Smoking and Diabetic Nephropathy
In 1978, Christiansen reported that cigarette smoking is a risk factor for the development of diabetic nephropathy . He found a significantly higher prevalence of persistent proteinuria among patients who were or had been cigarette smokers. In a later study by Telmer et al. , the earlier findings were confirmed in a greater number and better characterised group of Type 1 diabetic patients. In 668 patients, the prevalence of diabetic nephropathy was significantly higher among heavy smokers (more than 10 cigarettes per day for more than 1 year) than among other patients, that is 19% vs. 12%. In addition, a higher frequency of clinical nephropathy was found with increasing cigarette consumption. Among patients who smoked a maximum of 10 cigarettes per day, about 13% had clinical diabetic nephropathy, whereas it was more than 25% among those patients who smoked 30 cigarettes per day. An association between smoking and nephropathy was also observed by Norden and Nyberg . They compared smoking habits in 47 matched pairs of Type 1 diabetic patients with and without nephropathy. Patients with nephropathy had a significantly higher smoking index than their controls. There were also more current smokers, more heavy smokers, and fewer individuals who had never smoked in the nephropathy group than in the control group. With respect to retinopathy, study results had been controversial . It is of note, that in these early studies glycosylated haemoglobin values had not been included into the analyses as a possible confounding factor.
KeywordsDiabetic Patient Diabetic Nephropathy Lupus Nephritis Nicotine Dependence Autonomic Neuropathy
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