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.