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The Relationship between Cigarette Smoking and Renal Function: A Large Cohort Study
Yoav Hammer1, Eytan Cohen1, Amos Levi1
1Department of Internal Medicine F-Recanati, Rabin Medical Center (Beilinson Campus), Petah Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Current cigarette smoking is linked to higher estimated glomerular filtration rate (eGFR) and proteinuria, particularly in males. Past smoking is associated with a lower eGFR, suggesting potential long-term renal impact.
Area of Science:
- Nephrology
- Cardiovascular Health
- Public Health
Background:
- Cigarette smoking and chronic kidney disease (CKD) are established risk factors for cardiovascular disease and atherosclerosis.
- The precise impact of smoking on renal function remains incompletely understood.
Purpose of the Study:
- To examine the association between cigarette smoking and renal function.
- To determine if smoking intensity affects renal function.
Main Methods:
- Retrospective analysis of 24,081 participants from a screening center.
- Classification of subjects into current smokers, non-smokers, and past smokers.
- Renal function assessed using CKD-EPI equation for estimated glomerular filtration rate (eGFR); multivariate and gender-based analyses performed.
Main Results:
- Current smokers exhibited a significantly higher eGFR (100.8) than non-smokers (98.7) (P < 0.001).
- Proteinuria rates were higher in current smokers (15.3%) compared to non-smokers (9.3%) (P < 0.001).
- The eGFR difference between smokers and non-smokers was more pronounced in males; past smokers showed the lowest eGFR.
Conclusions:
- Cigarette smoking correlates with elevated eGFR and increased proteinuria, suggesting a potential hyperfiltration mechanism.
- Gender-based differences in the smoking-renal function relationship were observed, with males showing a more pronounced effect.
- Past smoking is linked to reduced eGFR, indicating potential progressive renal damage over time.
Background:
Both cigarette smoking and chronic kidney disease (CKD) are linked to cardiovascular morbidity and development of atherosclerosis. However, the relationship between cigarette smoking and renal function is not clearly understood.
Objectives:
To investigate the relationship between cigarette smoking and renal function, and determine whether the intensity of cigarette smoking influences renal function.
Methods:
We conducted a retrospective analysis of subjects attending the screening center at the Rabin Medical Center. Subjects were classified as smokers, non-smokers and past smokers. Renal function was evaluated by means of the CKD-EPI equation for estimating glomerular filtration rate (eGFR). Multivariate and gender-based analyses were performed.
Results:
The study population comprised 24,081 participants, of whom 3958 (17%) were classified current smokers, and 20,123 non-smokers of whom 4523 were classified as past smokers. Current smokers presented a higher eGFR compared to the non-smoking group (100.8 vs. 98.7, P < 0.001) as well as higher rates of proteinuria (15.3% vs. 9.3%, P < 0.001). The difference in eGFR between smokers and non-smokers was more significant in males than in females. Past smokers had the lowest eGFR of all groups, this difference remained significant after age adjustments (P = 0.005).
Conclusions:
Cigarette smoking is associated with higher eGFR compared to non-smoking. This difference was more pronounced in males than females, implying a gender-based difference. The higher prevalence of proteinuria in smokers suggests a mechanism of hyperfiltration, which might result in future progressive renal damage.
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