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Does Smoking Affect Kidney Function

The Effects Of Nicotine On Kidneys

How Does Smoking Affect Your Kidneys?

Nicotine can cause many health problems. It can temporarily raise blood pressure and heart rate because it causes blood vessels to narrow. Nicotine can also make the blood more likely to clot and block an artery, and it can cause damage to the lungs and make breathing difficult. Nicotine in the body is first processed by the liver and then excreted by the kidneys. Over time nicotine can have negative effects on the kidneys.

Who Should Not Take This Medication

Do not take this medication if you are allergic to varenicline or any ingredients of the medication.

Do not take varenicline if you are using nicotine replacement therapy such as patches, gum, or the nicotine inhaler. Combining varenicline and nicotine replacement therapy may cause more side effects than with varenicline alone and is unlikely to improve your chances of quitting.

Smoking May Negatively Impact Kidney Function Among Adolescents

Exposure to tobacco smoke could negatively impact adolescent kidney function this is according to a new study led by a team of researchers at the Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins Childrens Center. They examined the association between exposure to active smoking and kidney function among U.S. adolescents and found the effects of tobacco smoke on kidney function begin in childhood. The results are featured in the April 2013 issue of Pediatrics.

Tobacco use and exposure to secondhand tobacco smoke are major health problems for adolescents, resulting in short-term and long-term adverse health effects, said Ana Navas-Acien, MD, PhD, senior author of the study and an associate professor with the Bloomberg Schools Department of Environmental Health Sciences. In this nationally representative sample of U.S. adolescents, exposure to tobacco, including secondhand smoke and active smoking, was associated with lower estimated glomerular filtration ratesa common measure of how well the kidneys are working. In addition, we found a modest but positive association between serum cotinine concentrations, a biomarker of tobacco exposure, among first-morning albumin to creatinine ratio. These findings further support the conclusion that tobacco smoke may damage the kidneys.

Media contact for Johns Hopkins Bloomberg School of Public Health: Natalie Wood-Wright at 410-614-6029 or.

Johns Hopkins Bloomberg School of Public Health

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What Is The Relationship Between Smoking And Renal Function

Smoking is an independent risk factor for renal failure smokers are four times more likely to develop renal failure compared to non-smokers.

Smoking increases heart rate, blood pressure, blood clot formation and promotes fatty deposits in the arteries. These are some of the most likely smoking related processes which can lead to renal function being affected.

Compared to non-smokers, smokers have an increased risk of the following:

  • protein in urine
  • diabetic related kidney damage and almost double the rate of progression to end-stage renal failure
  • twice more likely to develop kidney cancer compared to non-smokers .

Does Smoking Affect Your Kidneys

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Smokers and people who breathe secondhand smoke increase their risk of developing diseases and conditions that can lead to CKD or make it worse. Cardiovascular disease, which can be caused by smoking, does terrible things to your bodys veins and arteries.7 Damage to your cardiovascular system can directly harm your kidneys, affecting their ability to filter your blood. Examples of these harmful effects include:

  • Peripheral arterial disease, which narrows blood vessels, including those in the kidneys
  • Arteriosclerosis, which thickens and hardens arteries, including renal arteries
  • Heart disease
  • A weakened immune system
  • Interference with blood pressure medications4
  • Asthma attacks
  • Sudden infant death syndrome
  • Ear infections and respiratory problems in children
  • Health problems in newborns

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Regardless, cannabinoids have demonstrated their effectiveness in helping treat symptoms associated with kidney disease including anorexia/cachexia, insomnia, anxiety, depression, and pruritis. Chronic pain is another common symptom associated with kidney disease, which can be treated with THC. It has been found that THC acts as an analgesic in addition to containing anti-emetic, anti-nausea, appetite stimulating, and muscle relaxant properties. Additionally, several clinical studies have discovered that sleep quality significantly improved in patients who consumed cannabinoids to treat chronic pain and intractable pruritis.

Speaker: Cannabis Can Benefit Patients With Kidney Disease

Miller Hedin L. Session #232. Presented at: American Nephrology Nurses Association National Symposium Aug. 29-31, 2020 .

Disclosures: We were unable to process your request. Please try again later. If you continue to have this issue please contact .

Cannabis has been long misunderstood as a dangerous narcotic by federal regulators and has medicinal value for patients with chronic kidney disease, a speaker at the American Nephrology Nurses Associations National Symposium said.

We have been terribly and systemically misled in the United States for the last 70 years about the dangers of cannabis, Lisa Miller Hedin, BSN, RN, told attendees. We are in a paradigm shift, and I can tell you is not going away.

As nurses, we need to be responsible and find out if our patients are taking it and how we can treat them safely, she said.

Cannabis was first used as a popular medicine by people in China in 1900 BC, she told attendees. Egyptians used it for glaucoma, inflammation and enemas, and in India, around 1000 BC, a drink of cannabis and milk called bhang was used as an anesthetic.

Lisa Miller Hedin

Due to its historical connection to Mexican immigrants after the Mexican Revolution of 1910, when immigrants came into the United States in large numbers,we really try to stay away from use of the word marijuana, unless we are talking about the marijuana plant, Miller Hedin said. It really is a racist word.

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What Was Known Before

Synthetic cannabinoids such as dronabinol and nabilone have been approved for a wide range of indications such as HIV/AIDS-induced anorexia, chemotherapy-induced nausea and vomiting, and neuropathic pain. Although nonsynthetic cannabinoids have been used for a plethora of therapeutic claims, the evidence to support these indications has not been well reviewed, particularly with respect to chronic kidney disease.

Smoking And Cardiovascular Disease And Mortality Risk In Renal Patients

Cigarettes & Smoking Cause Further Kidney Damage & Loss Of Kidney Function

Mortality is high in patients with CKD and outnumbers that observed in the general population by a factor of 10 to 20, with > 50% of this excess burden being attributable to CVD . The association between smoking and cardiovascular mortality has been documented beyond any doubt in the general population . In contrast, the data available in patients with CKD are limited. Because the cardiovascular risk increases with the degree of renal function impairment , we discuss patients who have CKD and are in the predialysis phase and patients who have CKD with ESRD that requires dialysis separately. Finally, the specific situation of patients after renal transplantation is addressed.

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The Effects Of Smoking On Progression In Patients With Nondiabetic Renal Disease

Recently, Kasiske and Klinger noted higher graft loss in renal transplanted patients in his retrospective analysis, this was accounted for by cardiovascular death with functioning grafts. In an ongoing prospective study, this issue is currently addressed by us in collaboration with G. Opelz , but a preliminary retrospective analysis of Opelz suggests that smoking by itself adversely affects late graft function, even if corrections are made for cardiovascular death .

Table1.

Tobaccoassociated risk to be in endstage renalfailure in male patients with IgA glomerulonephritis andautosomal dominant polycystic kidney disease .

Packyears

Smoking And Kidney Disease

Smoking can seriously harm the kidneys in a number of ways. It can:

  • increase your risk of developing some kidney cancers
  • damage your heart and blood vessels , leading to poor blood flow to the kidneys and causing kidney damage over time. Cardiovascular damage can also increase your risk of stroke and heart attack
  • help to cause or advance diabetic kidney disease the most common cause of kidney failure.
  • it can lead to surges in blood pressure

Kidney disease and its associated complications can kill thats why its so important to stop smoking.

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How Does This Medication Work What Will It Do For Me

Varenicline belongs to the class of medications called smoking cessation therapies. It is used to help people quit smoking when nicotine replacement therapy has not been effective or is not appropriate. Varenicline is intended to be used by adults in combination with quit-smoking education and counselling.

Varenicline works in the brain to reduce cravings and withdrawal symptoms. It also decreases the pleasure that people get from smoking. It is thought to have these effects by working at the same receptors that nicotine from cigarettes affects, although how varenicline exactly works is not clear.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it. Do not stop taking this medication without consulting your doctor.

Quitting For A Healthier Outcome

Does abnormal kidney function affect heart failure?

Whether you currently have kidneydisease, or are at risk of developing it, its important that you quit smoking. Doing away with tobacco products might seem like a difficult task, but with todays cessation aids, most anyone can quit successfully. Be sure to discuss patches, gum or prescription medications with your doctor before use, to ensure the aid you choose is compatible with your condition.

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Adverse Effects Of Marijuana

The adverse effect of marijuana can be described in 3 general themes: behavioral, respiratory, and effects in other body systems. With respect to adverse effects in patients with ESRD, cognitive impairment is of concern for home dialysis patients and those driving to a dialysis center. Also concerning is the association of an increased mortality post-myocardial infarction , and respiratory complications, as described below.

With regard to the respiratory system, cannabis can be an irritant, leading to chronic bronchitis. When combined with tobacco use, dyspnea, hoarseness, chronic obstructive pulmonary disease , or pharyngitis have been noted., When smoked, cannabis has been associated with tumors of the upper respiratory tract, gastrointestinal tract, lungs, bladder, and nasopharyngeal area. It is not associated with head and neck tumors . All-cause mortality is affected by motor vehicle accidents and tumors attributed to cannabis but the data are from systematic reviews of case reports . Evidence of other effects on the respiratory system, skin, mucosa and on the immune system are rated at a level 4.

Current Kidney Disease Treatments

To determine if someone has kidney disease or poor kidney function, a physician can administer different tests to find out whats going on. Once someone is diagnosed with kidney disease, its common to experience chronic pain alongside other physical and emotional symptoms. Many physicians prescribe painkillers like opioids to their patients as a form of pain management. However, opioids can cause and/or intensify additional adverse effects of the disease including nausea, insomnia, anorexia, and pruritis. These adverse effects can negatively impact a patients quality of life and overall well-being. Depending on the severity of the disease though, some patients undergo dialysis or a kidney transplant.

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Can Hbp Cause Kidney Failure

Your kidneys and your circulatory system depend on each other for good health. The kidneys help filter wastes and extra fluids from blood, and they use a lot of blood vessels to do so. When the blood vessels become damaged, the nephrons that filter your blood dont receive the oxygen and nutrients they need to function well. This is why high blood pressure is the second leading cause of kidney failure. Over time, uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden. These damaged arteries are not able to deliver enough blood to the kidney tissue.

The Effects Of Smoking On Development And Progression Of Diabetic Nephropathy

Smoking and Kidney Disease Damage and How To Quit. Cigarettes Are Damaging To The Kidneys.

Diabetologists were the first to notice that patients with type 1 diabetes who smoked had more frequently microalbuminuria and overt diabetic nephropathy , a finding that meanwhile has been confirmed by numerous subsequent investigators . Smoking increases the risk to develop microalbuminuria , shortens the interval from microalbuminuria to overt nephropathy and accelerates progression of nephropathy and loss of GFR. Biesenbach et al. noted that the rate of loss of measured endogenous creatinine clearance was nearly twice as high in smoking compared to nonsmoking type 1 or type 2 diabetic patients: the rate of loss of GFR in patients with type 1 diabetes was 0.86±0.31ml/min/month in nonsmokers, but 1.24±0.29ml/min/month in smokers the respective values for patients with type 2 diabetes were similar, i.e. 0.73±0.38ml/min/month and 1.21±0.34ml/min/month.

Matters are somewhat more complex in type 2 diabetes, since smoking also increases the risk of subjects to develop type 2 diabetes, possibly because it increases insulin resistance . Nevertheless, the risk of smokers to develop microalbuminuria and acceleration of the progression of nephropathy has been equally well documented in type 2 as in type 1 diabetes.

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Purpose Of The Kidneys & Possible Causes Of Kidney Disease

For those who dont know, the main purpose of our kidneys is to clean our blood through the removal of excess fluid, minerals, and waste. Our kidneys also help keep the body clean and free from toxic compounds including byproducts accumulated from chemical consumption, digestion, and even muscle activity. Additionally, the kidneys are responsible for maintaining the correct amount of potassium, sodium, salt, phosphorous, and minerals within our bloodstream.

Adverse Effects Of Smoking In Patients With A Renal Transplant

Contraintuitively, it has been documented that smoking does not appear to increase the risk of microalbuminuria in patients with a renal transplant . Most studies published to date indicated a lack of correlation of smoking with the development of progressive allograft dysfunction .

In an ongoing prospective study using the large Collaborative Transplant Study database, the issue is currently adressed by G Opelz . A preliminary retrospective analysis of Opelz suggests that smoking by itself adversely affects late graft function, even if corrections are made for cardiovascular death with a functioning graft . A similar analysis was performed by the group of LC Paul and yielded the same results . It is likely that the final results of these investigations will confirm the data of Sung et al. .

It is of note that an investigation of kidney donor lifestyle factors, including smoking, drinking, drug use, and sexual history, found no significant negative impact on renal allograft survival .

The increase in cardiovascular death is due to the well known atherogenic effects of smoking . Smoking appears to increase the risk for low-output left ventricular failure in patients with a renal transplant . As one would expect, cigarette smoking at the time of transplantation is an independent risk factor for cerebrovascular and peripheral vascular disease in transplanted patients . Smoking post-transplantation is a risk factor for carotid plaques and peripheral vascular occlusive disease .

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From Bench To Bedside Or To The Population

To conclude, evidence suggests a role of smoking on the incidence and progression of CKD, irrespective of the original native disease. Most likely this takes place through classical pathways involved in fibrogenesis. Most important, the solid evidence of a substantial negative impact of smoking should lead the nephrological community to take action. Unfortunately, the relevance of this problem is hidden in the smoke screen produced by the pharmaceutical industry, which is trying to keep the problems relating to their products on the agenda and in the scope of awareness, rather than a lifestyle problem such as smoking. It will take intellectual bravery and leadership to keep the focus on the right spot.

Data Source And Study Population

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Information regarding the Korean NHIS have been published previously,. Among the participants who received at least one health examination between 2009 and 2012, 23,452,862 were included after excluding duplicated data and participants under 20 years of age. The information regarding smoking status was reported in health examinations. Smoking status was classified based on the health examination questionnaire records as follows: current smokers, defined as those who had smoked more than 5 packs throughout their lifetime and continued to smoke, ex-smokers, defined as those who had smoked more than 5 packs throughout their lifetime but had quit smoking, and never smokers, defined as those who had smoked 5 packs or fewer. Both ex-smokers and current smokers recorded the total duration of smoking and the average daily amount of cigarettes smoked in the self-reporting questionnaire. The cumulative lifetime smoking exposure was reported as the pack-year by multiplying the average cigarette consumption per day by the smoking period .

After excluding people with missing data for health examinations and those with ESKD diagnosed before 2009 , 23,232,091 participants without ESKD were followed-up from the January 2009 to the December 2016. Figure shows a flowchart of the study design.

Figure 2

Correspondence to Soo Wan Kim.

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