At the nexus of CKD, diabetes, hypertension, and their coexistence: a prospective observational study of risk factors, therapeutic strategies, monitoring metrics, and complications

Abstract Background: Chronic kidney disease (CKD) continues to be a major global health issue, especially among patients with diabetes mellitus (DM), hypertension (HTN), or both. The presence of both DM and HTN accelerates the progression and complications of CKD, underscoring the need for effective evaluation and management strategies. Aim: To evaluate risk factors, treatment methods, and their effects on monitoring parameters and complications in CKD patients with type 2 DM, HTN, and their coexistence. Materials and Methods: A prospective observational study was conducted at Medicover Hospitals involving 233 CKD patients divided into DM, HTN, and DM + HTN groups. Demographic, clinical, and biochemical data were collected and analyzed using paired t -tests to compare pre- and post-treatment outcomes. (Study design is mentioned in the abstract as per the suggestion.) Results: The prevalence of CKD was highest among patients with DM and HTN (49.57%), followed by those with HTN alone (29.6%) and DM alone (21.03%). Males accounted for 72.53% of cases, with most presenting in stage 5 CKD (53%). The DM + HTN group had the longest average hospital stay (3.62 ± 0.86 days). Post-treatment, serum creatinine and blood urea nitrogen levels significantly decreased ( P < 0.005), along with improvements in estimated glomerular filtration rate and blood pressure. Insulin and combination antihypertensive therapies were commonly prescribed. Anemia (80%), electrolyte imbalance (66.95%), and metabolic acidosis (34.78%) were frequent complications in the DM + HTN group. Conclusion: The coexistence of DM and HTN significantly increases the prevalence, severity, and complications of CKD. Early detection, combined therapeutic strategies, and regular monitoring are crucial for slowing disease progression and enhancing outcomes.