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. 2022 May-Jun;19(3):14791641221098193.
doi: 10.1177/14791641221098193.

Diabetic nephropathy ameliorated in patients with normal home blood pressure compared to those with isolated high home systolic blood pressure: A 5-year prospective cohort study among patients with type 2 diabetes mellitus

Nobuko Kitagawa  1 , Emi Ushigome  1 , Noriyuki Kitagawa  1   2 , Hidetaka Ushigome  3 , Isao Yokota  4 , Naoko Nakanishi  1 , Masahide Hamaguchi  1 , Mai Asano  1 , Masahiro Yamazaki  1 , Michiaki Fukui  1
Affiliations

Diabetic nephropathy ameliorated in patients with normal home blood pressure compared to those with isolated high home systolic blood pressure: A 5-year prospective cohort study among patients with type 2 diabetes mellitus

Nobuko Kitagawa et al. Diab Vasc Dis Res. 2022 May-Jun.

Abstract

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.

Keywords: IH-home SBP; albuminuria; diabetes mellitus; diabetic nephropathy; normal home BP.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article Emi Ushigome received grant support from the Japanese Study Group for Physiology and Management of Blood Pressure, the Astellas Foundation for Research on Metabolic Disorders (Grant number: 4024), the Japan Society for the Promotion of Science, Mishima Kaiun Memorial Foundation, and received personal fees from Nippon Boehringer Ingelheim Co., Ltd., Mitsubishi Tanabe Pharma Corporation, LIMITED, Ltd., Takeda Pharmaceutical Company Ltd., Novo Nordisk Pharma Ltd., MSD K.K., DAIICHI SANKYO COMPANY, Kyowa Hakko Kirin Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Kowa Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., AstraZeneca K.K., and Sanofi K.K., outside the submitted work. Donated Fund Laboratory of Diabetes therapeutics is an endowment department, supported with an unrestricted grant from Taiyo Kagaku Co. Ltd., Ono Pharmaceutical Co., Ltd., and Taisho Pharmaceutical Co., Ltd. Mai Asano received personal fees from Kowa Pharmaceutical Co., Ltd., Abbott Japan Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Novo Nordisk Pharma Ltd., AstraZeneca K.K., and Chugai Pharmaceutical Co., Ltd., outside the submitted work. Masahide Hamaguchi received grants from AstraZeneca K.K., Nippon Boehringer Ingelheim Co. Ltd., Ono Pharma Co. Ltd., Oishi Kenko inc., Yamada Bee Farm, and received personal fees from Ono Pharma Co. Ltd., AstraZeneca K.K., Eli Lilly, Japan, Mitsubishi Tanabe Pharma Corp., Sumitomo Dainippon Pharma Co., Ltd., Daiichi Sankyo Co. Ltd., Sanofi K.K., Kowa Pharma Co. Ltd., outside the submitted work. Masahiro Yamazaki reports personal fees from MSD K.K., personal fees from Sumitomo Dainippon Pharma Co., Ltd., personal fees from Kowa Company, Limited, personal fees from Takeda Pharmaceutical Company Limited, personal fees from AstraZeneca PLC, personal fees from KOWA PHARMACEUTICAL COMPANY LTD., personal fees from Kyowa Hakko Kirin Co., Ltd., personal fees from DAIICHI SANKYO COMPANY, LIMITED, personal fees from ONO PHARMACEUTICAL CO., LTD., outside the submitted work. Isao Yokota reports grants from KAKENHI, AMED, and Health, Labour and Welfare Policy Research Grants, research fund by Nihon Medi-Physics, and speaker fees from Chugai Pharmaceutical Co, AstraZeneca plt, Japan Tabacco Pharamaceutical Division, and Nippon Shinyaku Co, outside the submitted work. Michiaki Fukui received grant support from Ono Pharma Co. Ltd., Oishi Kenko inc., Yamada Bee Farm, Nippon Boehringer Ingelheim Co. Ltd., Kissei Pharma Co. Ltd., Mitsubishi Tanabe Pharma Corp., Daiichi Sankyo Co. Ltd., Sanofi K.K., Takeda Pharma Co. Ltd., Astellas Pharma Inc., MSD K.K., Kyowa Kirin Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Kowa Pharma Co. Ltd., Novo Nordisk Pharma Ltd., Sanwa Kagagu Kenkyusho CO., Ltd., Eli Lilly, Japan, K.K., Taisho Pharma Co., Ltd., Terumo Corp., Tejin Pharma Ltd., Nippon Chemiphar Co., Ltd., Abbott Japan Co. Ltd., and Johnson & Johnson K.K. Medical Co., TERUMO CORPORATION, and received personal fees from Nippon Boehringer Ingelheim Co., Ltd., Kissei Pharma Co., Ltd., Mitsubishi Tanabe Pharma Corp., Daiichi Sankyo Co. Ltd., Sanofi K.K., Takeda Pharma Co. Ltd., Astellas Pharma Inc., MSD K.K., Kyowa Kirin Co. Ltd., Sumitomo Dainippon Pharma Co. Ltd., Kowa Pharma Co. Ltd., Novo Nordisk Pharma Ltd., Ono Pharma Co. Ltd., Sanwa Kagaku Kenkyusho Co. Ltd., Eli Lilly Japan K.K., Taisho Pharma Co., Ltd., Bayer Yakuhin, Ltd., AstraZeneca K.K., Mochida Pharma Co. Ltd., Abbott Japan Co. Ltd., Teijin Pharma Ltd., Arkray Inc., Medtronic Japan Co. Ltd., and Nipro Corp., TERUMO CORPORATION, outside the submitted work. The sponsors were not concerned with the study design, collection, analysis, interpretation of data, nor in the writing of this manuscript, nor in the decision to submit the article for publication. The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial benefits from any commercial entity related to the subject of this article. The authors declare that although they are affiliated with a department that is supported financially by pharmaceutical company, the authors received no financial benefits for this study and department affiliation does not alter their adherence to all journal policies on sharing data and materials.

Figures

Figure 1.
Figure 1.
Flow diagram for the KAMOGAWA-HBP cohort.
Figure 2.
Figure 2.
Transition of diabetic nephropathy remission or regression.
See this image and copyright information in PMC

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