Impact of hypertension and diabetes on new-onset CKD

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 (P_trend<.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.