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 .
How To Quit Though
Thats the next problem, isnt it? The how.
People, even our own loved ones, usually think, Well, just dont smoke today. That should start you quitting, right? as if its the easiest thing in the world. But former smokers know better.
Thats why the CDC started Tips from Former Smokers, or Tips, its first-ever paid national tobacco education campaign that profiles real people who are living with serious long-term health effects from smoking and secondhand smoke exposure.
Part of the campaigns educational advice is for smokers create a quit plan which, if you are a smoker having difficulties with quitting, you can do with the following steps:
1. Choose your quit date. Smokers usually pick a date within two weeks to quit to have enough time to prepare. You, as a smoker, are advised to choose a date where you wont be busy or tempted to smoke, like night-outs with friends and such.
Encircle your quit date in a calendar and put it where you can see it every day as a reminder.
2. Inform your loved ones. Support from family and friends is always a great help in quitting smoking. Let them know of your quit date and tell them how they can help you with achieving it.
3. Get rid of smoking reminders. Cigarettes, matches, lighters, and ashtrays should be put permanently away from your home or even workspace. Cravings can also be triggered even when you smell cigarettes, so its best to stay away from other smokers, too.
Nonhemodynamic Mechanisms As Potential Mediators Of Smoking
Endothelial cell dysfunction, activation of growth factors , tubulotoxic effects, oxidative stress, increased clotting of platelets, impaired lipoprotein and glycosaminoglycan metabolism, modulation of immune mechanisms, vasopressin-mediated antidiuresis, and insulin resistance all are affected by smoking exposure . We focus on more recent data that implicate additional mechanisms.
In an in vitro study that used human mesangial cells, Jaimes et al. reported that nicotine induced cell proliferation and increased fibronectin production by 50%. Both mesangial cell proliferation and increased production of fibronectin are players in the progression of CKD. This study documented that nicotinic acetylcholine receptors, which mediate cell proliferation , are expressed on human mesangial cells. A study that used rat mesangial cells documented that exposition of these cells to cigarette smoke concentrate induced an increase of TGF-1, a major player in the genesis of renal fibrosis, and 8-epi-PGF2, a marker of lipid peroxidation . Similar results were found in other experimental models and in humans . It is interesting that in nonmacroalbuminuric patients with type 2 diabetes, cessation of smoking led to a significant reduction of urine TGF-1 excretion, which implicates a beneficial effect of smoking cessation on progression of early diabetic renal damage.
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Tobacco Use: A Chronic Kidney Disease Accelerant
Penn Presbyterian Medical Center, Division of Nephrology
Medical Office Building Suite 240, 51 N. 39th Street
Philadelphia, PA 19104
Cigarette smoking is a modifiable risk factor for several chronic disease states, including cardiovascular disease, cancer, and pulmonary diseases. The association between cigarette smoking and chronic kidney disease has also been evaluated in observational settings, with most studies showing a positive relationship between smoking and CKD .
Wesson et al. conducted a prospective study in 216 hypertensive patients with CKD stage 2 with albuminuria to test the hypothesis whether smoking cessation restores ACE inhibition , kidney protection against progression compared to those who continued smoking and nonsmokers . Individuals with diabetes, systolic blood pressure > 200 mm Hg, history of malignancy or transplant, or inability to tolerate ACEIs were excluded. Individuals who had limited smoking exposure were also excluded. Current smokers were defined as those consuming 10 cigarettes per day for 1 year. All smokers were offered pharmacologic and non-pharmacologic smoking cessation interventions. Smoking cessation was defined as a reduction of urine and plasma cotinine at 24 weeks to < 10%, compared to baseline. Of the 108 individuals enrolled who smoked, 23% ceased smoking and were defined as quitters. Study participants were followed prospectively for 5 years, with yearly blood work, urine studies, and BP measurements.
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.
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What Are Common Asthma Attack Triggers
An asthma attack happens when someone comes in contact with substances that irritate them. Healthcare providers call these substances triggers. Knowing what triggers your asthma makes it easier to avoid asthma attacks.
For some people, a trigger can bring on an attack right away. Sometimes, an attack may start hours or days later.
Triggers can be different for each person. But some common triggers include:
- Air pollution: Many things outside can cause an asthma attack. Air pollution includes factory emissions, car exhaust, wildfire smoke and more.
- Dust mites: You cant see these bugs, but they are in many homes. If you have a dust mite allergy, they can cause an asthma attack.
- Exercise: For some people, exercising can cause an attack.
- Mold: Damp places can spawn mold. It can cause problems for people with asthma. You dont even have to be allergic to mold to have an attack.
- Pests: Cockroaches, mice and other household pests can cause asthma attacks.
- Pets: Your pets can cause asthma attacks. If youre allergic to pet dander , breathing in the dander can irritate your airways.
- Tobacco smoke: If you or someone in your home smokes, you have a higher risk of developing asthma. The best solution is to quit smoking.
- Strong chemicals or smells.
With asthma, you may not have all of these symptoms. You may have different signs at different times. And symptoms can change between asthma attacks.
Smoking And Your Kidneys: What You Should Know
Does smoking affect your kidneys? The short answer is yes. Smoking can speed up the progression of chronic kidney disease, contribute to the risk of kidney cancer, and cause renal artery stenosis.
Kidneys are highly resilient organs that play a significant role in your bodys flawless operation. However, many outside factors can affect the health of your kidneys, including smoking.
Smoking can have various adverse effects by slowing down the blood flow to your kidneys and elevating your blood pressure. It can cause problems for people who already have chronic conditions and those who are otherwise healthy. Lets take a closer look at how it works.
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Sleeping Smoking And Kidney Diseases: Evidence From The Nhanes 20172018
- 1Division of Nephrology, Department of Internal Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- 2National Defense Medical Center, Department and Graduate Institute of Microbiology and Immunology, Taipei, Taiwan
- 3School of Public Health, National Defense Medical Center, Taipei City, Taiwan
- 4Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- 5TMU Research Centre of Urology and Kidney, Taipei Medical University, Taipei, Taiwan
- 6Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- 7Division of Nephrology, Department of Medicine, School of Medicine, Fu-Jen Catholic Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
- 8Department of Surgery, National Defense Medical Center, Songshan Branch of Tri-Service General Hospital, Taipei City, Taiwan
- 9Division of Biostatistics and Informatics, Department of Epidemiology, National Defense Medical Center, School of Public Health, Taipei, Taiwan
- 10Department of Public Health, China Medical University, Taichung City, Taiwan
- 11Department of Public Health, Kaohsiung Medical University, Kaohsiung City, Taiwan
Methods: Data were obtained from the National Health and Nutrition Examination Survey. The study population were categorized into nine subgroups by smoking and sleep duration .
Hemodynamic Mechanisms As Potential Mediators Of Smoking
BP and heart rate are increased by smoking, which for the major part is due to the action of nicotine . Because increased BP is one of the most important factors promoting progression of CKD, it is likely to play an important role in mediating smoking-induced renal damage. The rise in BP is due to an increase in cardiac output and total peripheral vascular resistance. The BP rise appears immediately and occurs before any increase in circulating catecholamines . Some data implicate an alteration of the diurnal rhythm of BP in smokers . Because alterations of the day/night BP profile do have a notable impact on renal and cardiovascular risk, more data on this issue would be of importance. It is of note that smoking interacts with the effects of some antihypertensive drugs. At least in nonrenal patients, smoking blunts the antihypertensive effect of blockers . Furthermore, in the short term, cigarette smoking blunts the beneficial effect of amlodipine on arterial stiffness .
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Smoking And Atherosclerotic Renal Artery Stenosis/ischemic Nephropathy
The prevalence of atherosclerotic renal artery stenosis is increasing in the ageing population and ischemic nephropathy is a significant cause of ESRF in patients over 65 years of age .
The incidence of renal vascular stenosis increases as the extent of peripheral vascular disease increases . Since the latter is common in smokers, it is not surprising that smokers have a higher risk of critical atherosclerotic renal artery stenosis . Smoking is well known to promote atherogenesis. It is of interest that plasma total homocysteine concentration, a predictor of atherogenic risk, is strongly and dose-dependently related to cigarette smoking . There is, however, no doubt that other pathogenic mechanisms also play a role.
Hadj-Abdelkader et al. examined elderly hypertensive patients with renal failure by arteriography. A significantly higher proportion of patients with atherosclerotic renal artery stenosis, i.e. 80.5% were smokers compared to patients without atherosclerotic renal artery stenosis, i.e. 44%. A correlation was found with the number of cigarettes smoked and the exposure time. In a Spanish observational multicenter study 156 elderly patients with bilateral atherosclerotic renal artery stenosis and elevated serum-creatinine concentration were investigated. A high proportion, i.e. 70% were smokers . As one would expect, the prevalence of smokers is increased both amongst patients with unilateral and bilateral atherosclerotic renal artery stenosis.
Smoking And Healthy Kidneys
Even those with healthy kidneys may develop kidney disease while smoking. According to Davita, studies have shown that smokers who do not have kidney disease are still more likely to die from renal failure than those who do not smoke. Smoking reduces blood flow to the kidneys, constricts arteries and blood vessels, and causes extensive damage over time.
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Benefits Of Smoking Cessation In Renal Patients
Only a little information is available concerning the beneficial effects of smoking cessation on the course of renal function. The few studies that investigated this issue all found a positive effect, however. Chase et al. observed that in patients who had type 1 diabetes and nephropathy and in whom BP was adequately controlled, cessation of smoking significantly reduced urine albumin excretion, although glycemia was not perfectly controlled. Sawicki et al. performed a prospective follow-up study during 1 yr in a sequential sample of 34 smokers, 35 nonsmokers, and 24 ex-smokers with type 1 diabetes, hypertension, and diabetic nephropathy. They reported that progression of diabetic nephropathy was observed in 53% of current smokers but only 33% of ex-smokers . These data were confirmed in patients with type 2 diabetes and by documenting reduction of urine TGF-1 excretion as a marker of renal injury after smoking cessation . Finally, Sung et al. reported that smoking cessation before renal transplantation led to better graft survival as compared with graft recipients who continued smoking after renal transplantation. Taken together, although prospective, randomized intervention studies are lacking, there is sufficient evidence that smoking cessation slows the rate of renal function decline.
Baseline Characteristics And The Impacts Of Sleep Duration On The Renal Functions
The normal sleep duration group was the youngest and had the lowest BMI on average . The primary marital status of nmSleep was married or living with partners compared with the other two sleep groups with less or more sleep duration . Except for malignancy, nmSleep had a lower prevalence of hypertension, high cholesterol, DM, failing kidneys, anemia, congestive heart failure, coronary heart disease, heart attack, stroke, and COPD than the other two sleep groups .
Table 2. Baseline characteristics of study population grouped by sleep duration.
Renal function was associated with sleep duration. nmSleep and moreSleep had higher eGFR levels. nmSleep had the lowest blood urea nitrogen, the lowest serum creatinine, and a lower uric acid among the three sleep groups. No difference was found in the albumincreatinine ratio. Taken together, nmSleep had the best renal function. The U-shaped effects of the renal function levels were observed among the sleep duration groups . Significantly higher cotinine and hydrocotinine levels were observed in lessSleep compared with the other two sleep groups .
Figure 1. The association among smoking, cotinine, hydrocotinine, and sleep duration. Boxplots of serum cotinine levels grouped by sleep duration , grouped by smoking frequency , and grouped by sleep duration and smoking frequency . The scatter plot of cotinine and hydrocotinine with the Pearson correlation r = 0.85.
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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.
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Urine Tests For Kidney Disease
Damaged or inflamed kidneys leak substances such as blood or protein into the urine. The preferred test for detecting protein in the urine is a urine albumin-to-creatinine ratio test, which shows the amount of albumin in the urine.
A urine ACR test should be done at least once a year if the person has diabetes or high blood pressure, and every two years if the person has any of the other identified risk factors for developing chronic kidney disease.
A urine ACR test is performed by sending a sample of your urine to a laboratory for analysis.
Association Between Lung Function And Mortality
During follow-up over 5 years, the overall mortality rate was 24% among the 404 individuals. As almost half of the G-5 individuals underwent renal transplantation during the follow-up period, competing-risk regression models with transplantation as a competing risk were used for survival analyses.
Among all 404 GFR categories 1-5 individuals, 1-SD higher %FEV1 and 1-SD higher %FVC associated with lower mortality risk with crude sHR = 0.49 and crude sHR = 0.56 respectively. After adjusting for tertiles of Framingham CVD score , the survival benefits associated with 1-SD higher %FEV and 1-SD higher %FVC remained significant, sHR 0.62 and sHR 0.63 respectively.
The highest tertiles of %FEV1 and %FVC respectively associated with lower all-cause mortality after adjustments for tertiles of Framingham CVD score , presence of CVD and PEW, and albumin, BMI, hsCRP, and albuminuria, sHR of 0.49 and sHR of 0.56 respectively .
After applying the same adjustments, the highest tertile of %FEV1 associated with lower CVD mortality with sHR of 0.16 . The association of the highest tertile of %FVC with CVD mortality was not significant data not shown).
Restrictive lung dysfunction associated with increased mortality risk while the association with obstructive lung impairment was not significant after adjusting for Framingham CVD risk score presence of CVD, PEW and albuminuria and levels of BMI, plasma albumin and hsCRP, as well as %HGS, .
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Diabetes And Kidney Disease
About 20 to 30 per cent of people with diabetes develop a type of kidney disease called diabetic nephropathy. This is a serious disease and may worsen other diabetic complications such as nerve and eye damage, as well as increasing the risk of cardiovascular disease.
Diabetic nephropathy is the main cause of kidney failure .
Effect Of Smoking On Urinary Albumin/protein Excretion In Subjects Of The General Population With Apparently Normal Kidney Function
The nephrotoxic effect of smoking in the general population is documented by a cross-sectional study in 7,476 non-diabetic subjects in Groningen, The Netherlands . The study found that urinary albumin excretion rate correlates to the amount of cigarettes smoked per day. After adjustment for several potential confounding factors, subjects who smoked < 20 cigarettes/day and subjects who smoked > 20 cigarettes/day, respectively, showed a dose-dependent association between smoking and high normal albuminuria and microalbuminuria . Interestingly, in a study including 40,619 subjects aged 2875 years, smoking was associated even with increased urinary albumin concentrations far below the microalbuminuric range . Analysis of a well defined non-diabetic and non-hypertensive subgroup of this latter study revealed that smoking was still independently associated with microalbuminuria . Halimi et al. documented a marked risk of irreversible proteinuria that may occur despite moderate smoking in a study including 28,409 subjects in France. These results from the Netherlands and France have recently been confirmed by a preliminary report documenting an association of smoking and albuminuria in a large cross-sectional probability sample of adults in the USA .
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