Common blood pressure medication may raise kidney damage risk by 33% in type 2 diabetes

A commonly used group of blood pressure medicines called dihydropyridine calcium-channel blockers (DCCBs) may be linked to a higher risk of kidney damage in people with type 2 diabetes, even when they are already receiving kidney-protective treatment. The finding, presented at the European Renal Association’s annual congress, adds new questions to the treatment of diabetic kidney disease (DKD).

Key points

• Dihydropyridine calcium-channel blockers (DCCBs), often prescribed to lower blood pressure, may increase kidney damage risk in people with type 2 diabetes.
• Among patients using DCCBs together with standard kidney-protective therapies, including RAS inhibitors and SGLT2 inhibitors, the risk of major adverse kidney events was 33% higher.
• Researchers believe the drugs may affect kidney blood flow in a way that raises pressure inside the kidneys.
• More research is needed to confirm the results and help guide treatment choices.

Why the finding matters

Diabetic kidney disease is a major complication of type 2 diabetes and can eventually lead to kidney failure. Controlling blood pressure is an important part of slowing its progression. For many years, renin-angiotensin system (RAS) inhibitors and sodium-glucose cotransporter-2 (SGLT2) inhibitors have been central to treatment because they provide meaningful protection for the kidneys.

The new study, which reviewed data from more than 31,000 adults with type 2 diabetes between 2016 and 2021, suggests that adding DCCBs to those standard therapies may reduce some of that benefit. Patients taking DCCBs along with RAS and SGLT2 inhibitors had a 33% higher risk of major adverse kidney events, a category that includes a substantial decline in kidney filtration or progression to end-stage kidney disease requiring dialysis or transplantation.

Possible explanation and next steps

Researchers suspect DCCBs may harm the kidneys by relaxing the blood vessels entering the kidneys more than those leaving them. That imbalance could increase pressure inside the kidney’s filtering structures and worsen existing damage.

The study was observational, so it cannot prove that DCCBs directly cause kidney injury. Still, the results are viewed as important because these drugs are widely used. Lead researcher Dr. Timna Agur said patients should not stop taking prescribed medication without speaking to their doctor first. The researchers called for prospective studies and randomized controlled trials to confirm the findings and determine the safest approach to blood pressure treatment in people with diabetic kidney disease.

Lifestyle habits still matter

Medication is only one part of managing blood pressure and protecting kidney health in people with type 2 diabetes. Other important steps include keeping a healthy weight, lowering sodium intake, exercising regularly, eating potassium-rich foods, limiting alcohol, managing stress, and getting enough sleep. Regular kidney function checks are also important for early detection and treatment.

Sources

• Popular Blood Pressure Meds Linked To Kidney Damage Risk In Type 2 Diabetes, U.S. News & World Report.
• Study Links Popular Blood Pressure Meds to Higher Kidney Damage Risk, HealthDay.
• Common blood pressure medication associated with poorer kidney outcomes in type 2 diabetes, Medical Xpress.
• ALERT: Popular Blood Pressure Drug May Cause Kidney Disease – BlackDoctor, Black Doctor.
• Blood Pressure Drug Linked to Worse Kidney Outcomes in T2D: ERA, EMJ.