Cigarette smoking and vascular pathology in renal biopsies (original) (raw)
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Clinical Journal of the American Society of Nephrology, 2008
Although it is beyond any doubt that smoking is the number one preventable cause of death in most countries, smoking as an independent progression factor in renal disease has been questioned against the background of evidence-based criteria. This is because information from large, randomized, prospective studies that investigate the effects of smoking on renal function in healthy individuals as well as in patients with primary or secondary renal disease are lacking. Since 2003, a substantial number of clinical and experimental data concerning the adverse renal effects of smoking have been published, including large, prospective, population-based, observational studies. These more recent data together with evidence from experimental studies clearly indicate that smoking is a relevant risk factor, conferring a substantial increase in risk for renal function deterioration. This review summarizes the present knowledge about the renal risks of smoking as well as the increased cardiovascular risk caused by smoking in patients with chronic kidney disease. The conclusion is that smoking is an important renal risk factor, and nephrologists have to invest more efforts to motivate patients to stop smoking.
Nephrology, 2000
ABSTRACT There is substantial evidence for the adverse impact of smoking on deterioration of renal function in diabetic nephropathy but very little information is available concerning effects of smoking on the evolution of other renal diseases. In a prospective study in parallel group design with matched groups, 45 cigarette smoking patients (≥ 1 pack/day) with glomerular or tubulointerstitial lesions were compared with 45 non-smoking patients matched for age, gender, cause and severity of renal disease as well as presence of hypertension. The monthly decline of creatinine clearance was significantly faster in smoking patients than in non-smoking patients (follow-up period 2 years) (1.25 mL/min vs 0.67 mL/min, P < 0.001). Smoking promoted progression of both glomerular and tubulointerstitial nephropathy. This effect occurred independently of changes in blood pressure, proteinuria or lipid concentration. The results of this investigation indicate that cigarette smoking is an independent risk factor not only for diabetic but also for non-diabetic nephropathies.
Association between smoking and chronic kidney disease: a case control study
BMC Public Health, 2010
Background: The progression of chronic kidney disease (CKD) remains one of the main challenges in clinical nephrology. Therefore, identifying the pathophysiological mechanisms and the independent preventable risk factors helps in decreasing the number of patients suffering end stage renal disease and slowing its progression. Methods: Smoking data was analyzed in patients with CKD throughout 2005-2009. One hundred and ninety-eight patients who had recently been diagnosed with stage three CKD or higher according to the National Kidney Foundation (NKF) 2002 Classification were studied. The control group was randomly selected and then matched with the case subjects using a computerized randomization technique. The relative risk was estimated by computing odds ratio (OR) by using multinomial logistic regression in SPSS ® for Windows between the two groups. Results: Smoking significantly increases the risk of CKD (OR = 1.6, p = 0.009, 95% CI = 1.12-2.29). When compared to nonsmokers, current smokers have an increased risk of having CKD (OR = 1.63 p = 0.02, 95% CI = 1.08-2.45), while former smokers did not have a statistically significant difference. The risk increased with high cumulative quantity (OR among smokers with > 30 pack-years was 2.6, p = 0.00, 95% CI = 1.53-4.41). Smoking increased the risk of CKD the most for those classified as hypertensive nephropathy (OR = 2.85, p = 0.01, 95% CI = 1.27-6.39) and diabetic nephropathy (2.24, p = 0.005, 95% CI = 1.27-3.96). No statistically significant difference in risk was found for glomerulonephritis patients or any other causes. Conclusion: This study suggests that heavy cigarette smoking increases the risk of CKD overall and particularly for CKD classified as hypertensive nephropathy and diabetic nephropathy.
Journal of Analytical & Pharmaceutical Research, 2018
Smokeless tobacco may able to induce microalbuminuria. The present study investigates the relation between nicotine and cotinine with renal function in gutkha and khaini users. Methods: The levels of nicotine and cotinine were estimated by HPLC methods and other urine variables were detected by spectrophotometric methods. Current smokeless tobacco users have shown that significantly elevated levels of nicotine, cotinine, and epinephrine excretion in the urine than non-tobacco users. Renal function was assessed by glomerular filtration rate (GFR), levels of urea, and creatinine. Among the kidney function measures that we examined, microalbuminuria, decreased glomerular filtration rate, and creatinine clearance were found associated with gutkha and khaini users. Significantly decreased proteinuria, urea and increased levels of uric acid and creatinine excretion with the concomitant increase in plasma total proteins, urea, and decreased uric acid levels were observed in the group I and group II users compared to group III users. The products of smokeless tobacco are regarded as good predictors of assessing the free radical levels in the cells. The active markers of nitroxidative stress have been elevated progressively with the uptake of nicotine and exposure. The nicotine and cotinine were significantly positive correlated with renal markers (creatinine, urea, and GFR), nitric oxide, malondialdehyde, and epinephrine. Increased excretion of nicotine and epinephrine indicated that the renal related complications may occur. The smokeless tobacco products were significantly and directly proportional to the levels of kidney dysfunction.
Early Diagnosis of Kidney Damage Associated with Tobacco Use: Preventive Application
Journal of Personalized Medicine
Although long-term smoking has been associated with chronic kidney disease, its effect on kidney function in early stages has not been clarified. Therefore, the proposed objectives were: (1) to identify subclinical kidney damage in smokers, through a panel of biomarkers; (2) to evaluate the progression of subclinical kidney damage after two years of consumption in these patients; and (3) study whether quitting smoking reduces kidney damage. A prospective study was carried out (patients recruited from a primary care centre and a clinical smoking unit). Kidney function was assessed using a panel of biomarkers and compared between smokers and non-smokers, taking into account potential risk factors for kidney damage. These results show, for the first time in the literature, the relationship between smoking and early (subclinical) kidney damage and provide a panel of biomarkers capable of detecting this condition (Neutrophil gelatinase-associated lipocalin, Kidney injury molecule-1, N-ac...
Cigarette Smoking and Progression of IgA Nephropathy
American Journal of Kidney Diseases, 2010
Background: Multiple community-based cohort studies of mainly middle-aged and elderly populations have shown that cigarette smoking is a risk factor for chronic kidney disease. However, little information is available about an effect of cigarette smoking on progression of primary kidney diseases, including immunoglobulin A (IgA) nephropathy.
Role of Smoking as a Modifiable Risk Factor in Diabetic Nephropathy and Nondiabetic Nephropathy
IOSR Journals , 2019
Objective: To study the effect of smoking on development and progression of nephropathy in type II diabetic and non diabetic patients and to compare the effect of smoking on progression of nephropathy in above two groups. Material and methods-It was a cross sectional study done over a period of 2 years on total 120 subjects which were divided in 4 groups of 30 subjects each, Diabetic smokers, diabetic non smokers, non diabetic smokers and non diabetic non smokers. The main parameters assayed were: blood urea, serum creatinine, urine albumin creatinine ratio (ACR) , glomerular filtration rate (GFR) , fasting plasma glucose (FPG) and serum lipid profile. The parameters assayed in the different groups were compared .Logistic regression analysis was done to study the effect of smoking on renal function. Results: Mean difference of blood urea, serum creatinine, urinary ACR excretion between diabetic smokers and diabetic non smokers and also between non diabetic smokers and non diabetic non smokers was found to be statistically significant. As the number of pack years increased , mean ACR level also increased in both diabetic and non diabetic smokers. Mean difference of total cholesterol, triglycerides, HDL, LDL, and VLDL excretion between diabetic smokers and diabetic non smokers and also between non diabetic smokers and non diabetic non smokers was found to be statistically significant. On stepwise logistic regression analysis, overall derangement in renal function due to smoking in diabetics and in non diabetics came out to be 50.2%. and 49% respectively. Conclusion: Smoking increases risk of proteinuria and renalfunction deterioration in both diabetics as well as non diabetics. So, smoking is an independent risk factor in development and progression of diabetic as well as non diabetic nephropathy.
Renal Parameters in Mild, Moderate, and Chronic Cigarette Smokers
International Journal of Integrated Health Sciences
Objective: To explore the link between cigarette smoking and kidney function through renal parameter assessment. Methods: The present study was performed at the Department of Biochemistry Santosh Medical College, Ghaziabad, India, from September 2019 to April 2021. In this study, 140 subjects were included, out of which 35 were non-smokers, 35 smoked <5 cigarette per day, 35 smoked 5-10 cigarette per day, and the remaining 35 smoked more than 10 cigarettes per day. Results: Blood urea, serum creatinine, urinary albumin, and uACR levels were found to increase significantly (p<0.001) in smokers as compared to non-smokers. These increases were higher among chronic cigarette smokers (p<0.001) as opposed to mild and moderate smokers. In contrast, serum uric acid, e-GFR, and urinary creatinine levels decreased significantly (p<0.001) in smokers when compared to non-smokers, with a higher decrease observed in chronic cigarette smokers (p<0.001) as opposed to the mild and mod...
Cigarette smoking and cardio-renal events in patients with atherosclerotic renal artery stenosis
Journal of The American Society of Hypertension, 2015
Cigarette smoking causes cardiovascular disease and is associated with poor kidney function in individuals with diabetes mellitus and primary kidney diseases. However, the association of smoking on patients with atherosclerotic renal artery stenosis has not been studied. The current study utilized data from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL, NCT00081731) clinical trial to evaluate the effects of smoking on the risk of cardio-renal events and kidney function in this population. Baseline data showed that smokers (n = 277 out of 931) were significantly younger at enrollment than non-smokers (63.3±9.1 years vs 72.4±7.8 years; p<0.001). In addition, patients who smoke were also more likely to have bilateral renal artery stenoses and peripheral vascular disease (PVD). Longitudinal analysis showed that smokers experienced composite endpoint events (defined as first occurrence of: stroke; cardiovascular or renal death; myocardial infarction; hospitalization for congestive heart failure; permanent renal replacement; and progressive renal insufficiency defined as 30% reduction of GFR from baseline sustained for ! 60 days) at a substantially younger age compared to non-smokers (67.1±9.0 versus 76.1±7.9, p<0.001). Using linear regression and generalized linear modeling analysis controlled by age, sex, and ethnicity, smokers had significantly higher cystatin C levels (1.3±0.7 vs 1.2±0.9, p<0.01) whereas creatinine and estimated glomerular filtration rate (eGFR) were not different from non-smokers. From these data we conclude that smoking has a significant association with deleterious cardio-renal outcomes in patients with renovascular hypertension.