ArticleCureus2025
Management of Diabetic Kidney Disease With Persistent Hypotension: A Case of Lifestyle-Driven Renal Recovery.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
Diabetic kidney disease (DKD) is typically accompanied by hypertension, which enables guideline-directed renoprotective therapy. We describe a 61-year-old woman with type 2 diabetes mellitus (T2DM) and persistent hypotension (≈92/55-98/65 mmHg) without albuminuria, in whom angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARBs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors were deemed unsafe due to baseline low blood pressure. Management, therefore, emphasized non-pharmacologic measures, tight glycemic control, weight reduction (~10 lb), hydration, and avoidance of nephrotoxins in a resource-limited setting. Renal function improved from an eGFR of 55 mL/min/1.73 m² (2023) to 69 (2024) and stabilized at 67.2 (2025) with HbA1c 6.3-6.6% and continued lack of albuminuria; neurologic and ophthalmic diabetic manifestations remained stable. This case illustrates a guideline gap: when persistent hypotension and absent albuminuria preclude standard agents, individualized metabolic and lifestyle strategies may achieve renal stabilization. Although causality cannot be inferred, the temporal association between improved weight/glycemia and estimated glomerular filtration rate (eGFR) recovery suggests a pragmatic pathway for hypotensive T2DM patients outside conventional algorithms.
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