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Prospective study of the impact of hypertension upon kidney function in diabetes mellitus.

Longitudinal data were obtained on 131 diabetic subjects enrolled in a study designed to evaluate the impact of persistent elevation of the blood pressure (BP) upon progression of renal damage in diabetes mellitus. For both insulin-dependent and non-insulin-dependent diabetes, serum creatinine exhibited a more rapid rise in those individuals whose BP remained elevated above 140 mm Hg despite therapy. Since no significant difference in age, duration of diabetes, diabetic control, or renal function at entry in the study could be identified as possible explanations for these differences, the findings support the conclusion that persistent elevation of the BP adds significantly to the risk of renal damage in both insulin-dependent and non-insulin-dependent diabetes, with more rapid decline occurring in non-insulin-dependent diabetes. Hypertensive subjects exhibited higher levels of plasma angiotensin II during the follow-up period.