Smoking may elevate chronic kidney disease risk
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Key takeaways:
- Current smoking status was associated with a 26% higher risk for CKD compared with never smoking.
- Lifetime smoking index suggested a 22% higher CKD risk for smokers.
Patients’ smoking behaviors may be associated with elevated risks for chronic kidney disease, but more data are needed, according to researchers.
Overall, “CKD is associated with increased risks of cardiovascular diseases and end-stage kidney disease, which could lead to reduced life expectancy and quality of life,” Zhilong Zhang, a master’s degree student at Peking University Health Science Center in Beijing, China, wrote with colleagues. Therapeutic options for CKD are limited, with management mostly “aimed at controlling diabetes, blood pressure and complications such as cardiovascular diseases, anemia and metabolic bone disease. Therefore, the identification of the risk factors for CKD and the corresponding preventing strategies are essential to alleviate the disease burden.”
Researchers used data from the U.K. Biobank of approximately 500,000 adults aged between 40 and 69 years. Patients in the study were recruited from 2006 to 2010 in 22 assessment centers. Researchers analyzed links between two smoking indices — current smoking status and lifetime smoking index — and the incidence of CKD stages 3 to 5.
Current smoking status was associated with a 26% higher CKD risk compared with never smoking 1.26 (HR = 1.26; 95%; CI, 1.22-1.3). The lifetime smoking index, which incorporates smoking intensity, duration, initiation and cessation, also suggested smokers were at higher risk for CKD (HR = 1.22; 95%; CI, 1.2-1.24).
In addition, in one- and two-sample Mendelian randomization analyses, Zhang and colleagues used genetic variants linked with the lifetime smoking index as instrumental variables. Of 344,255 adults of white British ancestry gathered from the Chronic Kidney Disease Genetics Consortium, findings showed no significant causal link between smoking and CKD risk. Genetic tools were validated by statistical tests.
“Our results emphasize the need for more detailed mediation analyses on large-scale, multi-ethnic datasets to fully understand the interplay between smoking and CKD,” Luxia Zhang, MD, MPH, professor in nephrology and researcher at Peking University Health Science Center, said in a press release. “While smoking remains a significant health risk factor, its direct role in CKD development requires further investigation.”
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