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Jackson Heart Study: Smoking linked with rapid renal function decline in black adults
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Researchers have found an independent association between cigarette smoking and rapid renal function decline in black participants of the Jackson Heart Study, particularly among current smokers and those who smoke a high number of cigarettes per day.
“Cardiovascular and kidney diseases are closely linked, but few people are aware of the impact of smoking on kidney function,” Michael Hall, MD, assistant professor of medicine at the University of Mississippi Medical Center, said in a press release. “It’s important for those who have risk factors for kidney disease to realize that smoking is a significant risk factor and could ultimately end up leading to dialysis.”
Michael Hall
The researchers determined rates of rapid renal function decline among 3,648 black participants of the Jackson Heart Study, who ranged in age from 21 to 84 years at baseline and completed three questionnaires over 12 years.
After the researchers adjusted for age, sex, BMI, physical activity, hypertension, cholesterol, diabetes, education, alcohol consumption and existing CVD, they found:
Current smokers had an 83% higher incidence of rapid renal function decline compared with those who never smoked (incidence rate ratio [IRR] = 1.83; 95% CI, 1.31-2.56).
Current smoking of 1 to 19 cigarettes per day was associated with a 75% greater decline in rapid renal function (IRR = 1.75; 95% CI, 1.18-2.59) and 20 or more cigarettes per day was associated with a 97% greater decline in rapid renal function (IRR = 1.97; 95% CI, 1.17-3.31).
Current smoking was associated with a 1.38-fold increase in C-reactive protein compared with participants who never smoked.
Black adults are disproportionately affected by chronic kidney disease and may be susceptible to potential adverse effects of smoking to the kidneys. Other research has shown that while black adults are less likely to smoke than white adults, their metabolism of substances in cigarettes also differs compared with other racial/ethnic groups.
“We should be aggressive with screening patients who have risk factors for kidney disease by finding out if they smoke and, if so, encourage them to quit or cut back as much as possible if they can’t quit, because there does seem to be a dose-dependent effect, meaning patients who smoke more are at higher risk for having worsening kidney injury over time,” Hall said. – by Dave Quaile
Disclosure: This research is part of a multicenter collaboration for the American Heart Association Tobacco Regulation and Addiction Center. Research reported in this work was supported by a grant from the National Heart, Lung and Blood Institute and the FDA Center for Tobacco Products.
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