New findings presented at the 63rd ERA Congress suggest that dihydropyridine calcium-channel blockers (DCCBs), commonly prescribed blood pressure drugs, may be linked to worse kidney outcomes in people with type 2 diabetes (T2D). Patients who took DCCBs in addition to standard therapies experienced a significantly greater risk of major adverse kidney events than patients treated with other blood pressure medications.

DKD is among the most common causes of kidney failure worldwide. The condition develops as prolonged high blood sugar damages tiny blood vessels within the kidneys, gradually interfering with their ability to remove waste from the bloodstream. Keeping blood pressure under control is a key part of managing the disease because elevated blood pressure can speed up this damage. Treatment for DKD has changed considerably in recent years with the introduction of two important classes of medication: renin-angiotensin system (RAS) inhibitors, which lower blood pressure while also reducing pressure inside the kidney’s filtering structures, and sodium-glucose cotransporter-2 (SGLT2) inhibitors, initially developed to treat diabetes but now recognized for their ability to protect kidney function and lower the risk of kidney failure. The two drug classes are now part of standard treatment for many people with DKD.

Researchers examined health data from 31,031 adults with T2D between 2016 and 2021. Every participant was receiving both RAS and SGLT2 inhibitors. Of the total group, 12,172 (39.2%) were also taking DCCBs, while 18,859 (60%) were being treated with other antihypertensive medications. The median follow-up period was approximately 3.5 years.

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 (R 1.33, 95%, CI 1.03-1.73). Researchers classified these events as either a major loss of kidney filtration capacity, involving a decline of 40% or more in estimated glomerular filtration rate (eGFR), the standard measure of kidney function, or progression to end-stage kidney disease that required dialysis or transplantation.

“DCCBs are widely used as second-line blood pressure treatments in patients with DKD,” said Dr. Timna Agur, lead author of the study. “Our findings raise important questions about whether these medications are always the best option for patients already receiving modern kidney-protective therapies.”

This is a summary. Read the original at sciencedaily.com.