DCCBs linked to 33% higher kidney risk in type 2 diabetes
Get the Health newsletter
Daily health & science — research, biotech, public health, the studies worth knowing. Free.
- Dihydropyridine calcium-channel blockers (DCCBs) were associated with a 33% greater risk of major adverse kidney events (95% CI 1.03–1.73) in type 2 diabetes patients already on RAS and SGLT2 inhibitors, per findings from the 63rd ERA Congress.
- The observational study tracked 31,031 adults with type 2 diabetes between 2016 and 2021, with a median follow-up of approximately 3.5 years; 12,172 patients (39.2%) were taking DCCBs alongside their other antihypertensives.
- Dr. Timna Agur, lead author, said researchers "initially thought the kidney-protective effects of SGLT2 inhibitors might counterbalance the potential harms associated with DCCBs" — but the elevated kidney-disease-progression risk persisted regardless.
- Major adverse kidney events were defined as a 40% or greater decline in estimated glomerular filtration rate (eGFR) or progression to end-stage kidney disease requiring dialysis or transplantation.
- Researchers hypothesize the association stems from how DCCBs preferentially relax afferent blood vessels entering the kidney's filtering units, potentially raising pressure inside those structures and worsening damage already driven by hyperfiltration in diabetic kidney disease.
- Because the design was observational, researchers emphasized the findings cannot prove causation and called for prospective studies and randomized controlled trials to confirm the association before treatment guidelines shift.
Why it matters: The 12,172 DCCB users in this study represent a widely used second-line BP strategy for diabetic kidney disease — one of the most common causes of kidney failure worldwide. Because the observational design cannot prove causation, researchers are calling for randomized trials before guidelines change, leaving clinicians in limbo on a drug class prescribed to large numbers of patients with DKD.
Ask SkimNews
