Association of uncontrolled blood pressure with diabetic nephropathy in patients of type 2 diabetes mellitus.

Abstract

Objective: To find the association between uncontrolled BP and diabetic nephropathy in patients with T2DM. Study Design: Cross-sectional Analytical study. Setting: Khawar Surgical Centre, Khanewal. Period: January 2024 to March 2025. Methods: A total of 355 patients with type 2 diabetes mellitus (T2DM) were enrolled using non-probability consecutive sampling. Data were collected on demographics, BP records, HbA1c, urinary albumin-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR). BP was categorized as controlled (<130/80 mmHg) or uncontrolled (≥130/80 mmHg). Diabetic nephropathy was defined by UACR ≥30 mg/g or eGFR <60 ml/min/1.73 m². Results: Diabetic nephropathy was present in 178 patients (50.1%), with a significantly higher prevalence in the uncontrolled BP group (62.4%) compared to the controlled group (31.7%) (p < 0.001). The uncontrolled BP group had higher mean UACR (68.5 ± 35.4 mg/g vs. 41.2 ± 23.1 mg/g) and lower eGFR (63.4 ± 15.7 vs. 77.6 ± 13.9 ml/min/1.73 m²) (both p < 0.001). Logistic regression confirmed uncontrolled BP as an independent predictor of diabetic nephropathy (OR = 3.61; 95% CI: 2.35–5.56; p < 0.001). Conclusion: Uncontrolled blood pressure is strongly associated with increased risk of diabetic nephropathy in patients with Type 2 Diabetes Mellitus. These findings reinforce the importance of integrating strict blood pressure control into standard diabetic management to reduce the risk of renal complications.