Impact of Hypertension on Kidney Function in Diabetic Patients.
1Abdullah Choudhry, 2Nadia Salam, 3Dr. Fazal Muhammad,4Dr . Sohail Nasir, 5Dr Muhammad Shaukat, 6Qamar Yasmeen.
Submission: 10 January 2026 | Acceptance: 25 January 2026 | Publication: 20 February 2026,
1Assistant Professor, MBBS FCPS Medicine, Amna Inayat Medical College Sheikhupura.
2Hospital Avicenna Medical and Dental College.
3Assistant Professor Head of Nephrology Department Baluchistan institute of Nephro urology Quetta.
4Lahore Medical and Dental college Lahore.
5Assistant professor Neprology. Gomal Medical College Dera Ismail Khan & DHQr Teaching Hospital Dera Ismail Khan KPK.
6Associate professor(PhD) ), Niazi medical and dental college, Sargodha.
Background:Hypertension is a major accelerant of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM), yet optimal blood pressure (BP) targets and therapeutic strategies remain debated. While aggressive BP control reduces cardiovascular risks, excessively low systolic BP (SBP) may paradoxically worsen renal outcomes. Emerging therapies such as SGLT2 inhibitors, GLP-1 receptor agonists, and non-steroidal mineralocorticoid receptor antagonists have shown renal protective effects, but their use in real-world settings remains uneven..
Aim:To evaluate the impact of hypertension on kidney function in patients with T2DM by integrating published clinical trial evidence with local hospital data and a targeted clinician survey.).
Methods:We conducted a narrative synthesis of recent high-quality studies (n=12), including randomized controlled trials and guideline updates on BP targets, kidney outcomes, and adjunctive therapies in hypertensive diabetic patients (1–12). In parallel, retrospective data from a local hospital cohort (n=200) stratified by SBP ranges (<130, 130–139, ≥140 mmHg) were analyzed for changes in estimated glomerular filtration rate (eGFR) over 3 years. A structured survey of 50 clinicians assessed prevailing treatment strategies and target BP preferences..
Results:Published data identified SBP 130–139 mmHg as the optimal range for renal protection (1), with semaglutide (2), SGLT2 inhibitors (6), and finerenone (12) showing significant benefit. Local data mirrored these trends, with the lowest eGFR decline in the 130–139 mmHg group. Survey results indicated 60% of clinicians target this BP range and 79% prescribe semaglutide for nephroprotection..Conclusion:Moderately controlled BP (130–139 mmHg) combined with reno-protective agents offers the most effective strategy for preserving kidney function in T2DM. Local outcomes support global findings and underscore the need for tailored BP targets and drug accessibility in diabetic nephropathy management..
Keywords:Diabetic nephropathy; Hypertension; Systolic blood pressure; Semaglutide; SGLT2 inhibitors; Finerenone; Kidney function; Type 2 diabetes.