New research suggests aggressive treatment of blood pressure and cholesterol may result in poor kidney outcomes in some patients with type 2 diabetes.
A paper by Amy Mottl, MD, MPH, FASN, associate professor of medicine in the division of nephrology, has been selected for presentation during the American Society of Nephrology’s Kidney Week 2018, the world’s largest meeting of kidney health professionals, taking place in San Diego, CA, this week.
This year, the first-ever “Best of ASN Journals: CJASN and JASN” will be introduced on Thursday, from 2-4 pm. The session will highlight innovative clinical, translational, and basic research in nephrology and presents diverse, novel, and clinically applicable science across a variety of nephrology disciplines.
Mottl’s paper, Long-Term Effects of Intensive Glycemic and Blood Pressure Control and Fenofibrate Use on Kidney Outcomes, was selected for presentation during the “Chronic Kidney Disease” portion of the session and will be available online here: http://cjasn.asnjournals.org/
The research suggests that attempts to normalize blood pressure, and cholesterol may have negative long-term effects on kidney health in adults with type 2 diabetes who are at high risk for cardiovascular disease. The results will appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).
Study co-authors include John B. Buse, MD, PhD, Faramarz Ismail-Beigi, MD, Ronald J. Sigal, MD, MPH, Carolyn F. Pedley, MD, Vasilios Papademetriou, MD,Dsc, Debra L. Simmons, MD, MS, Lois Katz, MD, Josyf C. Mychaleckyj, DPhil and Timothy Craven, MSPH.
The team found that intensive blood sugar control aiming for normal average blood sugar (hemoglobin A1c target <6%) reduced the risk for macroalbuminuria (a high amount of protein excreted in the urine) over an average follow-up of 7.7 years, but it had no impact on more significant kidney outcomes such as serum creatinine doubling (a marker of worsening kidney function) or the need for dialysis or transplantation. Intensive control of blood pressure or the use of fenofibrate to lower cholesterol increased the risk for doubling of serum creatinine but did not increase the need for dialysis or transplantation.
“These results, along with those from the primary study which showed no benefit of the interventions on heart attacks and strokes, provide evidence against aggressive targets for glucose, blood pressure, and use of fenfibrate in adults with type 2 diabetes at high risk of cardiovascular events,” said Mottl.
Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has nearly 20,000 members representing 124 countries. For more information, visit http://www.asn-online.org.