Impact of hypertension and diabetes on new-onset CKD

  • Wang M & al.
  • J Clin Hypertens (Greenwich)
  • 24 Dec 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Incidence of new-onset hypertension and diabetes increase the risk for new-onset chronic kidney disease (CKD).
  • Simple hypertension and diabetes had no difference on the risk of new-onset CKD.

Why this matters

  • Findings warrant research to investigate the mechanism of the synergetic effect of hypertension and diabetes on new-onset CKD and evaluation of the proper blood pressure and glucose level to prevent the development of kidney diseases.

Study design

  • 21,905 participants with hypertension or diabetes were divided into 5 groups according to baseline and follow-up hypertension and diabetes status:
    • baseline hypertension (BH; n=14,702),
    • BH and incidence of diabetes (BHID; n=3449),
    • baseline diabetes (BD; n=517),
    • BD and incidence of hypertension (BDIH; n=1066) and
    • baseline hypertension and diabetes (BHD; n=2171).
  • Funding: The Natural Science Foundation of China.

Key results

  • During the median follow-up of 7.05±2.59 years, the prevalence of new-onset CKD was 27.1, 43.79, 25.4, 36.6 and 45.1 per 1000 years in the BH, BHID, BD, BDIH and BHD groups, respectively.
  • After adjustment for confounders, compared with BH group, the risk for new-onset CKD was higher in:
    • BHID (HR, 1.50; 95% CI, 1.38-1.63),
    • BDIH (HR, 1.25; 95% CI, 1.07-1.47) and
    • BHD (HR, 1.52; 95% CI, 1.35-1.70) groups (Ptrend<.001>
  • The risk for new-onset CKD did not differ between BH and BD groups (HR, 0.93; 95% CI, 0.73-1.18).
  • In women, BHID (HR, 1.60; 95% CI, 1.30-1.98) and BHD (HR, 1.37; 95% CI, 1.02-1.83) group had a higher risk for new-onset CKD compared with BH group.

Limitations

  • The duration of hypertension or diabetes, and data on medication use were not considered.