Key result
Combined glucose and blood-pressure control yields greatest kidney preservation over single interventions in simulation modeling.
Why the study?
A nonlinear mathematical model is needed to understand interactions among blood glucose, kidney function, and blood pressure in CKD progression due to lack of longitudinal clinical data.
Does combined glucose-lowering and antihypertensive intervention theoretically improve kidney function preservation in a mathematical model of CKD progression?
Does combined glucose-lowering and antihypertensive intervention theoretically improve kidney function preservation in a mathematical model of CKD progression?
A mathematical model simulation of CKD progression suggests that simultaneous control of hyperglycemia and hypertension provides superior preservation of kidney function over single-target strategies.
Combined glucose-BP control may best preserve kidney function in CKD models; leaves open prospective clinical validation.
This study develops a nonlinear mathematical model for chronic kidney disease (CKD) progression involving blood glucose, kidney function, plasma urea, plasma creatinine, and mean arterial pressure. Two control variables representing glucose-lowering and antihypertensive interventions are incorporated. Numerical simulations show that persistent hyperglycemia and hypertension accelerate the decline in kidney function, while reduced eGFR increases metabolic waste accumulation and contributes to elevated blood pressure. Sensitivity analysis identifies the renal deterioration and clearance-related parameters as important determinants of CKD progression. Optimal control simulations indicate that combined glucose and blood-pressure management provides the greatest preservation of kidney function. Since several parameters are assumed due to the absence of longitudinal clinical data, the results are interpreted as qualitative and scenario-based. The model provides a foundation for future data-driven calibration and extension toward more clinically realistic CKD dynamics.
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Herdiana et al. (2026) studied Chronic Kidney Disease. Glucose-lowering and antihypertensive interventions vs. Uncontrolled model (no intervention) was evaluated. Optimal control simulations of a mathematical model indicated that combined glucose and blood-pressure management provided the greatest preservation of kidney function compared with single interventions.
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