By Abdullahi Jamaa
A class of widely prescribed blood pressure medicines was associated with a 33% higher risk of kidney problems in people with type 2 diabetes, a new study published by Science Daily has found.
The findings, presented at the 63rd Congress of the European Renal Association, suggest that dihydropyridine calcium-channel blockers (DCCBs) may be associated with worse kidney outcomes even among patients already receiving newer kidney-protective treatments.
Researchers analysed health data from 31,031 adults with type 2 diabetes between 2016 and 2021. All participants were taking both renin-angiotensin system (RAS) inhibitors and sodium-glucose cotransporter-2 (SGLT2) inhibitors, medicines widely used to protect kidney function.
Of those studied, 12,172 patients, or 39.2%, were also taking DCCBs. Another 18,859 patients, about 60%, were receiving other blood pressure medicines. Researchers followed the patients for a median period of about 3.5 years.
After adjusting for differences in patients’ clinical and demographic characteristics, DCCB use was associated with a 33% higher risk of a major adverse kidney event compared with other antihypertensive treatments.
The researchers defined major kidney events as either a decline of at least 40% in estimated glomerular filtration rate (eGFR), a standard measure of kidney function, or progression to end-stage kidney disease requiring dialysis or a transplant.
DCCBs lower blood pressure by relaxing blood vessels and are commonly prescribed as second-line treatment for people with diabetic kidney disease.
The finding is notable because treatment of diabetic kidney disease has changed significantly with the wider use of RAS and SGLT2 inhibitors. Both drug classes can lower blood pressure, while also helping protect kidney function.
“DCCBs are widely used as second-line blood pressure treatments in patients with DKD,” said Dr Timna Agur, the study’s lead author. “Our findings raise important questions about whether these medications are always the best option for patients already receiving modern kidney-protective therapies.”
The study shows an association between DCCB use and kidney outcomes. It does not, based on the information provided, establish that DCCBs directly caused the increased risk.
The findings therefore raise questions about treatment choices for people with type 2 diabetes and kidney disease, particularly those already receiving RAS and SGLT2 inhibitors.
Further research would be needed to determine whether the association reflects a direct effect of the drugs or differences between patients receiving different blood pressure treatments.
