Common Blood Pressure Medication May Exacerbate Kidney Damage in Type 2 Diabetes Patients

A recent study presented at the 63rd ERA Congress has revealed a concerning link between a commonly prescribed group of blood pressure medications and a higher risk of serious kidney damage in people with type 2 diabetes.

The medications in question, known as dihydropyridine calcium-channel blockers (DCCBs), lower blood pressure by relaxing blood vessels. They are often prescribed as second-line treatments for people with diabetic kidney disease (DKD), but the study suggests that they may actually worsen kidney outcomes in patients already taking newer medications designed to protect kidney function.

DKD is one of the most common causes of kidney failure worldwide, and managing blood pressure is a crucial part of treating the condition. Prolonged high blood sugar damages tiny blood vessels within the kidneys, gradually interfering with their ability to remove waste from the bloodstream. Elevated blood pressure can speed up this damage, making it even more challenging for patients to manage their condition.

The study examined health data from 31,031 adults with type 2 diabetes between 2016 and 2021. Every participant was receiving both renin-angiotensin system (RAS) inhibitors and sodium-glucose cotransporter-2 (SGLT2) inhibitors, which are now part of standard treatment for many people with DKD. Of the total group, 12,172 (39.2%) were also taking DCCBs, while 18,859 (60%) were being treated with other antihypertensive medications.

After accounting for differences in patients’ initial clinical and demographic characteristics, the researchers found that DCCB use was associated with a 33% greater risk of a major adverse kidney event. These events were classified as either a major loss of kidney filtration capacity, involving a decline of 40% or more in estimated glomerular filtration rate (eGFR), or progression to end-stage kidney disease that required dialysis or transplantation.