Combined impact of diabetes mellitus and hypertension on acute kidney injury and survival in critically ill patients: a decade of experience from a Jordanian Tertiary Hospital.

Aims: To examine the independent and combined effects of diabetes mellitus (DM) and hypertension (HTN) on acute kidney injury (AKI) and 90-day mortality in critically ill patients.

Patients and methods: We retrospectively analyzed 3,282 adult intensive care unit (ICU) admissions to King Abdullah University Hospital, Jordan (2012-2022). Patients were stratified by DM and HTN status. Logistic regression identified predictors of AKI, and Cox proportional hazards models assessed 90-day mortality.

Results: AKI occurred in 44.7% of DM patients versus 40.8% without DM (p = 0.0423). Patients with both DM and HTN had the highest AKI incidence (48.6%) and the highest 90-day mortality (37.8%). In addition, the HTN × DM interaction was a significant predictor of AKI in multivariable analysis (OR = 1.18, 95% CI: 1.07-1.36, p = 0.0059) and increased the mortality hazard independently (HR = 1.43, 95% CI: 1.04-1.97, p = 0.0286).

Conclusions: DM is associated with increased AKI and mortality in critically ill patients, and concurrent HTN further amplifies these risks. These findings support integrated cardiometabolic risk assessment in ICU settings.