The study explained that dihydropyridine calcium channel blockers (DCCBs), common drugs used to lower blood pressure by relaxing blood vessels, may not always be the best option for diabetic nephropathy patients, despite their frequent use as an adjunctive therapy in these cases.
The disease mechanism includes diabetic nephropathy, a leading cause of kidney failure worldwide. Chronic high blood sugar damages the tiny blood vessels within the kidneys, gradually reducing their ability to filter waste products from the blood. Controlling blood pressure is crucial in slowing this deterioration.
In recent years, two drug classes have contributed significantly to improving the treatment of the disease: renin-angiotensin system inhibitors, which reduce pressure within the kidneys, and SGLT2 inhibitors, which have shown additional benefits in protecting kidney function and reducing the risk of kidney failure.
The researchers analyzed data from over 31,000 patients with type 2 diabetes between 2016 and 2021, all of whom were receiving modern kidney-protective therapies, including renin-angiotensin system (RAS) inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors. Of these, approximately 12,000 patients were also taking calcium channel blockers, while the remainder received other blood pressure-lowering medications. The participants were followed for an average of three and a half years.
The results showed that the use of dihydropyridine calcium channel blockers was associated with a 33% increased risk of serious kidney complications compared to non-users. These complications include a significant decrease in the kidneys' ability to filter or the progression to end-stage renal failure requiring dialysis or kidney transplantation.
Researchers suggest that the likely cause of the results is the effect of these drugs on blood flow within the kidneys, as they may lead to changes that increase pressure within the microfiltration units, which may exacerbate existing damage in diabetic patients.
However, the researchers emphasized that the study was observational, meaning it only shows an association and does not prove a direct causal relationship. They stressed the need for further studies and clinical trials to determine the best and safest blood pressure treatment options for this patient group.
The research team said their findings raise important questions about the widespread use of these drugs, especially among diabetic nephropathy patients who are already receiving modern treatments to protect the kidneys, which calls for a reassessment of their role in future treatment plans.
The results were presented at the 63rd Congress of the European Society of Nephrology.
