In summary, ET may be important in the pathogenesis of multiple diseases of the kidney. Alterations in ET-1 production and action may lead to severe vasoconstriction, mesangial cell contraction, glomerular cell proliferation, and enhanced sodium and water retention. It is not surprising, therefore, that intense investigations are under way in an effort to develop specific inhibitors of ET action, including ECE inhibitors and ET receptor blockers. It is likely that with the development of these agents, we will uncover even more diseases in which ET mediates renal dysfunction and in which, hopefully, blockers of ET action will be of therapeutic benefit.