Smoking as a risk factor for end-stage renal failure in men with primary renal disease

Orth, Stephan R.; Stöckmann, Axel; Conradt, Christian; Ritz, Eberhard; Ferro, Mariza; Kreußer, W.; Piccoli, G; Rambausek, M; Roccatello, D; Schäfer, Katrin; Sieberth, H. G.; Wanner, Christoph; Watschinger, Bruno; Zucchelli, P

doi:10.1046/j.1523-1755.1998.00067.x

Cited by 271 publications

(196 citation statements)

References 20 publications

(18 reference statements)

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“…In an observational study of patients with nondiabetic kidney disease, the risk of developing end-stage renal disease was increased in patients on conventional antihypertensive therapy, whereas patients taking ACE inhibitors were protected (30). In our long-term prospective observational study, we could not demonstrate a difference in the rate of decline in GFR in smokers with and without ACE inhibitor therapy.…”

Section: Discussioncontrasting

confidence: 74%

Smoking and Progression of Diabetic Nephropathy in Type 1 Diabetes

Hovind

Rossing²,

Tarnow³

et al. 2003

Diabetes Care

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OBJECTIVE -Cigarette smoking contributes to development of diabetic nephropathy. However, long-term studies on the effect of smoking on decline in kidney function in diabetic nephropathy are lacking. We assessed the impact of smoking on progression of diabetic nephropathy in type 1 diabetic patients enrolled in a prospective observational cohort study started in 1983.RESEARCH DESIGN AND METHODS -We identified all albuminuric type 1 diabetic patients (n ϭ 301) followed for at least 3 years, median (range) 7 years (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), who underwent at least yearly measurement of glomerular filtration rate (GFR) by the 51 Cr-EDTA plasma clearance technique (n ϭ 8, range 3-24). In total, 192 men and 109 women were included (age [mean Ϯ SD] 36 Ϯ 11 years, duration of diabetes 22 Ϯ 8 years); 271 patients were treated with antihypertensive drugs, predominantly ACE inhibitors in 179 patients. Patients were classified as smokers if they smoked more than one cigarette per day during a portion of or the entire observation period. Blood pressure, albuminuria, HbA 1c , and serum cholesterol were measured every 3-4 months during the study. RESULTS -In all 301 patients, the mean (SE) rate of decline in GFR (⌬GFR) was 4.0 (0.2) ml ⅐ min -1 ⅐ year -1 during the investigation period. No difference in ⌬GFR was demonstrated between nonsmokers (n ϭ 94), ⌬GFR 4.5 (0.4), ex-smokers (n ϭ 31), ⌬GFR 3.1 (0.7), and smokers (n ϭ 176), ⌬GFR 3.9 (0.3) ml ⅐ min -1 ⅐ year -1 , respectively (NS). Adjustment for other risk factors for progression of diabetic nephropathy did not alter the results: smoking was not associated with ⌬GFR, whereas blood pressure, albuminuria, HbA 1c , and serum cholesterol were demonstrated to be independent progression promoters.CONCLUSIONS -In our study, smoking was not associated with decline in kidney function in type 1 diabetic patients with diabetic nephropathy. Diabetes Care 26:911-916, 2003

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Section: Discussioncontrasting

confidence: 74%

Smoking and Progression of Diabetic Nephropathy in Type 1 Diabetes

Hovind

Rossing²,

Tarnow³

et al. 2003

Diabetes Care

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“…The available data on this issue are limited, however. A retrospective case-control study in patients with IgA glomerulonephritis and autosomal dominant polycystic kidney disease was the first to document an increased risk for ESRD in the 144 male patients investigated (38). The risk increased with the amount of cigarettes consumed over time.…”

Section: Patients With Primary Hypertension or Primary Renal Diseasementioning

confidence: 99%

Smoking

Orth

Hallan²

2008

Clinical Journal of the American Society of Nephrology

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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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“…Among studies investigating the relationship between smoking and CKD in patients with primary glomerulonephritis, the report by Orth et al 19 is the most well-known and one of the earliest. In this study, 54 patients with IgA nephropathy and 48 patients with autosomal dominant polycystic kidney disease were compared with 102 control cases, whose creatinine level stayed under 3 mg dl À1 during the observation period, matched by original kidney disease, sex, age and residence.…”

Section: Smoking and Ckd In Patients With Primary Glomerulonephritismentioning

confidence: 99%

Cigarette smoking and chronic kidney diseases

et al. 2011

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Observational studies have suggested that different chronic kidney diseases (CKDs) have differing relationships to smoking, but no randomized controlled trial has been conducted to examine this topic. In this article, we review available evidence concerning the relationship between smoking and each type of CKD in the general population as well as in patients with diabetes mellitus (DM), hypertension (HT), primary glomerulonephritis and kidney transplants. There is good evidence of a relationship between smoking and CKD in patients with IgA nephropathy and kidney transplant recipients, but not in patients with DM or HT. Interestingly, it has been reported that the effect of smoking on CKD progression varies depending on the CKD stage. This variation might indicate a cumulative effect of smoking, possibly through oxidative stress. A better understanding of the relationship between smoking and CKD would be useful for nephrologists.

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Smoking as a risk factor for end-stage renal failure in men with primary renal disease

Abstract: Smoking increases the risk of ESRF in men with inflammatory and non-inflammatory renal disease.

Cited by 271 publications

References 20 publications

Smoking and Progression of Diabetic Nephropathy in Type 1 Diabetes

Smoking and Progression of Diabetic Nephropathy in Type 1 Diabetes

Smoking

Cigarette smoking and chronic kidney diseases

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