Key result
Normal home blood pressure was associated with an improvement in diabetic nephropathy compared to isolated high home systolic blood pressure (OR 2.52; 95% CI 1.01-5.99; p=0.05).
Why the study?
Whether diabetic nephropathy improves among diabetic patients without isolated high home systolic blood pressure had not been previously assessed.
Does normal home blood pressure improve diabetic nephropathy in patients with type 2 diabetes mellitus and moderate or severe albuminuria compared to isolated high home systolic blood pressure?
Cohort (n=264)
Does normal home blood pressure improve diabetic nephropathy in patients with type 2 diabetes mellitus and moderate or severe albuminuria compared to isolated high home systolic blood pressure?
Effect estimate: OR 2.52 (95% CI 1.01-5.99)
p-value: p=0.05
Maintaining normal home blood pressure is associated with a higher likelihood of ameliorating diabetic nephropathy in patients with type 2 diabetes compared to isolated high home systolic blood pressure.
May inform home BP assessment in T2DM nephropathy; hypothesis-generating for randomized trials on targets.
Background: Using normal home blood pressure (home BP) as a reference, isolated high home systolic blood pressure (IH-home SBP) increases the risk of diabetic nephropathy. However, whether diabetic nephropathy would improve among diabetic patients without IH-home SBP has not been previously assessed. Methods: This prospective 5-year cohort study of 264 patients with moderate or severe albuminuria investigated the effect of IH-home SBP or normal home BP on the risk of diabetic nephropathy in patients with type 2 diabetes mellitus. Improvement of diabetic nephropathy was defined as remission or regression from moderate or severe albuminuria to normal or mildly increased albuminuria. Results: Improvement of diabetic nephropathy was shown in 59 out of 264 patients during 5 years. The adjusted odds ratio (95% confidence interval) of normal home BP for improving diabetic nephropathy was 2.52 (1.01–5.99, p = 0.05). Conclusion: Normal home BP had relation to an improvement in diabetic nephropathy among type 2 diabetic patients with moderate and severe increased albuminuria in the observation period of 5 years. Good home BP control might be valuable to ameliorate diabetic nephropathy.
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Kitagawa et al. (2022) conducted a cohort in Type 2 diabetes mellitus with diabetic nephropathy (n=264). Normal home blood pressure vs. Isolated high home systolic blood pressure was evaluated on Improvement of diabetic nephropathy (remission or regression from moderate or severe albuminuria to normal or mildly increased albuminuria) (OR 2.52, 95% CI 1.01-5.99, p=0.05). Normal home blood pressure was associated with an improvement in diabetic nephropathy compared to isolated high home systolic blood pressure (OR 2.52; 95% CI 1.01-5.99; p=0.05).
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