Tobacco and end stage diabetic nephropathy.

Markedly increased renal disease mortality and incidence of renal replacement therapy among IDDM patients in Japan in contrast to Allegheny County, Pennsylvania, USA

“…However, there is no data available for comparison of glycaemic control between Japan and the USA. Other environmental factors such as treatment for hypertension, cigarette smoking [21], high protein diet [22], and salt intake [17] can have an impact on the difference in frequency of ESRD. In terms of host susceptibility to ESRD, there appear to be many related factors; for example, 1) differences in genetic susceptibility to hypertension, 2) differences in genetic susceptibility to diabetic renal disease, 3) genetic differences in the rate for progression of renal disease to ESRD [22][23][24][25][26][27][28].…”

Smoking and Progression of Diabetic Nephropathy in Type 1 Diabetes

“…Prospective studies have supported the concept that cigarette smoking is of importance in the development of microalbuminuria (8 -10,20). Although some cross-sectional studies initially failed to demonstrate a relationship between smoking and overt diabetic nephropathy (21,22), several other cross-sectional (12)(13)(14) as well as prospective studies (15,16,20) have found an association. Therefore, the available data suggest an association between cigarette smoking and development of diabetic nephropathy.…”

“…To obtain valid determination of the rate of decline in GFR, the following requirements should be fulfilled: the applied GFR method should have good accuracy and precision, repeated measurements of GFR should be performed (approximately every 6 -12 months), and the observation period should be extended to at least 2 years (25). These requirements have been fulfilled in our study, in which the follow-up time was 7 years (range [3][4][5][6][7][8][9][10][11][12][13][14].…”

“…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.…”

Smoking and the Kidney

“…The available literature documents that smoking (1) increases the risk to develop microalbuminuria (14,20 -30), (2) accelerates the rate of progression from microalbuminuria to manifest proteinuria (31)(32)(33)(34)(35)(36), and (3) accelerates progression of renal failure (32,(37)(38)(39)(40).…”