Effects of Smoking on Systemic and Intrarenal Hemodynamics

Orth, Stephan R.

doi:10.1097/01.asn.0000093461.36097.d5

Cited by 115 publications

(109 citation statements)

References 53 publications

(43 reference statements)

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“…210 Finally, with a higher daily number of cigarettes smoked or a longer duration of smoking the risk of developing hypertension increases. [211][212][213] Consequently, it is logical to assume that beyond its own specific mechanisms of inducing hypoxiamediated CDK, cigarette smoking also utilizes those manifest in hypertension.…”

Section: Hypertensionmentioning

confidence: 99%

Hypoxia: The Force that Drives Chronic Kidney Disease

Colgan

Shelley

2016

Clinical Medicine & Research

125

111

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In the United States the prevalence of end-stage renal disease (ESRD) reached epidemic proportions in 2012 with over 600,000 patients being treated. The rates of ESRD among the elderly are disproportionally high. Consequently, as life expectancy increases and the baby-boom generation reaches retirement age, the already heavy burden imposed by ESRD on the US health care system is set to increase dramatically. ESRD represents the terminal stage of chronic kidney disease (CKD). A large body of evidence indicating that CKD is driven by renal tissue hypoxia has led to the development of therapeutic strategies that increase kidney oxygenation and the contention that chronic hypoxia is the final common pathway to end-stage renal failure. Numerous studies have demonstrated that one of the most potent means by which hypoxic conditions within the kidney produce CKD is by inducing a sustained inflammatory attack by infiltrating leukocytes. Indispensable to this attack is the acquisition by leukocytes of an adhesive phenotype. It was thought that this process resulted exclusively from leukocytes responding to cytokines released from ischemic renal endothelium. However, recently it has been demonstrated that leukocytes also become activated independent of the hypoxic response of endothelial cells. It was found that this endothelium-independent mechanism involves leukocytes directly sensing hypoxia and responding by transcriptional induction of the genes that encode the β2-integrin family of adhesion molecules. This induction likely maintains the long-term inflammation by which hypoxia drives the pathogenesis of CKD. Consequently, targeting these transcriptional mechanisms would appear to represent a promising new therapeutic strategy.

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Section: Hypertensionmentioning

confidence: 99%

Hypoxia: The Force that Drives Chronic Kidney Disease

Colgan

Shelley

2016

Clinical Medicine & Research

125

111

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“…Chronic smoking damages the kidney by causing a loss of filtration rate and contributes to kidney failure. 77,78 In fact, smoking is also correlated with albuminuria in healthy individuals. 78 As even mild renal insufficiency leads to collagen accumulation in elastic arteries as well as calcification, 79 these smoking-induced alterations in kidney function increase arterial stiffness by altering the structure of the arteries.…”

Section: Mechanismsmentioning

confidence: 99%

The effect of smoking on arterial stiffness

et al. 2010

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A systematic literature review was conducted using PubMed, Embase and the Cochrane Library to determine the effect of acute, chronic and passive smoking on arterial stiffness and to determine whether these effects are reversible after smoking cessation. A total of 39 relevant studies were identified and included. Acute smoking was found to cause an acute increase in arterial stiffness. Similarly, passive smoking increased arterial stiffness acutely and chronically. The majority of studies identified chronic smoking as a risk factor for increasing arterial stiffness. However, some studies found no statistical difference in arterial stiffness between nonsmokers and long-term smokers, although chronic smoking seems to sensitize the arterial response to acute smoking. In addition, whether arterial stiffness is reversed after smoking cessation and the timeline in which this may occur could not be determined from the identified literature. The effect of smoking discontinuation on arterial stiffness remains to be established by prospective smoking cessation trials.

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“…BP and heart rate are increased by smoking, which for the major part is due to the action of nicotine (for review, see reference [10]). Because increased BP is one of the most important factors promoting progression of CKD, it is likely to play an important role in mediating smoking-induced renal damage.…”

Section: Hemodynamic Mechanisms As Potential Mediators Of Smoking-indmentioning

confidence: 99%

“…This has pre- viously been reviewed in detail (10). In brief, the data available led to the hypothesis of increased glomerular pressure induced by smoking as a result of impaired renal autoregulation, at least in patients with renal disease.…”

Section: Hemodynamic Mechanisms As Potential Mediators Of Smoking-indmentioning

confidence: 99%

Smoking

Orth

Hallan²

2008

Clinical Journal of the American Society of Nephrology

251

174

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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.

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Effects of Smoking on Systemic and Intrarenal Hemodynamics

Cited by 115 publications

References 53 publications

Hypoxia: The Force that Drives Chronic Kidney Disease

Hypoxia: The Force that Drives Chronic Kidney Disease

The effect of smoking on arterial stiffness

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