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Secondhand smoke exposure is associated with proteinuria in children with chronic kidney disease

Abiodun Omoloja1, Judith Jerry-Fluker, Derek K Ng

  • 1Department of Pediatrics, Wright State University, One Children's Plaza, Dayton, OH 45404, USA. omolojaa@childrensdayton.org

Pediatric Nephrology (Berlin, Germany)
|April 16, 2013
PubMed

Insights

Secondhand smoke (SHS) exposure is common in children with chronic kidney disease (CKD). SHS exposure was linked to an increased risk of nephrotic range proteinuria, suggesting it may impact CKD progression.

Area of Science:

  • Pediatric Nephrology
  • Environmental Health
  • Chronic Kidney Disease Research

Background:

  • Cigarette smoking increases CKD progression risk in adults.
  • Secondhand smoke (SHS) exposure is linked to elevated blood pressure in children.
  • No prior studies investigated SHS prevalence or effects in pediatric CKD.

Purpose of the Study:

  • To determine the prevalence of SHS exposure in children with CKD.
  • To assess the association between SHS exposure and proteinuria in pediatric CKD patients.

Main Methods:

  • 366 children (aged 1-16) with CKD from the CKiD Study were analyzed.
  • SHS exposure assessed via questionnaire and confirmed by urine cotinine (Ucot) levels.
  • Cross-sectional analysis of SHS exposure and proteinuria.

Main Results:

  • 22% of children with CKD showed evidence of SHS exposure via Ucot.
  • SHS exposure associated with lower maternal education, African American race, and higher prevalence of nephrotic range proteinuria and left ventricular hypertrophy.
  • Multivariate analysis revealed SHS-exposed children had 2.64 times higher odds of nephrotic range proteinuria.

Conclusions:

  • SHS exposure is prevalent (22%) in children with CKD.
  • SHS exposure is independently associated with nephrotic range proteinuria in this cohort.
  • SHS exposure may be a significant factor influencing CKD progression in children.
Abstract

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