# Creatininestijging tijdens bloeddrukbehandeling en uitkomsten bij diabetes type 2

*geplaatst 2018-12-01 · Preventie · Hypertension (Dallas, Tex. : 1979) · doi 10.1161/HYPERTENSIONAHA.118.11944 · https://hartvaat.nl/2018/12/01/creatininestijging-tijdens-bloeddrukbehandeling-en-uitkomsten-bij-diabetes-type-/*

Studie naar het risico op ongunstige uitkomsten bij creatininestijging tijdens antihypertensieve behandeling bij diabetes type 2.

## English: Creatinine Rise During Blood Pressure Therapy and the Risk of Adverse Clinical Outcomes in Patients With Type 2 Diabetes Mellitus.

This study showed that creatinine rise during antihypertensive therapy in type 2 diabetes does not consistently predict adverse outcomes, suggesting that moderate renal function changes should not always prompt treatment de-escalation.

## Abstract (original, from the publication)

Lowering blood pressure may affect renal function. Current guidelines state that reducing antihypertensive therapy should be considered in patients with a >30% serum creatinine increase after initiation of antihypertensive therapy. We examined the association between a serum creatinine increase and adverse clinical outcomes in the ACCORD-BP trial (Action to Control Cardiovascular Risk in Diabetes Blood Pressure), were patients with type 2 diabetes mellitus were randomized to intensive (target systolic blood pressure <120 mm Hg) and standard antihypertensive (<140 mm Hg) treatment. The primary outcome was a combined end point consisting of all-cause mortality, major cardiovascular events, and renal failure. Patients were stratified into 3 groups according to serum creatinine increase between baseline and 4 months (<10%, 10%-30%, >30%). A total of 4733 patients, aged 62.2 years, 52% men with a mean estimated glomerular filtration rate 81.5 mL/min per 1.73 m2 were included. Follow-up was available for 4446 patients, 2231 were randomized to intensive and 2215 to standard therapy. Kaplan-Meier analysis showed no association between a serum creatinine increase and the composite end point in the intensive ( P=0.20) and the standard treatment group ( P=0.17). After adjusting for possible confounders, a >30% serum creatinine increase was associated with a higher risk of clinical adverse outcomes in both treatment groups, but to a similar extent. These data suggest that a >30% serum creatinine increase that coincides with lower blood pressure values should not directly lead to a reduction in antihypertensive medication in patients with type 2 diabetes mellitus. Clinical Trial Registration- URL: http://www.clinicaltrials.gov . Unique identifier: NCT00000620.

Auteurs: Didier Collard, Tom F Brouwer, Ron J G Peters, Liffert Vogt, Bert-Jan H van den Born

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Bron: Hypertension (Dallas, Tex. : 1979), https://doi.org/10.1161/HYPERTENSIONAHA.118.11944. Bijgewerkt 2026-07-03T13:26:51Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.