Abstract
Introduction
Cigarette smoking is one of the most important life-modifiable risk factors for CVD events. The effect on CKD progression caused by smoking remained uncertain, while the effect on CVD had been established.
Method
The study population included participants from the specific health check and specific health guidance, an annual health check-up for all inhabitants of Japan who were aged between 40 and 74 years. 149,260 subjects (male, 37.1%; female, 62.9%) were included in this analysis.
Results
The relationship between smoking status along with new-onset proteinuria and eGFR deterioration more than 15 mL/min/1.73 m2 was examined. Median observation periods were 1427 days [738, 1813] in males and 1437 days [729, 1816] in females. In male participants, the strongest factor upon kidney dysfunction was new-onset proteinuria (1.41 [1.31 1.51], P < 0.001). The second strongest factor on kidney deterioration was smoking (1.24 [1.16 1.31], P < 0.001). In female participants, strongest factor upon kidney dysfunction was smoking (1.27 [1.16–1.39], P < 0.001). The second strongest factor on kidney deterioration was new-onset proteinuria (1.26 [1.17 1.36], P < 0.001). To reveal the relationship of effects from new-onset proteinuria and smoking on the kidney function, the participants were divided into four groups with and without new-onset proteinuria and smoking. The group with both proteinuria and smoking had significantly worst renal prognosis (P for trend < 0.001).
Conclusion
Large longitudinal observation study revealed smoking has an evil effect on the progression of CKD. This evil effect could be observed in CKD patients with proteinuria as well as in general population without new-onset proteinuria.
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Data is not open to public.
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10157_2024_2487_MOESM1_ESM.pptx
Supplemental figure 1. The time-dependent outcomes of new onset proteinuria in the male participants according to smoking status. New-onset proteinuria in smoker was significantly higher than that in non-smoker both in male participants, although the differences between in smoker and in non-smoker were relatively small. Supplemental figure 2. The time-dependent outcomes of new onset proteinuria in the female participants according to smoking status. New-onset proteinuria in smoker was significantly higher than that in non-smoker both in male participants, although the differences between in smoker and in non-smoker were relatively small. Supplementary file1 (PPTX 485 KB)
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Matsumoto, A., Nagasawa, Y., Yamamoto, R. et al. Cigarette smoking and progression of kidney dysfunction: a longitudinal cohort study. Clin Exp Nephrol (2024). https://doi.org/10.1007/s10157-024-02487-6
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DOI: https://doi.org/10.1007/s10157-024-02487-6