Systolic inter-arm blood pressure difference and estimated glomerular filtration rate in type 2 diabetic patients in Palestine: a cross-sectional study

Abstract

Objectives

This study aimed to investigate the association between systolic inter-arm blood pressure difference (IABPD) and the estimated glomerular filtration rate (eGFR), as well as chronic kidney disease (CKD), in patients with type 2 diabetes mellitus (T2DM).

Patients and methods

This cross-sectional study included 189 Palestinians diagnosed with T2DM. Data were collected through personal interviews, medical records and three separate blood pressure measurements from both arms. Patients were stratified in two ways: based on systolic IABPD ≥15 mmHg and the presence of CKD, indicated by an eGFR of <60 mL/min/1.73 m² over a three months period. We used simple and multiple linear regression analyses to clarify the association between systolic IABPD (mmHg) and eGFR and to identify independent predictors for eGFR.

Results

The mean age was 61.3 years, with a female percentage of 57.7%. The prevalence of systolic IABPD ≥15 mmHg and CKD was 27.5% and 30.2%, respectively. Among patients with eGFR <60 mL/min/1.73 m², the median systolic IABPD was 12.5 mmHg (interquartile range (IQR), 13.5 mmHg), whereas in patients with eGFR ≥60 mL/min/1.73 m², it was 7.5 mmHg (IQR, 9.8 mmHg) with a significant difference (p = .021). The results of the multiple linear regression model did not reveal an independent association between systolic IABPD and eGFR, with an unstandardized coefficient (B) of −0.257 (95% confidence interval (CI), −0.623 to 0.109; p = .167). However, older age (B, −0.886; 95% CI, −1.281 to −0.49; p < .001), hypertension (B, −12.715; 95% CI, −22.553 to −2.878; p = .012) and a longer duration of DM (B, −0.642; 95% CI, −1.10 to −0.174; p = .007) were significantly and negatively associated with eGFR.

Conclusions

Systolic IABPD did not exhibit an independent association with eGFR in T2DM patients. However, older age, a previous history of hypertension, and a longer duration of DM were all significantly associated with lower eGFR.

Keywords:

• Type 2 diabetes mellitus
• estimated glomerular filtration rate
• chronic kidney disease
• systolic inter-arm blood pressure difference
• diabetes complications

Acknowledgements

The authors thank each of Baraah Farun, Peter Bael, Aya Siaj, Aseel Nassar, Alhareth Amro, Yahya abu Jwaid, Bayan Awad, Adan Rabayah, Basel Zaben, Natalie Khamashta, Mo’men Alashwas, Anas Barabrah, Anas Toqan, Mohammad Shehadeh and Raya Amer for their assistance in the data collection for this project.

Author contributions

Raghad Sweity: data collection, methodology, validation, investigation, and writing – original draft, visualization. Khadeeja Fanoun: data collection, methodology, validation, investigation, writing – original draft, and visualization. Tareq Jarrar: data collection, methodology, validation, investigation, and writing – original draft, visualization. Bayan F. Alqtishat: methodology, investigation, data curation, resources, writing – review and editing, and project administration. Mohammad Abdelhafez: methodology, software, validation, formal analysis, resources, data curation, writing – review and editing, and supervision. Suheir Ereqat: conceptualization, methodology, validation, formal analysis, writing – review and editing, and supervision.

Disclosure statement

The authors report there are no competing interests to declare.

Data availability statement

Data set is available with the corresponding author and can be provided upon request.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.