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The Role of Smoking as a Modifiable Risk Factor in Diabetic Nephropathy
M Jija Jose1, Vipin Varkey2, R Chandni3
1Assistant Professor, Department of Physiology, Medical College, Kozhikode.
The Journal of the Association of Physicians of India
|October 21, 2016
Summary
Smoking significantly impacts kidney function in type 2 diabetes. Smokers with diabetes show higher urine protein-creatinine ratio and serum creatinine, indicating accelerated diabetic nephropathy progression.
Area of Science:
- Nephrology
- Endocrinology
- Public Health
Background:
- Type 2 diabetes mellitus (T2DM) is a leading cause of chronic kidney disease.
- Diabetic nephropathy is a major complication, and risk factors require identification.
- Smoking is a known contributor to cardiovascular and renal disease.
Purpose of the Study:
- To investigate the relationship between smoking and abnormal renal function in individuals with T2DM.
- To assess renal function markers and lipid profiles in diabetic and non-diabetic smokers and non-smokers.
Main Methods:
- A comparative study involving 160 subjects divided into four groups: diabetic smokers, diabetic non-smokers, non-diabetic smokers, and non-diabetic non-smokers.
- Assessed parameters included urine protein-creatinine ratio, blood urea, serum creatinine, fasting blood glucose, and serum lipid profile.
- Logistic regression analysis was employed to determine the effect of smoking on renal function.
Main Results:
- Diabetic smokers exhibited significantly higher urine protein-creatinine ratios and serum creatinine levels compared to non-diabetic smokers.
- Statistically significant differences were observed in blood urea and all measured serum lipid profile parameters (Total Cholesterol, Triglycerides, HDL, LDL, VLDL) across the study groups.
- Regression analysis indicated that smoking alone accounted for 12.9% of the alteration in renal function (R² = 0.129).
Conclusions:
- Smoking is identified as an independent risk factor for the progression of diabetic nephropathy.
- Smoking, obesity, hypertension, and dyslipidemia collectively explained 24.8% of renal function deterioration.
- Targeting smoking cessation is crucial for managing and preventing kidney disease progression in diabetic patients.
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