Smoking and Kidney Disease
There are several studies linking smoking to the appearance (and in fact the appearance of CKD in the general population, e.g. to people without a risk factor for nephropathy) but also to the development of preexisting CKD. There is a greater impact in patients suffering from diabetic nephropathy or renal disease due to high blood pressure.
How does smoking affect kidney function?
The various mechanisms by which smoking exerts its adverse effects on renal function and exacerbate renal impairment are:
- Increased blood pressure
- Reduction of renal perfusion
- Increased production of various hormones that accelerate renal damage
In addition, smoking causes chronic kidney damage since:
- It narrows the blood vessels that bleed the kidneys as well as the small vessels in the kidneys
- Tobacco contains over 3000 to 4000 particles and gases, many of which are nephrotoxic on their own
- There are heavy metals in tobacco smoke
- The oxidative stress created directly causes kidney damage
- It reduces glomerular filtration rate over time
Is smoking related to the onset of CKD or its aggravation?
It is associated with its appearance and evolution. Tobacco smoke can even damage healthy kidneys without pre-existing kidney disease. In fact, this negative effect is also related to the number of cigarettes that individuals smoke. There has been a direct and independent association of tobacco with albuminuria (or proteinuria) incidence, a finding that links smoking with permanent renal damage. For every 5 cigarettes a person smokes per day, there is a relative risk of 30% for creatinine increase by 0.3 mg / dl over the next 3 years.
I suffer from CKD. Is smoking related to this?
Yes, as it accelerates renal damage and at the same time greatly increases cardiovascular risk (acute myocardial infarction, stroke) but also peripheral arterial occlusion.
I undergo dialysis. Is smoking related to this?
Smoking for dialysis patients greatly increases cardiovascular risk. It is an independent risk factor for calcification and hardening of the vessels, that is, only its existence can increase all the above risks, regardless of other known risk factors (diabetes mellitus, hypertension etc). It is also associated with emerging cardiac failure and emerging peripheral vascular obstructive disease.
Is quitting smoking beneficial for me as far CKD is concerned?
Naturally, in addition to the known benefits of stopping smoking for lung diseases, heart disease, etc., evidence suggests that quitting smoking causes a slowdown in CKD, reducing the rate of creatinine growth, and reducing the amount of albumin (as a risk factor).
What are the next steps;
Consult your doctor and decide to quit smoking. This is the first important step. Then with your doctor you will find the proper way for you to get rid of this harmful habit.
By the Scientific Director Aristides Paraskevopoulos
1.Elihimas Júnior UF, Elihimas HC, Lemos VM, Leão Mde A, Sá MP, França EE, Lemos A, Valente LM, Markman Filho B. Smoking as risk factor for chronic kidney disease: systematic review. J Bras Nefrol. 2014 Oct-Dec;36(4):519-28. doi: 10.5935/0101-2800.20140074. Review.
2.Mora-Fernández C, Domínguez-Pimentel V, de Fuentes MM, Górriz JL, Martínez-Castelao A, Navarro-González JF. Diabetic kidney disease: from
physiology to therapeutics. J Physiol. 2014 Sep 15;592(18):3997-4012. doi: 10.1113/jphysiol.2014.272328. Epub 2014 Jun 6. Review.
3.Wong CW, Wong TY, Cheng CY, Sabanayagam C. Kidney and eye diseases: common risk factors, etiological mechanisms, and pathways. Kidney Int. 2014 Jun;85(6):1290-302. doi: 10.1038/ki.2013.491. Epub 2013 Dec 11. Review.
4.Jain G, Jaimes EA. Nicotine signaling and progression of chronic kidney disease in smokers. Biochem Pharmacol. 2013 Oct 15;86(8):1215-23. doi: 10.1016/j.bcp.2013.07.014. Epub 2013 Jul 26. Review. PubMed PMID: 23892062;
5.Tsioufis C, Tatsis I, Thomopoulos C, Wilcox C, Palm F, Kordalis A, Katsiki N, Papademetriou V, Stefanadis C. Effects of hypertension, diabetes mellitus, obesity and other factors on kidney haemodynamics. Curr Vasc Pharmacol. 2014 May;12(3):537-48. Review.
6.Nagasawa Y, Yamamoto R, Rakugi H, Isaka Y. Cigarette smoking and chronic kidney diseases. Hypertens Res. 2012 Mar;35(3):261-5. doi: 10.1038/hr.2011.205. Epub 2011 Dec 8. Review.
7.Jones-Burton C, Seliger SL, Scherer RW, Mishra SI, Vessal G, Brown J, Weir MR, Fink JC. Cigarette smoking and incident chronic kidney disease: a systematic review. Am J Nephrol. 2007;27(4):342-51. Epub 2007 May 23. Review.
8.Bleyer AJ, Shemanski LR, Burke GL, Hansen KJ, Appel RG: Tobacco, hypertension, and vascular disease: Risk factors for renal functional decline in an older population. Kidney Int57 :2072– 2079,2000