Research trends and performance of endothelin A receptor antagonist in kidney care: a bibliometric analysis

Background: Endothelin A receptor antagonists (ERAs) have emerged as pivotal therapeutic agents in managing pulmonary hypertension (PH) and various kidney disorders, including chronic kidney disease (CKD) and proteinuric glomerular diseases such as IgA nephropathy (IgAN) and focal segmental glomerulosclerosis (FSGS). Although initially developed for pulmonary applications, recent research has highlighted their renoprotective effects, expanding their role in nephrology. This study presents a comprehensive bibliometric analysis of global research trends, key contributors, and emerging applications of ERAs in kidney care over the past three decades. Methods: A bibliometric analysis was performed using the Science Citation Index Expanded database (1992–2023). Relevant kidney-related publications were identified through specific keyword searches. Author performance was assessed using the Y-index. Results: ERA-related research has shown significant growth, particularly in nephrology. The United States and the University of Groningen lead in publication volume and international collaborations, with H.J.L. Heerspink emerging as a key contributor. While PH remains the dominant research focus, nephrology applications are rapidly increasing, particularly in CKD, diabetic nephropathy (DN), and glomerular diseases. A major milestone was the accelerated FDA approval of sparsentan for IgAN in 2023, followed by full approval in 2024 based on confirmatory efficacy data. However, challenges such as fluid retention and cardiovascular risks remain, necessitating further investigation into optimized ERA therapies, including combination strategies with SGLT2 inhibitors. Conclusions: The expanding role of ERAs in nephrology underscores their potential in treating proteinuric kidney diseases. Ongoing international collaborations are advancing research on ERA safety, efficacy, and novel therapeutic strategies, supporting their broader clinical application.