropathy; CHF = congestive heart failure; CI = confidence interval; ESKD = end-stage kidney disease; HR = hazard ratio; SONAR = Study of Diabetic Nephropathy with Atrasentan.