New research shown at the 63rd ERA Congress says a popular group of blood‑pressure medicines might hurt the kidneys of people with type‑2 diabetes. These medicines are called dihydropyridine calcium‑channel blockers, or DCCBs.
DCCBs lower blood pressure by relaxing the walls of blood vessels. Doctors often add them when other treatments are not enough for diabetic kidney disease (DKD).
Why Kidneys Matter in Diabetes
High blood sugar can damage tiny blood vessels in the kidneys. Over time the kidneys cannot clean the blood well. High blood pressure makes this damage happen faster.
Two newer drug families have helped a lot. Renin‑angiotensin system (RAS) blockers lower pressure and protect the tiny filters inside the kidney. Sodium‑glucose cotransporter‑2 (SGLT2) inhibitors were first made for diabetes, but they also guard the kidneys and cut the chance of kidney failure.
What the Study Looked At
Researchers examined health records of 31,031 adults with type‑2 diabetes from 2016‑2021. Every person was already using both a RAS blocker and an SGLT2 inhibitor.
Of them, 12,172 (about 39%) also took a DCCB, while 18,859 (about 60%) used other blood‑pressure drugs. They were followed for an average of 3.5 years.
After adjusting for age, other illnesses, and lab results, the team found that DCCB users had a 33% higher chance of a major kidney event compared with the other‑drug group.
What Counts as a Major Kidney Event?
A major event means either a drop of 40% or more in the estimated glomerular filtration rate (eGFR), which measures kidney function, or progression to end‑stage kidney disease needing dialysis or a transplant.
How DCCBs Might Harm the Kidneys
The scientists think DCCBs may change blood flow in the kidneys. In DKD, the kidneys already face high pressure and “hyperfiltration,” where the filters are over‑worked.
DCCBs may relax the blood vessels that bring blood into the filters more than those that take blood away. This could raise pressure inside the filters and keep the damage going.
What Comes Next?
The study was observational, so it cannot prove that DCCBs directly cause the damage. Still, because these drugs are used a lot, the link deserves attention.
Researchers say more prospective studies and randomized trials are needed to confirm the finding and to figure out the safest blood‑pressure plan for people with DKD.