Endothelin blockade works (eg PRECISION, and PROTECT) but does cause sodium retention. What’s the best way to proactively prevent this? In the RCTs they exclude patients with HF or high BNP, and still see weight gain. Should they be combined with a natriuretic, as @ChristosArgyrop and others have suggested?

In this small 🐀 study, adding a #Flozin to #Zibotentan did just that. Makes a lot of sense. Two good meds being synergistic. Let’s do a human trial now!

https://academic.oup.com/ndt/advance-article/doi/10.1093/ndt/gfad078/7143782?rss=1