Widely prescribed blood pressure drugs linked to 33% higher kidney risk in type 2 diabetes

 

New findings presented at the 63rd ERA Congress suggest that a commonly prescribed group of blood pressure drugs may be linked to worse kidney outcomes in people with type 2 diabetes (T2D), including patients already taking newer medications designed to protect kidney function.

The medications, known as dihydropyridine calcium-channel blockers (DCCBs), lower blood pressure by relaxing blood vessels. They are often prescribed as second-line treatments for people with diabetic kidney disease (DKD). In the new study, patients who took DCCBs in addition to standard therapies experienced a significantly greater risk of major adverse kidney events than patients treated with other blood pressure medications.

Protecting the Kidneys in Type 2 Diabetes

DKD is among the most common causes of kidney failure worldwide. The condition develops as prolonged high blood sugar damages tiny blood vessels within the kidneys, gradually interfering with their ability to remove waste from the bloodstream. Keeping blood pressure under control is a key part of managing the disease because elevated blood pressure can speed up this damage.

Treatment for DKD has changed considerably in recent years with the introduction of two important classes of medication. Renin-angiotensin system (RAS) inhibitors lower blood pressure while also reducing pressure inside the kidney's filtering structures. Sodium-glucose cotransporter-2 (SGLT2) inhibitors were initially developed to treat diabetes, but they are now also recognized for their ability to protect kidney function and lower the risk of kidney failure. The two drug classes are now part of standard treatment for many people with DKD.

Study Tracks More Than 31,000 Patients

Researchers examined health data from 31,031 adults with T2D between 2016 and 2021. Every participant was receiving both RAS and SGLT2 inhibitors. Of the total group, 12,172 (39.2%) were also taking DCCBs, while 18,859 (60%) were being treated with other antihypertensive medications. The median follow-up period was approximately 3.5 years.

After accounting for differences in patients' initial clinical and demographic characteristics, the researchers found that DCCB use was associated with a 33% greater risk of a major adverse kidney event (R 1.33, 95%, CI 1.03-1.73).

Researchers classified these events as either a major loss of kidney filtration capacity, involving a decline of 40% or more in estimated glomerular filtration rate (eGFR), the standard measure of kidney function, or progression to end-stage kidney disease that required dialysis or transplantation.

"DCCBs are widely used as second-line blood pressure treatments in patients with DKD," said Dr. Timna Agur, lead author of the study. "Our findings raise important questions about whether these medications are always the best option for patients already receiving modern kidney-protective therapies."

Why DCCBs Could Affect Kidney Function

The researchers suggest that the association may be related to how DCCBs alter blood flow through the kidneys. In DKD, the kidneys are already dealing with elevated pressure and hyperfiltration, a condition in which their filtering structures are placed under excessive strain.

DCCBs may relax the blood vessels that carry blood into these filtering units more strongly than they affect the vessels carrying blood away. According to the researchers, this imbalance could increase pressure inside the filtering structures and potentially contribute to continued kidney damage.

"We initially thought the kidney-protective effects of SGLT2 inhibitors might counterbalance the potential harms associated with DCCBs," said Dr. Agur. "However, the increased risk of kidney disease progression appeared to persist even in this group."

More Research Is Needed

Because the study was observational, the researchers emphasize that it cannot show that DCCBs directly caused the poorer kidney outcomes. Still, they say the association deserves attention because these medications are so frequently prescribed to people with DKD.

"Further prospective studies and randomized controlled trials are needed to confirm these observations and better define the safest blood pressure treatment strategies for patients with DKD," concluded Dr. Agur. "However, given how commonly these medications are prescribed, any increase in kidney risk could have important implications for large numbers of patients with DKD."

Story Source:

Materials provided by European Renal Association (ERA). Note: Content may be edited for style and length.

 

Courtesy:

European Renal Association (ERA). "Widely prescribed blood pressure drugs linked to 33% higher kidney risk in type 2 diabetes." ScienceDaily. ScienceDaily, 18 August 2026. <www.sciencedaily.com/releases/2026/08/260816044844.htm>. 

 

 

 

 

Scientists turn probiotic bacteria into tiny drug factories for pancreatic cancer

Cancer immunotherapy has dramatically changed how doctors treat many forms of cancer, yet pancreatic cancer has remained particularly resistant to these advances. A major obstacle is the environment that develops around pancreatic tumors. These tumors often create a "cold" tumor microenvironment that blocks immune cells from launching an effective attack.

Researchers at the University of Chicago have now developed a new approach that could help overcome this problem. In a study published in Science Advances, the team used BifidoSumIL-2, an engineered strain of Bifidobacterium longum, a probiotic bacterium naturally found in the gut, to carry an immune-stimulating treatment directly into tumors.

In animal models, the therapy slowed the growth of pancreatic tumors by selectively activating T cells that fight cancer. Its effects became even stronger when researchers combined it with chemotherapy, radiotherapy or immunotherapy. The findings suggest that BifidoSumIL-2 could eventually provide a new way to improve how pancreatic tumors respond to treatment.

Using Bacteria to Deliver Cancer Therapy

"A big unmet medical need has been pancreatic cancer, and so that was going to be our mountain to climb," said Ralph Weichselbaum, MD, the Daniel K. Ludwig Distinguished Service Professor and Chair of Radiation and Cellular Oncology at the University of Chicago.

BifidoSumIL-2 was created to release a modified version of interleukin-2 (IL-2) once it reaches a tumor. IL-2 is a potent immune signaling molecule that activates T cells involved in attacking cancer. Conventional IL-2 treatment, however, can produce serious side effects and can also stimulate immune cells that actually weaken the antitumor response.

The researchers sought to avoid these problems by using SumIL-2, a modified form of IL-2 engineered to more precisely activate cancer-fighting T cells while reducing stimulation of regulatory T cells. They then placed SumIL-2 inside Bifidobacterium longum so that the therapeutic molecule could be concentrated within tumors instead of throughout the body.

Developing the treatment required scientists from several disciplines to work together, including specialists in microbiology, synthetic biology, oncology, and immunology.

"This was a highly interdisciplinary effort," said Mark Mimee, PhD, Assistant Professor of Microbiology at the University of Chicago. "We had to bring together people who understand bacteria, people who understand tumors, and people who understand the immune system to make something like this possible."

Why Bifidobacterium Can Target Tumors

Bifidobacterium offered the researchers an unusual advantage as a delivery system. The bacterium grows in anaerobic environments, meaning places with very little oxygen. Low oxygen levels are common inside many solid tumors, including pancreatic tumors, while healthy tissues generally contain more oxygen and are therefore less suitable for the bacteria.

"Bifidobacterium is an obligate anaerobe, so it doesn't grow in the presence of oxygen," Mimee said. When the bacteria are injected systemically, they are cleared from healthy tissues with abundant oxygen. Inside the low-oxygen regions of tumors, however, they can become active.

That preference allows the engineered bacteria to function as microscopic drug factories inside tumors. Once there, they produce SumIL-2 where the treatment is needed rather than broadly throughout the body. Researchers also noted that Bifidobacterium has shown a favorable safety profile in preclinical models and is already well known as a probiotic organism. It is commonly present in yogurt and is generally recognized as a safe, off-the-shelf probiotic.

Engineering the organism was not simple.

"Bifidobacterium is not the easiest organism to work with," Mimee said. "It's anaerobic, it grows slowly, and the genetic tools for manipulating it are much more limited compared to model bacteria like E. coli. A lot of the work was just figuring out how to reliably engineer it."

Stronger Results With Combination Treatments

Tests in animal models showed that BifidoSumIL-2 preferentially gathered inside tumors, stimulated immune activity, and slowed the growth of pancreatic cancer. It also changed the tumor microenvironment in a potentially beneficial way by increasing the activity of cancer-fighting CD8+ T cells.

The results improved further when BifidoSumIL-2 was paired with established cancer treatments. Combining the bacterial therapy with chemotherapy, radiation therapy, or anti-PD-L1 immunotherapy led to better tumor control and longer survival than the individual treatments achieved on their own.

"This combination potential is one of the study's most important findings; BifidoSumIL-2 not only works by itself -- it works with radiotherapy, chemotherapy, and immunotherapy," Weichselbaum said.

Despite the encouraging findings, BifidoSumIL-2 has not been tested in humans. Future research will need to examine its long-term safety, the possibility of effects outside the intended tumor, how long the immune response lasts, and whether the bacteria might eventually be given orally instead of through injection. The researchers also want to investigate whether the strategy can be combined with newer pancreatic cancer treatments, including KRAS inhibitors.

The Growing "Bugs as Drugs" Approach

The research adds to growing interest in a strategy known as "bugs as drugs." By engineering probiotic bacteria to seek out tumors and produce therapies directly inside them, scientists may be able to concentrate powerful immune treatments where they are most useful while reducing unwanted effects elsewhere in the body.

The study, "Engineered probiotic Bifidobacterium for tumor-targeted pancreatic cancer therapy" was supported by funds from the Ludwig Foundation and the National Institutes of Health.

Additional authors include Jaehyun Lee, Kaiting Yang, Christina Nowicki, Wei Liu, Emile Naccasha, and Hua Liang from the University of Chicago; Zhichen Sun from the University of Texas Southwestern, Dallas; and Yang-Xin Fu from Tsinghua University, Beijing, China.

UChicago Medicine and the Biological Sciences Division continue to be at the forefront of cancer care and research. In April 2027, UChicago Medicine will open the AbbVie Foundation Cancer Pavilion, Chicago's first freestanding cancer pavilion, to bring advanced diagnostics, innovative treatments, translational discoveries, and comprehensive support to patients and the community.

Journal Reference:

1. Jaehyun Lee, Kaiting Yang, Christina A. Nowicki, Wei Liu, Kangdi Li, Emile Naccasha, Zhichen Sun, Yang-Xin Fu, Hua Liang, Ralph R. Weichselbaum, Mark Mimee. Engineered probiotic Bifidobacterium for tumor-targeted pancreatic cancer therapy. Science Advances, 2026; 12 (30) DOI: 10.1126/sciadv.adz1388

Courtesy:

University of Chicago Medical Center. "Scientists turn probiotic bacteria into tiny drug factories for pancreatic cancer." ScienceDaily. ScienceDaily, 19 August 2026. <www.sciencedaily.com/releases/2026/08/260816044830.htm>.