Hipertensão Arterial Sistêmica e Diabetes Mellitus como fatores de risco para doença renal crônica

• DOI: https://doi.org/10.22533/at.ed.334172510076

• Palavras-chave: Hipertensão arterial, Diabetes mellitus, Doença renal crônica, Fatores de risco, Progressão da doença.

• Keywords: Hypertension, Diabetes mellitus, Chronic kidney disease, Risk factors, Disease progression.

• Abstract: The study aims to evaluate the independent and combined association between systemic arterial hypertension (SAH) and diabetes mellitus (DM) in the progression of chronic kidney disease (CKD), using standardized clinical and laboratory parameters, focusing on prevention and screening strategies in at-risk populations. Methods: A systematic review was conducted following the PRISMA protocol, with searches in PubMed/MEDLINE up to April 2025. Observational studies in adults with SAH and/or DM were included, excluding reviews and case studies. The research question was structured using the PICO framework (Population: adults; Intervention/Exposure: SAH and DM; Comparator: without SAH and DM; Outcome: renal function/CKD). Data extraction included sample characteristics, study design, intervention/exposure, comparator, and outcomes. Results: Out of 29,599 identified articles, 29 were selected for analysis. Results showed that SAH and DM, individually or combined, significantly increased the risk of CKD progression. Patients with DM had an annual progression rate of 4.1% (vs. 2.8% without DM; p< 0.001), and elevated albuminuria (UACR ≥300 mg/g) was associated with higher risk (HR = 4.56; 95% CI: 3.78–5.50). Inadequate control of blood pressure (<130/80 mmHg) and glycemia (HbA1c >7%) accelerated renal deterioration. Conclusions: SAH and DM are independent and synergistic risk factors for CKD progression, emphasizing the need for strict control of these conditions and regular renal function monitoring in at-risk populations.