Mr Heng Wang1, Dr Keyi Fan2, Dr Chaonan Fan1, Prof Min Hu1, Prof Honglin Dong2, Prof Natasha Rogers1, Prof Guoping Zheng1
1Centre for Transplant and Renal Research, Westmead Institute for Medical Research, Westmead, Australia, 2Department of Vascular Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China
Biography:
Heng Wang is currently a visiting scholar at the Westmead Institute for Medical Research and will commence his PhD in Medicine at the University of Sydney in July 2025. He received his Bachelor of Clinical Medicine from Jilin University in 2020 and a research-based Master of Surgery from Shanxi Medical University in 2023. His research focuses on the molecular mechanisms of renal fibrosis and aortic aneurysm pathogenesis.
Aim:
To assess the mediating role of hypertension in kidney injury among patients with type 2 diabetes (T2D) and to characterize the global burden of type 2 diabetic nephropathy (T2DN).
Background:
T2DN is a leading cause of chronic kidney disease (CKD), affecting approximately 40% of patients with T2D. The contribution of hypertension to T2DN progression remains underexplored.
Methods:
Cross-sectional data were analyzed from the National Health and Nutrition Examination Survey (NHANES, 2001–2018), including 7,618 T2D patients with blood pressure data, based on the Population, Exposure, Comparator, and Outcome (PECO) framework. Risk factors were identified using linear and logistic regressions, with model performance evaluated by receiver operating characteristic (ROC) analysis. Trends in T2DN prevalence, mortality, and population attributable fractions (PAF) from 1990 to 2021 were assessed using the Global Burden of Disease (GBD) study.
Results:
Hypertension prevalence was higher in T2DN than non-T2DN patients (80.21% vs. 60.44%, P < 0.001). T2DN patients showed higher systolic blood pressure (SBP: 136 vs. 128 mmHg) and lower diastolic blood pressure (DBP: 65.33 vs. 70.67 mmHg). Estimated glomerular filtration rate (eGFR) correlated negatively with SBP (r = –0.1795) and positively with DBP (r = 0.2547); urinary albumin-to-creatinine ratio (UACR) correlated positively with SBP (r = 0.3099). Independent predictors included age, categorical blood pressure, heart failure, and stroke, with an area under the ROC curve (AUC) of 0.761. From 1990 to 2021, T2DN prevalence rose from 2,105.68 to 2,243.43 per 100,000, and mortality from 5.73 to 10.25. The PAF for deaths due to high SBP increased from 9.79% to 10.65%.
Conclusions:
Hypertension is a major driver of T2DN progression, highlighting the need for early blood pressure intervention in T2D management.