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Kunno J, Luangwilai T, Pimviriyakul P, Sematong S, Supawattanabodee B, Kuratong S, Robson MG. Active smoking in urban households: An association between urinary cotinine metabolite level and serum eGFR concentration. Tob Induc Dis 2024; 22:TID-22-59. [PMID: 38586496 PMCID: PMC10996036 DOI: 10.18332/tid/186071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION Smoking stands as a primary contributor to preventable deaths globally and is linked to an increased risk of developing kidney failure and other diseases. A few studies have focused on the negative correlation between serum cotinine and estimated glomerular filtration rate (eGFR), indicating decreased kidney function. This study investigated the associations between urinary cotinine metabolite concentration and serum eGFR among active smokers in urban households. METHODS This was a cross-sectional study of active smokers in urban households' community Bangkok, Thailand from January to April 2023. The study involved 85 participants aged ≥18 years who were active smokers. Both urinary cotinine and serum eGFR concentrations were used as biomarkers. Independent sample t-tests were used to compare the urinary cotinine metabolite based on differences in the characteristic variable. We used multiple linear regression to test the association between cotinine metabolite and characteristics variables. Spearman's analysis was used to test the correlation between cotinine metabolite and eGFR concentration. RESULTS The association between urinary cotinine metabolite and serum eGFR concentration decreased with increasing cotinine concentrations (r= -0.223, p=0.041), suggesting a decline in kidney function. However, this study found no significant difference between urinary cotinine metabolite and characteristic variables (p>0.05). Additionally, those who smoked for ≥10 years (117.40 ± 89.80 ng/mL), smoked ≥10 cigarettes per day (117.40 ± 89.80 ng/mL) and used conventional cigarettes (124.53 ± 115.10 ng/mL). The results of the multiple linear regression models analysis indicated that those who were smokers for ≥10 years (β=0.076; 95% CI: -31.575-59.715) and those who were smoked ≥10 cigarettes/day (β=0.126; 95% CI: -65.636-18.150) were not associated with urinary cotinine metabolite level. CONCLUSIONS This study shows that the urinary cotinine metabolite level is associated with serum eGFR concentration among active smokers in urban households. The current study suggests that clinical identification and a prospective cohort study are needed before robust conclusions about how tobacco affects kidney efficiency.
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Affiliation(s)
- Jadsada Kunno
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Titaporn Luangwilai
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Panu Pimviriyakul
- Department of Biochemistry, Faculty of Science, Kasetsart University, Bangkok, Thailand
| | - Saowanee Sematong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Busaba Supawattanabodee
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Sathit Kuratong
- Department of Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Mark Gregory Robson
- School of Environmental and Biological Sciences, Rutgers University, New Brunswick, United States
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Shinzato Y, Zamami R, Oshiro N, Nakamura T, Ishida A, Ohya Y, Kohagura K. The Association of Smoking and Hyperuricemia with Renal Arteriolosclerosis in IgA Nephropathy. Biomedicines 2023; 11:2053. [PMID: 37509692 PMCID: PMC10377274 DOI: 10.3390/biomedicines11072053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
The combination effects of smoking (SMK) and hyperuricemia (HU) on renal arteriolosclerosis in patients with IgA nephropathy remain unknown. We examined the cross-sectional association between smoking (current or former) and renal arteriolar hyalinosis and wall thickening with or without HU [uric acid (UA) level ≥ 7 and ≥5 mg/dL in men and women] in 87 patients with IgA nephropathy who underwent renal biopsy. Arteriolar hyalinosis and wall thickening were assessed by the semiquantitative grading of arterioles. The SMK/HU subgroup showed the highest indices for hyalinosis and wall thickening, followed by the non-SMK/HU, SMK/non-HU, and non-SMK/non-HU subgroups. Multiple logistic analysis showed that SMK/HU, but not SMK/non-HU, was significantly associated with an increased risk of higher-grade renal arteriolar wall thickening. However, this did not occur with hyalinosis compared to non-SMK/non-HU. The adjusted odds ratio (95% confidence interval, p value) for SMK/HU was 12.8 (1.36-119, p < 0.05) for wall thickening. An association between SMK and renal arteriolar wall thickening might be prevalent only among patients with HU and in patients with IgA nephropathy. Further prospective studies are needed to determine whether patients with HU and SMK history exhibit rapid eGFR deterioration.
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Affiliation(s)
- Yuki Shinzato
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan
- Dialysis Unit, University Hospital of the Ryukyus, Okinawa 903-0125, Japan
| | - Ryo Zamami
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan
| | - Nanako Oshiro
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan
- Dialysis Unit, University Hospital of the Ryukyus, Okinawa 903-0125, Japan
| | - Takuto Nakamura
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan
| | - Akio Ishida
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan
| | - Yusuke Ohya
- University of the Ryukyus Hospital, Okinawa 903-0125, Japan
| | - Kentaro Kohagura
- Dialysis Unit, University Hospital of the Ryukyus, Okinawa 903-0125, Japan
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Yuan T, Ding C, Xie Y, Zhou X, Xie C, Wang T, Yu C, Zhou W, Zhu L, Bao H, Cheng X. Association between remnant cholesterol and chronic kidney disease in Chinese hypertensive patients. Front Endocrinol (Lausanne) 2023; 14:1189574. [PMID: 37415665 PMCID: PMC10321593 DOI: 10.3389/fendo.2023.1189574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/02/2023] [Indexed: 07/08/2023] Open
Abstract
Background Remnant cholesterol (RC) and chronic kidney disease (CKD) have not been definitively linked in individuals with different characteristics. This study aims to investigate the relationship between serum RC level and CKD and examine possible effect modifiers in Chinese patients with hypertension. Methods Our study is based on the Chinese H-type Hypertension Project, which is an observational registry study conducted in real-world settings. The outcome was CKD, defined as an estimated glomerular filtration rate of less than 60 ml/min·1.73 m2. Multivariate logistic regression and smooth curve fitting were used to analyze the association between RC and CKD. Subgroup analyses were subsequently conducted to examine the effects of other variables. Results The mean age of the 13,024 patients with hypertension at baseline was 63.8 ± 9.4 years, and 46.8% were male. A conspicuous linear positive association was observed between RC level and CKD (per SD increment; odds ratio [OR], 1.15; 95% confidence interval [CI], 1.08-1.23). Compared with the lowest quartile group of RC, the risk of CKD was 53% higher (OR, 1.53; 95% CI, 1.26-1.86) in the highest quartile group. Furthermore, a stronger positive association between RC level and CKD was found among participants with a higher body mass index (BMI <24 vs. ≥24 kg/m2; P-interaction = 0.034) or current non-smokers (smoker vs. non-smoker; P-interaction = 0.024). Conclusions Among Chinese adults with hypertension, RC level was positively associated with CKD, particularly in those with a BMI of ≥24 kg/m2 and current non-smokers. These findings may help improve lipid management regimens in patients with hypertension.
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Affiliation(s)
- Ting Yuan
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Congcong Ding
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Yanyou Xie
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Xinlei Zhou
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Chong Xie
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Tao Wang
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Chao Yu
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Wei Zhou
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
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Eid HA, Moazen EM, Elhussini M, Shoman H, Hassan A, Elsheikh A, Rezk A, Moursi A, Atef M, Kabil A. The Influence of Smoking on Renal Functions Among Apparently Healthy Smokers. J Multidiscip Healthc 2022; 15:2969-2978. [PMID: 36582586 PMCID: PMC9793780 DOI: 10.2147/jmdh.s392848] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/12/2022] [Indexed: 12/25/2022] Open
Abstract
Background Cigarette smoking is an important modifiable risk factor in kidney disease progression. Although long-term smoking has been associated with chronic kidney disease (CKD), its effect on kidney function in early stages has not been clarified. Objective To detect the early effects of smoking either active or passive on kidney functions. Methodology The current study was comparative cross sectional study conducted on 280 participants, 140 were non‑smokers and 140 were smokers (70 passive smokers and 70 active smokers). The two groups were comparable in terms of all parameters. We investigated the possible effects of smoking on kidney functions using both serum kidney function tests especially; serum urea, serum creatinine, serum cotinine levels and detection of albumin in urine. Smoking history, full Laboratory investigations, Ventilatory function test including (FEV1/FVC, FEV1, FEF 25-75%, VC and FVC) were done. Results Serum urea, serum creatinine, serum cotinine levels and urinary albumin were statistically significant higher in smokers group in comparison to nonsmokers, also the serum cotinine levels and urinary albumin were statistically significant in active smokers in comparison to passive smokers. There were positive correlations between the level of urinary albumin and pack/year (r = 0.9, p<0.05), smoking index (r = 0.9, p<0.05), smoking duration (r = 0.4, p<0.05), and serum cotinine (r = 0.6, p<0.050) with good statistical significance. The most significant predictive risk factors of microalbuminuria among smokers group in descending orders were active smoking, passive smoking, age and serum cotinine level. Conclusion Both active and passive smoking, especially among heavy smokers, is a significant risk factor for microalbuminuria. This finding increase the importance of early cessation of smoking in order to minimize early renal affection among healthy smokers that may not be discovered by routine renal function tests.
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Affiliation(s)
- Hoda A Eid
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Eman M Moazen
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Manal Elhussini
- Department of Chest Diseases, Ahmed Maher Teaching Hospital, Cairo, Egypt
| | - Heba Shoman
- Internal medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Asmaa Hassan
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Asmaa Elsheikh
- Department of Community and Occupational Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Amr Rezk
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ashraf Moursi
- Internal medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Moaz Atef
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Kabil
- Department of Chest Diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt,Correspondence: Ahmed Kabil, Department of Chest diseases, Faculty of Medicine, Al-Azhar University, Cairo, Egypt, Tel +201006396601, Email
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5
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Campesi I, Montella A, Sotgiu G, Saderi L, Tonolo G, Seghieri G, Franconi F. Smoking and combined oral contraceptives should be considered as an independent variable in sex and gender-oriented studies. Toxicol Appl Pharmacol 2022; 457:116321. [PMID: 36423693 DOI: 10.1016/j.taap.2022.116321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
The influence of sex combined with smoking and combined oral contraceptives (COC) use on atherogenic indexes is scarcely studied. Thus, traditional lipid parameters were measured, and non-traditional atherogenic indexes were calculated in a young and healthy population of men, COC-free women, and COC users. Total cholesterol (TChol), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and HDL/LDL ratio were lower in men, while triglycerides (TG)/HDL ratio, atherogenic index of plasma (AIP), Castelli's Risk Index I (CRII) and CRI-II, atherogenic coefficient (AC), creatinine, creatinine clearance, and estimated glomerular filtration rate (eGFR) were higher in men. The use of COC modified TChol, HDL, TG, TG/HDL, and AIP which had significantly higher values in COC users. In addition, TG were also increased in COC users in comparison with men. Smoking reduced sexually divergent parameters: BMI, TG, HDL/LDL, TG/HDL, AIP, CRII, CRI-II, and AC became similar among the three cohorts, losing the reported sex differences. Smoking also reduced differences in TChol, HDL, TG, and AIP between COC-free women and COC users, but it does not affect CRII, CRI-II, creatinine, creatinine clearance, and eGFR, underlining that COC users and COC-free women have to be considered two different populations. Our results represent a complex landscape suggesting that for both sexes smoking should be an independent variable in medical studies. Moreover, in women, the use of COC evidenced two different cohorts. Thus, more variables should be considered during a single study indicating that sex, smoking, and COC should be studied together to get a picture of the real-life context.
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Affiliation(s)
- Ilaria Campesi
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100 Sassari, Italy; Laboratorio Nazionale di Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100 Sassari, Italy.
| | - Andrea Montella
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100 Sassari, Italy; Unità Operativa di Genetica e Biologia Dello Sviluppo, Azienda Ospedaliero Universitaria di Sassari, 07100 Sassari, Italy
| | - Giovanni Sotgiu
- Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università Degli Studi di Sassari, 07100 Sassari, Italy
| | - Laura Saderi
- Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università Degli Studi di Sassari, 07100 Sassari, Italy
| | - Giancarlo Tonolo
- S.C. Diabetologia, P.O. San Giovanni di Dio, ASSL Olbia-ATS Sardegna, 07026 Olbia, Italy
| | | | - Flavia Franconi
- Laboratorio Nazionale di Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100 Sassari, Italy
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van der Burgh AC, Rizopoulos D, Ikram MA, Hoorn EJ, Chaker L. Determinants of the Evolution of Kidney Function With Age. Kidney Int Rep 2021; 6:3054-3063. [PMID: 34901574 PMCID: PMC8640542 DOI: 10.1016/j.ekir.2021.10.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/23/2021] [Accepted: 10/04/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction Kidney function declines with age, but its determinants in the general population remain incompletely understood. We investigated the rate and determinants of kidney function decline in the general population. Methods Participants with information on kidney function were selected from a population-based cohort study. Joint models were used to investigate the evolution of the estimated glomerular filtration rate (eGFR, expressed in ml/min per 1.73 m2 per year) and the urine albumin-to-creatinine ratio (ACR, expressed in mg/g per year) with age. We stratified for 8 potential determinants of kidney function decline, including sex, cardiovascular risk factors, and cardiovascular disease. Results We included 12,062 participants with 85,922 eGFR assessments (mean age 67.0 years, 58.7% women) and 3522 participants with 5995 ACR measurements. The annual eGFR decline was 0.82 and the ACR increase was 0.05. All determinants appeared detrimental for eGFR and ACR, except for prediabetes and higher body mass index which proved only detrimental for ACR. In participants without the determinants, eGFR decline was 0.75 and ACR increase was 0.002. Higher baseline eGFR but faster eGFR decline with age was detected in men (0.92 vs. 0.75), smokers (0.90 vs. 0.75), and participants with diabetes (1.07 vs. 0.78). Conclusion We identify prediabetes, smoking, and blood pressure as modifiable risk factors for kidney function decline. As with diabetes, hyperfiltration seems important in accelerated kidney function decline in men and smokers. The interpretation of kidney function decline may require adjustment for age and sex to prevent overdiagnosis of chronic kidney disease in aging populations.
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Affiliation(s)
- Anna C van der Burgh
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dimitris Rizopoulos
- Department of Biostatistics, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ewout J Hoorn
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Layal Chaker
- Department of Internal Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Mickelsson M, Söderström E, Stefansson K, Andersson J, Söderberg S, Hultdin J. Smoking tobacco is associated with renal hyperfiltration. Scand J Clin Lab Invest 2021; 81:622-628. [PMID: 34669529 DOI: 10.1080/00365513.2021.1989713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/13/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
Tobacco consumption is a renal risk factor, but the effects on the estimated glomerular filtration rate (eGFR) remain unclear. We aimed to evaluate the possible impact of using tobacco products (smoking and snus) on eGFR based on creatinine or cystatin C. We used a first cohort with 949 participants and a second cohort with 995 participants; none had pre-existing renal disease. All subjects donated a blood sample and completed a questionnaire, including questions about tobacco use. To assess the effect on eGFR, hierarchical multiple linear regression models were used. Active smoking associated independently with a higher eGFRcreatinine in all subjects (p < 0.001; β = 0.11). Further analyses stratified for sex, showed similar findings for men (p < 0.001; β = 0.14) and for women (p = 0.026; β = 0.10). eGFRcystatin C was significantly associated with active smoking in all subjects (p = 0.040; β = -0.05), but no association was seen after stratification for sex. Snus did not associate with eGFR. In conclusion, smoking associated significantly with a higher eGFRcreatinine. The mechanism may be renal hyperfiltration of smaller molecules such as creatinine. This is probably caused by substances from smoked tobacco other than nicotine, as no effect was seen for snus.
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Affiliation(s)
- Malin Mickelsson
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Elisabet Söderström
- Department of Medical Biosciences, Clinical Chemistry, Norrbotten County Council, Sunderby Hospital, Umeå University, Umeå, Sweden
| | - Kristina Stefansson
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
| | - Jonas Andersson
- Department of Public Health and Clinical Medicine, Skellefteå Research Unit, Umeå University, Umeå, Sweden
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden
| | - Johan Hultdin
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, Umeå, Sweden
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Choi Y, Park JH, Kim DH, Kim HJ, Suh E, Kim KH, Ahn JJ, Lee GN, Jung JH, Han K, Shin YN. Association between cotinine-verified smoking status and moderately increased albuminuria in the middle-aged and older population in Korea: A nationwide population-based study. PLoS One 2021; 16:e0246017. [PMID: 33566809 PMCID: PMC7875375 DOI: 10.1371/journal.pone.0246017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 01/12/2021] [Indexed: 11/28/2022] Open
Abstract
Objectives Although several self-reported questionnaire-based studies have found an association between smoking and moderately increased albuminuria, this result remains controversial. We investigated whether moderately increased albuminuria was associated with smoking status, verified by urinary cotinine (an objective biomarker of tobacco exposure), using population-based, nationally representative data. Methods This study included 2059 participants aged ≥ 50 years from the 2014 Korean National Health and Nutrition Examination Survey. Individuals with a urinary cotinine level ≥ 50 ng/mL were identified as cotinine-verified smokers. Moderately increased albuminuria was defined as a urine albumin-to-creatinine ratio ranging between ≥ 30 mg/g and < 300 mg/g. Multivariable logistic regression was used to evaluate the association between cotinine-verified smoking status and moderately increased albuminuria. Results Among the study participants, 16.9% were cotinine-verified smokers, 84.8% of whom were men. After adjustment for multiple covariates, cotinine-verified smokers showed a significant positive association with moderately increased albuminuria (adjusted odds ratio: 4.37, 95% confidence interval: 1.63–11.71) compared with cotinine-verified non-smokers. The association between urinary cotinine and moderately increased albuminuria did not differ with age, sex, obesity, or comorbidities (P-value for interaction > 0.05 in all cases). Conclusion This large-scale observational study showed that cotinine-verified smoking is associated with moderately increased albuminuria in the Korean middle-aged and older general population, suggesting that smoking must be strictly controlled to reduce the risk of moderately increased albuminuria.
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Affiliation(s)
- Yeonjoo Choi
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Joo-Hyun Park
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
- * E-mail: (JHP); (DHK)
| | - Do-Hoon Kim
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
- * E-mail: (JHP); (DHK)
| | - Hyun Jin Kim
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Euijung Suh
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Ki-Hoon Kim
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Jae Joon Ahn
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Gyu-Na Lee
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin-Hyung Jung
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - You-Na Shin
- Korea Medical Institute Suwon Center, Suwon, Republic of Korea
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Kaplan A, Abidi E, Habeichi NJ, Ghali R, Alawasi H, Fakih C, Zibara K, Kobeissy F, Husari A, Booz GW, Zouein FA. Gender-biased kidney damage in mice following exposure to tobacco cigarette smoke: More protection in premenopausal females. Physiol Rep 2021; 8:e14339. [PMID: 31981316 PMCID: PMC6981307 DOI: 10.14814/phy2.14339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Multiple clinical studies documented renal damage in chronic cigarette smokers (CS) irrespective of their age and gender. Premenopausal female smokers are known to exert a certain cardiovascular and renal protection with undefined mechanisms. Given the multiple demographic variables within clinical studies, this experimental study was designed to be the first to assess whether gender‐biased CS‐induced kidney damage truly exists between premenopausal female and age‐matched C57Bl6J male mice when compared to their relative control groups. Following 6 weeks of CS exposure, cardiac function, inflammatory marker production, fibrosis formation, total and glomerular ROS levels, and glomerulotubular homeostasis were assessed in both genders. Although both CS‐exposed male and female mice exhibited comparable ROS fold change relative to their respective control groups, CS‐exposed male mice showed a more pronounced fibrotic deposition, inflammation, and glomerulotubular damage profile. However, the protection observed in CS‐exposed female group was not absolute. CS‐exposed female mice exhibited a significant increase in fibrosis, ROS production, and glomerulotubular alteration but with a pronounced anti‐inflammatory profile when compared to their relative control groups. Although both CS‐exposed genders presented with altered glomerulotubular homeostasis, the alteration phenotype between genders was different. CS‐exposed males showed a significant decrease in Bowman's space along with reduced tubular diameter consistent with an endocrinization pattern of chronic tubular atrophy, suggestive of an advanced stage of glomerulotubular damage. CS‐exposed female group, on the other hand, displayed glomerular hypertrophy with a mild tubular dilatation profile suggestive of an early stage of glomerulotubular damage that generally precedes collapse. In conclusion, both genders are prone to CS‐induced kidney damage with pronounced female protection due to a milder damage slope.
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Affiliation(s)
- Abdullah Kaplan
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Emna Abidi
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nada J Habeichi
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rana Ghali
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hiam Alawasi
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Christina Fakih
- Biology Department, Faculty of Sciences-I, Lebanese University, Beirut, Lebanon
| | - Kazem Zibara
- Biology Department, Faculty of Sciences-I, Lebanese University, Beirut, Lebanon
| | - Firas Kobeissy
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ahmad Husari
- Department of Internal Medicine, Respiratory Diseases and Sleep Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - George W Booz
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Fouad A Zouein
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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10
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Fan CH, Lin SC, Tsai KZ, Wu TJ, Lin YP, Lin YK, Lu SC, Han CL, Lin GM. Association of Single Measurement of dipstick proteinuria with physical performance of military males: the CHIEF study. BMC Nephrol 2020; 21:287. [PMID: 32682415 PMCID: PMC7368697 DOI: 10.1186/s12882-020-01948-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 07/13/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Proteinuria, a marker of kidney injury, may be related to skeletal muscle loss. Whether the severity of proteinuria is associated with physical performance is unclear. METHODS We examined the association of proteinuria severity with physical performance cross-sectionally in 3357 military young males, free of chronic kidney disease, from the cardiorespiratory fitness and hospitalization events in armed Forces (CHIEF) study in Taiwan. The grades of proteinuria were classified according to one dipstick urinalysis which were collected at morning after an 8-h fast as unremarkable (0, +/-, and 1+), moderate (2+) and severe (3+ and 4+). Aerobic physical performance was evaluated by time for a 3000-m run and anaerobic physical performance was evaluated by numbers of 2-min sit-ups and 2-min push-ups, separately. Multiple linear regressions were used to determine the relationship. RESULTS As compared with unremarkable proteinuria, moderate and severe proteinuria were dose-dependently correlated with 3000-m running time (β: 4.74 (95% confidence intervals (CI): - 0.55, 10.02) and 7.63 (95% CI: 3.21, 12.05), respectively), and inversely with numbers of 2-min push-ups (β = - 1.13 (- 1.97, - 0.29), and - 1.00 (- 1.71, - 0.28), respectively) with adjustments for age, service specialty, body mass index, blood pressure, alcohol intake, smoking, fasting plasma glucose, blood urea nitrogen, serum creatinine and physical activity. However, there was no association between proteinuria severity and 2-min sit-ups. CONCLUSIONS Our findings show a relationship of dipstick proteinuria with aerobic physical performance and parts of anaerobic physical performance in military healthy males. This mechanism is not fully understood and requires further investigations.
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Affiliation(s)
- Chia-Hao Fan
- Department of Nursing, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Ssu-Chin Lin
- Department of Nursing, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Kun-Zhe Tsai
- Department of Medicine, Hualien Armed Forces General Hospital, No. 163, Jiali Rd., Xincheng Township, Hualien, 97144, Taiwan
| | - Tsung-Jui Wu
- Department of Medicine, Hualien Armed Forces General Hospital, No. 163, Jiali Rd., Xincheng Township, Hualien, 97144, Taiwan
| | - Yen-Po Lin
- Department of Critical Care Medicine, Taipei Tzu Chi Hospital, New Taipei, Taiwan
| | - Yu-Kai Lin
- Department of Medicine, Hualien Armed Forces General Hospital, No. 163, Jiali Rd., Xincheng Township, Hualien, 97144, Taiwan
- Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shao-Chi Lu
- Department of Medicine, Hualien Armed Forces General Hospital, No. 163, Jiali Rd., Xincheng Township, Hualien, 97144, Taiwan
| | - Chih-Lu Han
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, No. 163, Jiali Rd., Xincheng Township, Hualien, 97144, Taiwan.
- Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
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11
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Ito K, Maeda T, Tada K, Takahashi K, Yasuno T, Masutani K, Mukoubara S, Arima H, Nakashima H. The role of cigarette smoking on new-onset of chronic kidney disease in a Japanese population without prior chronic kidney disease: Iki epidemiological study of atherosclerosis and chronic kidney disease (ISSA-CKD). Clin Exp Nephrol 2020; 24:919-926. [PMID: 32577942 DOI: 10.1007/s10157-020-01914-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/10/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Studies regarding harmful effects of smoking on the new-onset of chronic kidney disease (CKD) have been limited. Thus, we collected and retrospectively studied 8 years of data from the annual health check-ups of the residents in Iki City (Nagasaki Prefecture, Japan). METHODS From 2008 to 2016, 4540 adults were enrolled in the study. Information on smoking habits was obtained via a self-reported questionnaire. New-onset CKD was defined as a reduction of the estimated globular filtration rate (eGFR) to less than 60 mL/min/1.73 m2 and/or new-onset proteinuria during the follow-up examinations. RESULTS During an average follow-up of 4.6 years, proteinuria developed in 218 people (10.4 per 1000 person-years) and eGFR decline to less than 60 mL/min/1.73 m2 was confirmed in 594 people (28.3 per 1000 person-years) including 53 who showed both proteinuria and eGFR reduction (2.8 per 1000 person-years). In terms of proteinuria, current smokers showed a higher incidence than non-smokers (14.1 and 9.17 per 1000 person-years, respectively, p = 0.001), and a significantly high hazard ratio (HR) of 1.39 with a 95% CI of 1.01-1.92 in multivariable Cox's proportional-hazard analyses. The tendency was more drastic among younger participants (p = 0.015 for trend): current smokers who were < 50 years old had a significantly higher HR of 2.55 with a 95% CI of 1.01-6.45 (p = 0.004) than non-smokers. CONCLUSIONS Smoking significantly increased the risk for new-onset of CKD based on proteinuria development in a Japanese population without CKD, and the association was more predominant in the younger population.
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Affiliation(s)
- Kenji Ito
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
| | - Toshiki Maeda
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kazuhiro Tada
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.,Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Koji Takahashi
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Tetsuhiko Yasuno
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Kosuke Masutani
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | | | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hitoshi Nakashima
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
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12
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Ruckle D, Keheila M, West B, Baron P, Villicana R, Mattison B, Thomas A, Thomas J, De Vera M, Kore A, Wai P, Baldwin DD. Should donors who have used marijuana be considered candidates for living kidney donation? Clin Kidney J 2019; 12:437-442. [PMID: 31198546 PMCID: PMC6543962 DOI: 10.1093/ckj/sfy107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The use of marijuana in the USA has been steadily increasing over the last 10 years. This study is the first to investigate the effect of marijuana use by live kidney donors upon outcomes in both donors and recipients. METHODS Living kidney donor transplants performed between January 2000 and May 2016 in a single academic institution were retrospectively reviewed. Donor and recipient groups were each divided into two groups by donor marijuana usage. Outcomes in donor and recipient groups were compared using t-test, Chi-square and mixed linear analysis (P < 0.05 considered significant). RESULTS This was 294 living renal donor medical records were reviewed including 31 marijuana-using donors (MUD) and 263 non-MUDs (NMUD). It was 230 living kidney recipient records were reviewed including 27 marijuana kidney recipients (MKRs) and 203 non-MKRs (NMKR). There was no difference in donor or recipient perioperative characteristics or postoperative outcomes based upon donor marijuana use (P > 0.05 for all comparisons). There was no difference in renal function between NMUD and MUD groups and no long-term difference in kidney allograft function between NMKR and MKR groups. CONCLUSIONS Considering individuals with a history of marijuana use for living kidney donation could increase the donor pool and yield acceptable outcomes.
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Affiliation(s)
- David Ruckle
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Mohamed Keheila
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Benjamin West
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Pedro Baron
- Department of Transplant and Transplant Nephrology, Loma Linda University Health, Loma Linda, CA, USA
| | - Rafael Villicana
- Department of Transplant and Transplant Nephrology, Loma Linda University Health, Loma Linda, CA, USA
| | - Braden Mattison
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Alex Thomas
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Jerry Thomas
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Michael De Vera
- Department of Transplant and Transplant Nephrology, Loma Linda University Health, Loma Linda, CA, USA
| | - Arputharaj Kore
- Department of Transplant and Transplant Nephrology, Loma Linda University Health, Loma Linda, CA, USA
| | - Philip Wai
- Department of Transplant and Transplant Nephrology, Loma Linda University Health, Loma Linda, CA, USA
| | - D Duane Baldwin
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
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13
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Kawada T. Coffee Intake and Chronic Kidney Disease. Am J Med 2019; 132:e531. [PMID: 30827347 DOI: 10.1016/j.amjmed.2018.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 07/24/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School Tokyo, Japan.
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14
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Jhee JH, Han SH. The Reply. Am J Med 2019; 132:e532. [PMID: 30827348 DOI: 10.1016/j.amjmed.2018.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Jong Hyun Jhee
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
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15
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Reilly R, Spalding S, Walsh B, Wainer J, Pickens S, Royster M, Villanacci J, Little BB. Chronic Environmental and Occupational Lead Exposure and Kidney Function among African Americans: Dallas Lead Project II. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122875. [PMID: 30558242 PMCID: PMC6313544 DOI: 10.3390/ijerph15122875] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/28/2018] [Accepted: 12/04/2018] [Indexed: 01/02/2023]
Abstract
Background: We examined the effects of lead on kidney function in occupationally and environmentally exposed adults from a Dallas lead smelter community that was the site of an Environmental Protection Agency (EPA) Superfund clean-up. All subjects were African Americans—a racial group that bears a disproportionate burden of kidney disease. Methods: A two-phase health screening was conducted. Phase II included a physical examination and laboratory tests. Study subjects were African Americans residents, aged ≥19 years to ≤89 years. Of 778 subjects, 726 were environmentally exposed and 52 were both occupationally and environmentally exposed. The effects of lead exposure on estimated glomerular filtration rate (eGFR) were examined in three groups: male and female smelter-community residents, as well as males with both occupational and environmental exposure. Multiple linear regression was used to analyze the dependence of eGFR on log (blood lead level), duration of residence in the community, type 2 diabetes, and hypertension. Results: There was a statistically significant negative effect on kidney function for all three groups. Comparison of female and male residents showed a slightly larger negative effect of blood lead level on eGFR in females versus males, with the largest effect seen in male smelter-working residents. For each unit increase (log10 10 µg/dL = 1) in blood lead level, age-adjusted eGFR was reduced 21.2 mL/min/1.73 m2 in male residents, 25.3 mL/min/1.73 m2 in female residents and 59.2 mL/min/1.73 m2 in male smelter-working residents. Conclusions: Chronic lead exposure is associated with worsening kidney function in both African American male and female residents, as well as male workers in Dallas smelter communities. This effect is slightly, but not statistically significantly, worse in female residents than male residents, and significantly worse in males that both worked and resided in the smelter community.
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Affiliation(s)
- Robert Reilly
- Nephrology Division, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
- Medical Service, Birmingham VA Medical Center, Birmingham, AL 35233, USA.
| | | | - Brad Walsh
- Parkland Health and Hospital System, Dallas, TX 75235, USA.
| | - Jeanne Wainer
- Parkland Health and Hospital System, Dallas, TX 75235, USA.
| | - Sue Pickens
- Parkland Health and Hospital System, Dallas, TX 75235, USA.
| | | | - John Villanacci
- Environmental and Injury Epidemiology and Toxicology Branch, Texas Department of State Health Services, Austin, TX 78756 USA.
| | - Bert B Little
- Parkland Health and Hospital System, Dallas, TX 75235, USA.
- Medical Service, VA North Texas Health Care System, Dallas, TX 75216, USA.
- Department of Health Management and Systems Sciences, University of Louisville, Louisville, KY 40202, USA.
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16
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Popa SG, Moţa M, Mihălţan FD, Popa A, Munteanu I, Moţa E, Serafinceanu C, Guja C, Hâncu N, Catrinoiu D, Lichiardopol R, Bala C, Mihai B, Radulian G, Roman G, Timar R. Associations of smoking with cardiometabolic profile and renal function in a Romanian population-based sample from the PREDATORR cross-sectional study. Eur J Gen Pract 2017; 23:164-170. [PMID: 28595498 PMCID: PMC5774259 DOI: 10.1080/13814788.2017.1324844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 03/24/2017] [Accepted: 04/05/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The impact of smoking on morbidity is well known, but in Romania, limited data are available regarding the smoking prevalence and relationship with cardiometabolic profile and kidney function. OBJECTIVES To assess the association of smoking with cardiometabolic traits and kidney function, in a Romanian population-based sample from the PREDATORR study. METHODS PREDATORR was an epidemiological cross-sectional study. Between 2012 and 2014, participants were randomly selected from the lists of general practitioners and enrolled if they were aged 20 to 79 years, born and living in the past 10 years in Romania. Sociodemographic and lifestyle characteristics were collected through interviewer-administered questionnaires. RESULTS Overall, 2704 participants were included in the analysis, 18% of them being current smokers and 30.8% former smokers. Current smokers compared to non-smokers had higher total cholesterol (220.6 ± 50.4 versus 213.9 ± 86.8 mg/dl, P = 0.017), LDL-cholesterol (137.8 ± 45.2 versus 130.7 ± 83.7 mg/dl, P = 0.004) and glomerular filtration rate (96.9 ± 16.8 versus 90.7 ± 19.1 ml/min/1.73 m2, P <0.001) in women and higher triglycerides (170.7 ± 129.8 versus 144.3 ± 94.2 mg/dl, P = 0.007), glomerular filtration rate (97.6 ± 17 versus 90.3 ± 18 ml/min/1.73 m2, P < 0.001) and lower HDL-cholesterol (48 ± 15.5 versus 50.4 ± 14.1 mg/dl, P = 0.002) in men. Active smoking was associated with hypercholesterolaemia [OR: 1.40 (95% CI: 1.01-1.96), P = 0.04] and low HDL-cholesterolaemia [OR: 1.39 (95% CI: 1.01-1.91), P = 0.04] and negatively associated with overweight/obesity [OR: 0.67 (95% CI: 0.48-0.94), P = 0.02]. Male former smokers had higher prevalence of abdominal obesity (82.4% versus 76.4%, P = 0.02), hypertriglyceridaemia (43.6% versus 35.6%, P = 0.01), hypertension (64% versus 56.4%, P = 0.01) and ischaemic vascular disease (40.5% versus 30.9%, P = 0.003) than male non-smokers. CONCLUSION The PREDATORR study showed a high prevalence of smoking in the adult Romanian population providing data on the association of smoking with cardiometabolic traits.
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Affiliation(s)
- Simona Georgiana Popa
- Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of CraiovaCraiovaRomania
| | - Maria Moţa
- Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of CraiovaCraiovaRomania
| | | | - Adina Popa
- Department of Diabetes, Nutrition and Metabolic Diseases, Clinical Emergency Hospital of CraiovaCraiovaRomania
| | - Ioana Munteanu
- Pneumoftiziology Institute ‘Marius Nasta’ BucharestBucharestRomania
| | - Eugen Moţa
- Department of Nephrology, University of Medicine and Pharmacy of CraiovaCraiovaRomania
| | - Cristian Serafinceanu
- Department of Diabetes, University of Medicine and Pharmacy ‘Carol Davila’ BucharestBucharestRomania
| | - Cristian Guja
- Department of Diabetes, University of Medicine and Pharmacy ‘Carol Davila’ BucharestBucharestRomania
| | - Nicolae Hâncu
- Department of Diabetes, University of Medicine and Pharmacy ‘Iuliu Haţieganu’ Cluj-NapocaCluj-NapocaRomania
| | - Doina Catrinoiu
- Faculty of Medicine, ’Ovidius’ University ConstanţaConstanţaRomania
| | - Radu Lichiardopol
- Department of Diabetes, University of Medicine and Pharmacy ‘Carol Davila’ BucharestBucharestRomania
| | - Cornelia Bala
- Department of Diabetes, University of Medicine and Pharmacy ‘Iuliu Haţieganu’ Cluj-NapocaCluj-NapocaRomania
| | - Bogdan Mihai
- Department of Diabetes, University of Medicine and Pharmacy ‘Gr. T. Popa’ IaşiIaşiRomania
| | - Gabriela Radulian
- Department of Diabetes, University of Medicine and Pharmacy ‘Carol Davila’ BucharestBucharestRomania
| | - Gabriela Roman
- Department of Diabetes, University of Medicine and Pharmacy ‘Iuliu Haţieganu’ Cluj-NapocaCluj-NapocaRomania
| | - Romulus Timar
- Department of Diabetes, University of Medicine and Pharmacy ‘Victor Babeş’ TimişoaraTimişoaraRomania
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17
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Ueyama C, Horibe H, Yamase Y, Fujimaki T, Oguri M, Kato K, Yamada Y. Association of smoking with prevalence of common diseases and metabolic abnormalities in community-dwelling Japanese individuals. Biomed Rep 2017; 7:429-438. [PMID: 29109861 DOI: 10.3892/br.2017.991] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 07/06/2017] [Indexed: 01/19/2023] Open
Abstract
Smoking is a significant risk factor for cardiovascular diseases (CVDs). Given that certain common pathologies, including hypertension, dyslipidemia and type 2 diabetes mellitus, are major risk factors for CVDs, the association of smoking with CVDs may be attributable, at least in part, to its effects on common diseases. The aim of the present study was to determine the association of smoking with the prevalence of common diseases and metabolic abnormalities in community-dwelling Japanese individuals. The study included 5,959 subjects (1,302 current smokers, 1,418 past smokers and 3,239 nonsmokers) recruited to the Inabe Health and Longevity Study, a longitudinal genetic epidemiological study of atherosclerotic, cardiovascular and metabolic diseases. Various metabolic parameters and prevalence of common diseases were compared between smokers and nonsmokers using multivariable regression or logistic regression analysis with adjustments for age. Analysis indicated significantly higher serum concentrations of triglycerides and lower concentrations of high-density lipoprotein (HDL)-cholesterol in current smokers compared with nonsmokers in men and women. Serum concentrations of creatinine and systolic blood pressure were significantly lower and estimated glomerular filtration rate was higher in male current smokers. In addition, body weight was higher in female current smokers. In multivariable logistic regression analysis, smoking was significantly associated with the prevalence of dyslipidemia [P=6.3×10-10; odds ratio (OR), 1.81], hypertriglyceridemia (P=2.3×10-20; OR, 2.39), hypo-HDL-cholesterolemia (P=2.0×10-9; OR, 2.14), metabolic syndrome (P=0.0003; OR, 1.61) and chronic kidney disease (P=4.4×10-15; OR, 0.54) in men, but not in women. The results indicated that smoking is significantly associated with various metabolic abnormalities and prevalence of common diseases in Japanese individuals, with certain sex differences, which may lead to accelerated development of CVDs.
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Affiliation(s)
- Chikara Ueyama
- Department of Cardiovascular Medicine, Gifu Prefectural Tajimi Hospital, Tajimi 507-8522, Japan
| | - Hideki Horibe
- Department of Cardiovascular Medicine, Gifu Prefectural Tajimi Hospital, Tajimi 507-8522, Japan
| | - Yuichiro Yamase
- Department of Cardiovascular Medicine, Gifu Prefectural Tajimi Hospital, Tajimi 507-8522, Japan
| | - Tetsuo Fujimaki
- Department of Cardiovascular Medicine, Inabe General Hospital, Inabe 511-0428, Japan
| | - Mitsutoshi Oguri
- Department of Cardiology, Kasugai Municipal Hospital, Kasugai 486-8510, Japan
| | - Kimihiko Kato
- Department of Internal Medicine, Meitoh Hospital, Nagoya 465-0025, Japan
| | - Yoshiji Yamada
- Department of Human Functional Genomics, Advanced Science Research Promotion Center, Mie University, Tsu 514-8507, Japan.,Core Research for Evolutionary Science and Technology (CREST), Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
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18
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Drummond CA, Brewster PS, He W, Ren K, Xie Y, Tuttle KR, Haller ST, Jamerson K, Dworkin LD, Cutlip DE, Murphy TP, D’Agostino RB, Henrich WL, Tian J, Shapiro JI, Cooper CJ. Cigarette smoking and cardio-renal events in patients with atherosclerotic renal artery stenosis. PLoS One 2017; 12:e0173562. [PMID: 28306749 PMCID: PMC5357000 DOI: 10.1371/journal.pone.0173562] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 02/22/2017] [Indexed: 11/22/2022] Open
Abstract
Cigarette smoking causes cardiovascular disease and is associated with poor kidney function in individuals with diabetes mellitus and primary kidney diseases. However, the association of smoking on patients with atherosclerotic renal artery stenosis has not been studied. The current study utilized data from the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL, NCT00081731) clinical trial to evaluate the effects of smoking on the risk of cardio-renal events and kidney function in this population. Baseline data showed that smokers (n = 277 out of 931) were significantly younger at enrollment than non-smokers (63.3±9.1 years vs 72.4±7.8 years; p<0.001). In addition, patients who smoke were also more likely to have bilateral renal artery stenoses and peripheral vascular disease (PVD). Longitudinal analysis showed that smokers experienced composite endpoint events (defined as first occurrence of: stroke; cardiovascular or renal death; myocardial infarction; hospitalization for congestive heart failure; permanent renal replacement; and progressive renal insufficiency defined as 30% reduction of GFR from baseline sustained for ≥ 60 days) at a substantially younger age compared to non-smokers (67.1±9.0 versus 76.1±7.9, p<0.001). Using linear regression and generalized linear modeling analysis controlled by age, sex, and ethnicity, smokers had significantly higher cystatin C levels (1.3±0.7 vs 1.2±0.9, p<0.01) whereas creatinine and estimated glomerular filtration rate (eGFR) were not different from non-smokers. From these data we conclude that smoking has a significant association with deleterious cardio-renal outcomes in patients with renovascular hypertension.
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Affiliation(s)
- Christopher A. Drummond
- Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States of America
| | - Pamela S. Brewster
- Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States of America
| | - Wencan He
- Department of Mathematics, University of Toledo, Toledo, OH, United States of America
| | - Kaili Ren
- Department of Mathematics, University of Toledo, Toledo, OH, United States of America
| | - Yanmei Xie
- Department of Mathematics, University of Toledo, Toledo, OH, United States of America
| | - Katherine R. Tuttle
- Division of Nephrology, University of Washington School of Medicine, Providence Health Care, Spokane, WA, United States of America
| | - Steven T. Haller
- Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States of America
| | - Kenneth Jamerson
- Department of Medicine, University of Michigan, Ann Arbor, MI, United States of America
| | - Lance D. Dworkin
- Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States of America
| | - Donald E. Cutlip
- Harvard Clinical Research Institute, Boston, MA, United States of America
| | - Timothy P. Murphy
- Departments of Medicine and Diagnostic Imaging, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, RI, United States of America
| | | | - William L. Henrich
- University of Texas Health Science Center, San Antonio TX, United States of America
| | - Jiang Tian
- Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States of America
| | - Joseph I. Shapiro
- Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States of America
| | - Christopher J. Cooper
- Department of Medicine, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States of America
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19
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Jia L, Zhang W, Ma J, Chen X, Chen L, Li Z, Cai G, Huang J, Zhang J, Bai X, Feng Z, Sun X, Chen X. Pulse Pressure, Instead of Brachium-Ankle Pulse Wave Velocity, is Associated with Reduced Kidney Function in a Chinese Han Population. Kidney Blood Press Res 2017; 42:43-51. [PMID: 28291958 DOI: 10.1159/000468531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 01/23/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS In this study, we aim to investigate the association between renal function and arterial stiffness in a Chinese Han population, and further to discuss the effects of smoking on renal function. METHODS We collected the data of the brachium-ankle pulse wave velocity (baPWV), blood pressure, blood chemistry and smoking status. Then, the multiple linear regression was done to explore the relationship between estimated glomerular filtration (eGFR) and baPWV. Further, the parameters were compared among the four groups divided according to the quartiles of baPWV. Finally, the baPWV, eGFR and albuminuria values were compared between smokers and non-smokers. RESULTS baPWV is associated with eGFR in the correlation analysis and univariate linear regression model. After adjustment, the pulse pressure (PP) instead of baPWV showed a significant association with eGFR. Nevertheless, the eGFR values differed among the four baPWV groups; the baPWV values were significantly higher in the subjects at the CKD (eGFR<60 mL/min/1.73 m2) and the early CKD stage (eGFR60-80 mL/min/1.73 m2). The baPWV values and the ratio of proteinuria were significantly increased in smokers. CONCLUSION PP but not baPWV is a predictor of declined renal function. Smokers have worse arterial stiffness and worse renal function.
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Affiliation(s)
- Linpei Jia
- Department of Nephrology, Second Hospital of Jilin University, Changchun, China.,Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Weiguang Zhang
- Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Jie Ma
- Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Xizhao Chen
- Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Lei Chen
- Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Zuoxiang Li
- Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Guangyan Cai
- Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Jing Huang
- Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Jinping Zhang
- Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Xiaojuan Bai
- Department of Gerontology and Geriatrics, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhe Feng
- Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Xuefeng Sun
- Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
| | - Xiangmei Chen
- Department of Nephrology, Second Hospital of Jilin University, Changchun, China.,Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Disease, National Clinic Research Center for Kidney Diseases, Beijing, China
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20
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Wakasugi M, Kazama J, Narita I, Iseki K, Fujimoto S, Moriyama T, Yamagata K, Konta T, Tsuruya K, Asahi K, Kondo M, Kurahashi I, Ohashi Y, Kimura K, Watanabe T. Association between Overall Lifestyle Changes and the Incidence of Proteinuria: A Population-based, Cohort Study. Intern Med 2017. [PMID: 28626171 PMCID: PMC5505901 DOI: 10.2169/internalmedicine.56.8006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective This study aimed to examine the association between the changes in an overall healthy lifestyle, as quantified by the number of unhealthy lifestyle factors and obesity status, and the incidence of proteinuria in the general Japanese population. Methods A retrospective cohort study was conducted among 99,404 (men, 36.9%) participants aged from 40-74 years of age who underwent two health check-ups with a 1-year interval in Japan between 2008 and 2009. Any participants with chronic kidney disease at baseline were excluded. The smoking status, body mass index, physical activity, alcohol consumption, and healthy eating habits were combined into a simple overall healthy lifestyle score ranging from 0 to 5. The changes in overall healthy lifestyle scores from baseline (range, -5 to +5) and the incidence of proteinuria, defined by a dipstick urinalysis (score ≥1+), were assessed at the second check-up. A logistic regression analysis was used to examine the association between the changes in overall healthy lifestyle scores and the incidence of proteinuria. Results After one year of follow-up, 3.9% of men and 2.4% of women developed proteinuria. Each increase (or decrease) in the changes in overall healthy lifestyle scores was associated with a reduced (or increased) risk of proteinuria in both men (odds ratio (OR) 0.87; 95% confidence interval (CI), 0.81-0.94) and women (OR 0.87; 95%CI, 0.80-0.94) after adjusting for age, baseline lifestyle scores, hypertension, diabetes mellitus, and hypercholesterolemia. Stratified analyses based on age, the presence or absence of hypertension, or diabetes mellitus revealed similar results. Conclusion Overall lifestyle changes, even within a year, were found to influence the incidence of proteinuria.
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Affiliation(s)
- Minako Wakasugi
- Division of Comprehensive Geriatrics in Community, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Junichiro Kazama
- Departments of Nephrology and Hypertension, Fukushima Medical University, Japan
| | - Ichiei Narita
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Kunitoshi Iseki
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Shouichi Fujimoto
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Toshiki Moriyama
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Kunihiro Yamagata
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Tsuneo Konta
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Kazuhiko Tsuruya
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Koichi Asahi
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Masahide Kondo
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | | | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Japan
| | - Kenjiro Kimura
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
| | - Tsuyoshi Watanabe
- Steering Committee for "Design of the comprehensive health care system for chronic kidney disease based on the individual risk assessment by Specific Health Checkups", Japan
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21
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Franceschini N, Deng Y, Flessner MF, Eckfeldt JH, Kramer HJ, Lash JP, Lee DJ, Melamed ML, Moncrieft AE, Ricardo AC, Rosas SE, Kaplan RC, Raij L, Cai J. Smoking patterns and chronic kidney disease in US Hispanics: Hispanic Community Health Study/Study of Latinos. Nephrol Dial Transplant 2016; 31:1670-6. [PMID: 27257272 DOI: 10.1093/ndt/gfw210] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/17/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Intermittent smoking is prevalent among Hispanics, but little is known about whether this smoking pattern associates with increased chronic kidney disease (CKD) risk in this population. The objective of the present study is to identify patterns of exposure associated with CKD in US Hispanics. METHODS We used cross-sectional data on 15 410 participants of the Hispanics Community Health Study/the Study of Latinos, a population-based study of individuals aged 18-74 years, recruited in 2008 to 2011 from four US field centers (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA). Smoking exposure was obtained through a questionnaire. CKD was defined by an estimated glomerular filtration rate of <60 mL/min/1.73 m(2) or a urine albumin-to-creatinine ratio of ≥30 mg/g. RESULTS Approximately 14% of individuals were daily and 7% were intermittent smokers, and 16% were past smokers. There was a significant interaction between smoking status and pack-years of exposure (P = 0.0003). In adjusted models, there was an increased odds of CKD among daily, intermittent and past smokers by pack-years compared with never smokers. The association of intermittent smokers was significant at 10 pack-years [odds ratio (OR) = 1.38, 95% confidence intervals (CI) 1.06, 1.81], whereas for daily smokers this association was observed at 40 pack-years (OR = 1.43, 95% CI 1.09, 1.89). CONCLUSIONS Our findings of increased risk of CKD among Hispanics who are intermittent smokers support screening and smoking cessation interventions targeted to this population for the prevention of CKD. It also suggests novel mechanistic pathways for kidney toxicity that should be further explored in future studies.
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Affiliation(s)
- Nora Franceschini
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Yu Deng
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael F Flessner
- National Institute of Diabetes, Digestive, and Kidney Disease, Bethesda, MD, USA
| | - John H Eckfeldt
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Holly J Kramer
- Division of Nephrology, Loyola University, Maywood, IL, USA
| | - James P Lash
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | | | - Ana C Ricardo
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Sylvia E Rosas
- Joslin Diabetes Center, Harvard University, Boston, MA, USA
| | | | | | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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22
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Ohkuma T, Nakamura U, Iwase M, Ide H, Fujii H, Jodai T, Kaizu S, Kikuchi Y, Idewaki Y, Sumi A, Hirakawa Y, Kitazono T. Effects of smoking and its cessation on creatinine- and cystatin C-based estimated glomerular filtration rates and albuminuria in male patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry. Hypertens Res 2016; 39:744-751. [PMID: 27250568 DOI: 10.1038/hr.2016.51] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 03/11/2016] [Accepted: 03/17/2016] [Indexed: 12/19/2022]
Abstract
Cigarette smoking is an important modifiable risk factor for lifestyle diseases. The smoking rate remains high, and the prevalence of diabetes mellitus is increasing in Asian countries; however, few studies have examined the effects of smoking on chronic kidney disease (CKD) in Asian diabetic patients. The aim of the present study was to investigate the association between smoking and its cessation with CKD and its components in patients with type 2 diabetes. A total of 2770 Japanese male patients with type 2 diabetes aged ⩾20 years were divided according to the amount of cigarette smoking and the years since cessation. The associations with CKD, the urinary albumin-creatinine ratio (UACR) and the estimated glomerular filtration rate (eGFR) were cross-sectionally examined. The proportions of CKD and the mean UACR dose-dependently increased with increases in both the number of cigarettes per day and the Brinkman index compared with the never smokers. The creatinine-based eGFR also increased with increases in the amount of smoking, whereas the cystatin C-based eGFR decreased, and their average did not significantly change. These parameters exhibited inverse associations with the years after smoking cessation compared with the association with the amount of smoking. A dose-dependent association of active smoking and a graded inverse association of the years since quitting with CKD enhance the merit of smoking cessation in patients with type 2 diabetes.
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Affiliation(s)
- Toshiaki Ohkuma
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Udai Nakamura
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masanori Iwase
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Diabetes Center, Hakujyuji Hospital, Fukuoka, Japan
| | - Hitoshi Ide
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroki Fujii
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Division of General Internal Medicine, School of Oral Health Science, Kyushu Dental University, Kitakyushu, Japan
| | - Tamaki Jodai
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinako Kaizu
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yohei Kikuchi
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuhiro Idewaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Diabetes Center, Hakujyuji Hospital, Fukuoka, Japan
| | - Akiko Sumi
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichiro Hirakawa
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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23
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Suzuki S, Otsuka T, Sagara K, Kano H, Matsuno S, Takai H, Kato Y, Uejima T, Oikawa Y, Nagashima K, Kirigaya H, Kunihara T, Yajima J, Sawada H, Aizawa T, Yamashita T. Association between smoking habits and the first-time appearance of atrial fibrillation in Japanese patients: Evidence from the Shinken Database. J Cardiol 2014; 66:73-9. [PMID: 25458170 DOI: 10.1016/j.jjcc.2014.09.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 08/27/2014] [Accepted: 09/08/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND We previously reported a cross-sectional analysis regarding the relationship between smoking and atrial fibrillation (AF) in a single hospital-based cohort with Japanese patients, but the effect of cessation of smoking and/or total tobacco consumption were unclear. METHODS AND RESULTS We used data from the Shinken Database 2004-2011 (men/women, n=10,714/6803, respectively), which included all new patients attending the Cardiovascular Institute between June 2004 and March 2012. After excluding those previously diagnosed with AF (n=2296), 15,221 patients (men/women, n=9016/6205) were analyzed. During the follow-up period of 2.0±2.1 years (range 0.0-8.1), the incidence rates of new AF in smokers and non-smokers were 9.0 and 5.0 per 1000 patient-years, respectively. In adjusted models with Cox regression analysis, smokers were independently associated with new AF [hazard ratio (HR) 1.47, 95% confidence interval (CI) 1.09-2.00]. Also, current smokers (HR 1.81, 95% CI 1.17-2.79) and smokers with Brinkman index ≥800 (HR 1.69, 95% CI 1.05-2.70) were independently associated with new AF. However, in current smokers, the HRs were not different by Brinkman index (Brinkman index <800/≥800; HR 1.81/1.82, 95% CI 1.07-3.05/0.94-3.51, respectively). CONCLUSIONS Smoking was independently associated with the first-appearance of AF in patients in sinus rhythm, especially when the patients continued their smoking habit. However, in patients who continued smoking, difference by total tobacco consumption was not observed, suggesting the significance of cessation of smoking for preventing AF. Our data are limited because of a single hospital-based nature and a relatively short observation period.
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Affiliation(s)
- Shinya Suzuki
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan.
| | - Takayuki Otsuka
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Koichi Sagara
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Hiroto Kano
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Shunsuke Matsuno
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Hideaki Takai
- Department of Cardiovascular Surgery, The Cardiovascular Institute, Tokyo, Japan
| | - Yuko Kato
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Tokuhisa Uejima
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Yuji Oikawa
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Kazuyuki Nagashima
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Hajime Kirigaya
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Takashi Kunihara
- Department of Cardiovascular Surgery, The Cardiovascular Institute, Tokyo, Japan
| | - Junji Yajima
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Hitoshi Sawada
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Tadanori Aizawa
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
| | - Takeshi Yamashita
- Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan
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24
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Noborisaka Y, Ishizaki M, Yamazaki M, Honda R, Yamada Y. Elevated Blood Pressure and Serum γ -Glutamyltransferase as Significant Characteristics of Smokers With Chronic Kidney Disease. Nephrourol Mon 2014; 6:e20746. [PMID: 25695028 PMCID: PMC4317723 DOI: 10.5812/numonthly.20746] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 06/05/2014] [Accepted: 06/14/2014] [Indexed: 02/07/2023] Open
Abstract
Background: Smoking is a risk factor for chronic kidney disease (CKD). However, it is speculated that only a small subset of sensitive smokers develop CKD. Objectives: We aimed to reveal the characteristics of such smokers sensitive to the renal effects of smoking with respect to cardiovascular (CV) risk factors associated with smoking and/or CKD. Patients and Methods: Renal functions and CVD risk factors were assessed in middle-aged male workers. The patients were comprised of 336 nonsmokers, 332 smokers currently smoking up to one pack per day, and 38 who smoked more than one pack per day. CKD was determined by estimated glomerular filtration rate (eGFR) from serum creatinine and urinary albumin to creatinine ratio (ACR). The independent and interactive effects of smoking and CKD on the CVD risk factors adjusted for age, body mass index, alcohol consumption, and physical activity were statistically analyzed. Results: In comparison to nonsmokers, smokers had significantly higher waist circumference, white blood cells (WBC), serum triglycerides, γ-glutamyltransferase (GGT), and C-reactive protein (CRP) and lower serum high-density lipoprotein cholesterol and uric acid. On the other hand, blood pressure (BP) and WBC tended to be higher in those showing CKD than others. Serum GGT and fasting plasma glucose were significantly higher, and insulin resistance index of homeostatic model assessment (HOMA-IR) tended to be higher in those with CKD. Serum CRP was especially high in those with moderate to severe CKD. A significant interactive effect of smoking and CKD on BP and serum GGT levels was detected, i.e. BP and GGT were not different in the subjects among nonsmokers with and without CKD, but were conspicuously high among smokers with CKD. No significant interactive effect was found on either HOMA-IR or serum CRP. Conclusions: Smokers with a higher BP and/or serum GGT may be at a higher risk of developing CKD. The associations of BP and serum GGT with CKD in smokers are not entirely mediated by increased insulin resistance or chronic inflammation caused by smoking.
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Affiliation(s)
- Yuka Noborisaka
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Uchinada, Japan
- Corresponding author: Yuka Noborisaka, Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Uchinada, Ishikawa, 920-0293 Japan. Tel: +81-762188101, Fax: +81-762869723, E-mail:
| | - Masao Ishizaki
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Uchinada, Japan
| | - Michiko Yamazaki
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Uchinada, Japan
| | - Ryumon Honda
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Uchinada, Japan
| | - Yuichi Yamada
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, Uchinada, Japan
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25
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Suzuki S, Sagara K, Otsuka T, Kano H, Matsuno S, Takai H, Uejima T, Oikawa Y, Koike A, Nagashima K, Kirigaya H, Yajima J, Tanabe H, Sawada H, Aizawa T, Yamashita T. Effects of smoking habit on the prevalence of atrial fibrillation in Japanese patients with special reference to sex differences. Circ J 2013; 77:2948-53. [PMID: 24065034 DOI: 10.1253/circj.cj-13-0446] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Tobacco smoking is a well-known risk factor for cardiovascular disease, but controversial results have been reported regarding its relationship with atrial fibrillation (AF). Moreover, no study on the relationship between smoking and AF has yet been undertaken in a Japanese context. METHODS AND RESULTS We used data from the Shinken Database 2004-2011 (men/women, n=10,714/6,803, respectively), which included all new patients attending the Cardiovascular Institute between June 2004 and March 2012. AF was diagnosed in 1,698 and 598 men and women, respectively. In men, smokers were more prevalent in the AF than in the non-AF group (54.5% vs. 44.7%), whereas in women the prevalence of smokers was similar between AF and non-AF groups (14.4% vs. 15.4%). This discrepancy between the sexes seems to derive from a characteristic distribution pattern of smoking habit in women. After adjustment for various cofactors, smoking was independently associated with AF (odds ratio 1.54; 95% confidence interval 1.35-1.75; P<0.001) without a significant interaction between sex categories (P=0.195). CONCLUSIONS Smoking was independently associated with AF without a significant interaction between sex categories among Japanese patients visiting a cardiovascular hospital. Further studies using a prospective cohort design are required to confirm a causal link between smoking and AF in Japanese patients.
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Affiliation(s)
- Shinya Suzuki
- Departments of Cardiovascular Medicine, The Cardiovascular Institute
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26
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Early life influences kidney function at age 63-64 years, but so does adult body size: results from the newcastle thousand families birth cohort. PLoS One 2013; 8:e66660. [PMID: 23785509 PMCID: PMC3681764 DOI: 10.1371/journal.pone.0066660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 05/08/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND It is suggested that impaired fetal growth can affect kidney development, resulting in fewer glomeruli being formed and reduced kidney function later in life. The aim of this study was to investigate early life variables in relation to adult kidney function, and compare these to the influence of later life variables. METHODS Detailed information was collected prospectively regarding 1,142 babies, born in 1947 in Newcastle upon Tyne. At the age of 63-64 years, 335 participants had serum creatinine successfully measured and completed a lifestyle questionnaire. These measurements were used to calculate their estimated glomerular filtration rate (eGFR). RESULTS Body mass index (BMI) and being female were significantly negatively associated with eGFR. Birth weight was significantly positively associated with eGFR. In sex-specific analyses, BMI and cigarette smoking remained significant for males (n = 154), with a near significant association for birth weight, whereas none of the variables remained significant for females (n = 181). CONCLUSIONS The findings suggest that sex, size at birth and BMI may be important variables influencing adult kidney function. However, as only a small amount of variance in eGFR was explained by these variables, additional longitudinal studies would be beneficial for assessing lifecourse influences on kidney function.
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27
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Noborisaka Y, Ishizaki M, Yamada Y, Honda R, Yokoyama H, Miyao M, Tabata M. The effects of continuing and discontinuing smoking on the development of chronic kidney disease (CKD) in the healthy middle-aged working population in Japan. Environ Health Prev Med 2013; 18:24-32. [PMID: 22623223 PMCID: PMC3541810 DOI: 10.1007/s12199-012-0285-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 04/30/2012] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The strength of the association between smoking and the development of chronic kidney disease (CKD) in the healthy middle-aged working age population has not been established. METHODS This was a retrospective 6-year observational study involving 4,121 male and 2,877 female workers who were free of primary kidney disease, diabetes mellitus, severe hypertension, and the signs and symptoms of CKD. Proteinuria was detected by a dipstick method, and glomerular filtration rate (GFR) was estimated by the equation of the Japan Society of Nephrology. RESULTS Sixty men (1.5 %) and 21 women (0.7 %) developed proteinuria over the 6 years of the study. Irrespective of sex, in comparison with non-smokers, those who continued smoking showed an odds ratio (OR) of 2.52 with a 95 % confidence interval (CI) of 1.50-4.25 for developing proteinuria while those who quit smoking showed an OR of 1.29 (95 % CI 0.48-3.42), following adjustment for confounders. Among the study population, 443 men (10.7 %) and 356 women (12.4 %) developed a GFR of <60 mL/min/1.73 m(2), corresponding to stage III CKD. Continuing smokers had a low OR (0.74, 95 % CI 0.60-0.90) for developing a low GFR, as well as a higher mean GFR than non-smokers. The reduction in GFR during the 6-year study period was not different between smokers and non-smokers, but it was larger in those who developed proteinuria than in those who did not, irrespective of smoking. CONCLUSIONS Continuing smokers showed a twofold or more higher risk of developing proteinuria. Discontinuation of smoking substantially reduced the risk. A longer observational period may be required to detect the smoking-induced risk of developing stage III CKD in the middle-aged working population.
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Affiliation(s)
- Yuka Noborisaka
- Department of Social and Environmental Medicine, Kanazawa Medical University School of Medicine, 1-1 Daigaku, Uchinada, Kanazawa, Ishikawa, 920-0293, Japan.
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Noborisaka Y. Smoking and chronic kidney disease in healthy populations. Nephrourol Mon 2012; 5:655-67. [PMID: 23577327 PMCID: PMC3614318 DOI: 10.5812/numonthly.3527] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 12/08/2011] [Accepted: 01/09/2012] [Indexed: 11/16/2022] Open
Abstract
The objective of this review is to explore the link between smoking and the development of chronic kidney disease (CKD) in generally healthy populations without pre-existing renal dysfunction such as diabetic nephropathy. Twenty-eight epidemiological studies concerning the renal effects of smoking in the general population were collected from the MEDLINE database and were reviewed for indications of proteinuria and/or the decline of glomerular filtration rate (GFR), and evaluated on the level of evidence and the quality of the study. Sixteen of the 28 studies were cross-sectional in design. Most articles had some weakness in scope, such as the 6 articles which did not fully exclude DM patients from the subjects, the 4 that did not consider the effects of ex-smoking, and the 3 that focused on only a small number of subjects. From these cases, it is difficult to draw firm conclusions. However, proteinuria or microalbuminuria was persistently high in current smokers; as much as 5-8% or 8-15% respectively, which was up to 2 to 3-times the rate of lifelong non-smokers. On the other hand, only 5 studies broader in scope detected any decline of GFR in smokers, while 9 other studies suggested a higher GFR in smokers than in non-smokers. Two good quality studies showed an even a significantly lower risk of a decreased GFR in smokers. These paradoxical CKD markers in smokers, i.e., a higher appearance of proteinuria with a higher GFR, could be a focus for further studies to reveal the underlying reasons for smoking-induced CKD. Workplaces may be an excellent place to study this subject since the long-term changes in renal function of smokers can be observed by collecting data in the annual health check-ups mandated at places of employment.
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Affiliation(s)
- Yuka Noborisaka
- Department of Social and Environmental Medicine, School of Medicine, Kanazawa Medical University, Ishikawa, Japan
- Corresponding author: Yuka Noborisaka, Department of Social and Environmental Medicine, School of Medicine, Kanazawa Medical University, 1-1 Uchinada, Ishikawa, Japan. Tel.: +76-2188101, Fax: +76-2869723, E-mail:
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Ifegwu C, Osunjaye K, Fashogbon F, Oke K, Adeniyi A, Anyakora C. Urinary 1-hydroxypyrene as a biomarker to carcinogenic polycyclic aromatic hydrocarbon exposure. BIOMARKERS IN CANCER 2012; 4:7-17. [PMID: 24179391 PMCID: PMC3791913 DOI: 10.4137/bic.s10065] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In order to capture the extent of exposure to polycyclic aromatic hydrocarbons (PAHs), various biomarkers have been employed. The biomarkers employed for PAHs include PAHs genetoxic end points in lymphocytes, urinary metabolites, PAH-DNA adducts, and PAH-Protein adducts. Of these, excretory 1-hydroxypyene, a metabolite of pyrene, has been used extensively as a biological monitoring indicator of exposure to PAHs. This study attempts to assess the level of this biomarker in the body fluid of 68 exposed subjects using high performance liquid chromatography HPLC. The subjects screened included auto mechanics, drivers, and fuel attendants. 1-hydroxypyrene was extracted from the urine of the subjects using solid phase extraction method. The HPLC analysis was done in isocratic mode using water:methanol (12:88 v/v) mobile phase. The stationary phase was XBridge C18 (150 × 4.6 mm) 5 μm column. The wavelength was 250 nm at a flow rate of 1.2 mL/min. The oven temperature was 30 ºC and the injection volume was 20 μL. The run time was 3 minutes. The level of urinary 1-hydroxypyrene detected varied for the different categories of occupation studied. About 27% of sampled fuel attendants and 22% of auto mechanics had detectable 1-hydroxypyrene in their urine samples. There was no detectable 1-hydroxypyene in the urine samples of commercial drivers or in the urine samples of students used as controls. The results of this study showed that fuel attendants and auto mechanics have significant exposures to PAHs. So far, there is no established benchmark for level of PAHs in urine, but our findings indicate the possibility of future cancer cases in this population as a result of their occupational exposure. The study was not able to link the level of 1-hydroxypyene with the smoking habits of the subjects.
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Affiliation(s)
- Clinton Ifegwu
- Department of Pharmaceutcal Chemistry, Faculty of Pharmacy, University of Lagos, Lagos, Nigeria
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Maeda I, Hayashi T, Sato KK, Koh H, Harita N, Nakamura Y, Endo G, Kambe H, Fukuda K. Cigarette smoking and the association with glomerular hyperfiltration and proteinuria in healthy middle-aged men. Clin J Am Soc Nephrol 2011; 6:2462-9. [PMID: 21885794 PMCID: PMC3359554 DOI: 10.2215/cjn.00700111] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 07/12/2011] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVES Glomerular hyperfiltration and albuminuria accompanied by early-stage diabetic kidney disease predict future renal failure. Cigarette smoking has reported to be associated with elevated GFR in cross-sectional studies and with renal deterioration in longitudinal studies. The degree of glomerular hyperfiltration and proteinuria associated with smoking, which presumably is a phenomenon of early renal damage, has not been investigated in a satisfying manner so far. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS This study included 10,118 Japanese men aged 40 to 55 years without proteinuria or renal dysfunction at entry. Estimated GFR was calculated using the Modification of Diet in Renal Disease equation for Japanese. Glomerular hyperfiltration was defined as estimated GFR ≥117.0 ml/min per 1.73 m(2), which was the upper 2.5th percentile value of estimated GFR in the total population. Proteinuria was detected using standard dipstick. RESULTS During the 6-year observation period, there were 449 incident cases of glomerular hyperfiltration and 1653 cases of proteinuria. Current smokers had a 1.32-time higher risk for the development of glomerular hyperfiltration and a 1.51-time higher risk for proteinuria than nonsmokers after adjustment for baseline age, body mass index, systolic and diastolic BP, antihypertensive medication, diabetes, alcohol consumption, regular leisure-time physical activity, and estimated GFR. Both daily and cumulative cigarette consumption were associated with an increased risk for glomerular hyperfiltration and proteinuria in a dose-response manner. CONCLUSIONS In middle-aged Japanese men, smoking was associated with an increased risk of glomerular hyperfiltration and dipstick proteinuria. Of importance, past smokers did not exhibit any increased risk for these conditions.
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Affiliation(s)
- Isseki Maeda
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan; and
| | - Tomoshige Hayashi
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan; and
| | - Kyoko Kogawa Sato
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan; and
| | - Hideo Koh
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan; and
| | - Nobuko Harita
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan; and
| | - Yoshiko Nakamura
- Kansai Health Administration Center, Nippon Telegraph and Telephone West Corporation, Osaka, Japan
| | - Ginji Endo
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan; and
| | - Hiroshi Kambe
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan; and
- Kansai Health Administration Center, Nippon Telegraph and Telephone West Corporation, Osaka, Japan
| | - Kanji Fukuda
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan; and
- Kansai Health Administration Center, Nippon Telegraph and Telephone West Corporation, Osaka, Japan
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Cigarette smoking, proteinuria, and renal function in middle-aged Japanese men from an occupational population. Environ Health Prev Med 2011; 17:147-56. [PMID: 21863294 DOI: 10.1007/s12199-011-0234-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 07/30/2011] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVES To clarify the renal effects of cigarette smoking in a middle-aged occupational population because the effects have previously been demonstrated mainly in community populations that included many elderly people who are thought to be vulnerable to such effects. METHODS In 990 middle-aged men recruited from a chemical plant, proteinuria was measured by a dipstick method and the glomerular filtration rate was estimated (eGFR) using a formula proposed by the Japanese Society of Nephrology. RESULTS Proteinuria was found in 4.6% of the current smokers and 1.5% of the never-smokers. It was found in 4.8% of the subjects having a Brinkman index (BI) of 400-599 and 6.3% of those having a BI of 600 or above. The odds ratio for proteinuria in them was 2.94 (CI: 1.01-8.55) and 3.61 (CI: 1.29-10.1), respectively, adjusting for possible confounders. The mean eGFR was higher in smokers than in nonsmokers throughout middle age up to 64 years. Normal but high eGFR was found in 6.7% of the current heavy smokers and subnormal eGFR in 5.7% of the largest cumulative cigarette consumers in contrast to 3.0% or less of the never-smokers. Proteinuria was found in 13.3% of the subjects showing subnormal eGFR, specifically in 16.7% of the smokers and 8.3% of the nonsmokers. CONCLUSIONS Smoking causes proteinuria in working middle-aged men. Smokers tend to have a high eGFR, but those with subnormal eGFR showed proteinuria most frequently. Whether the high eGFR in smokers will eventually decrease and cause proteinuria remains an important focus for further studies.
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Sauriasari R, Sakano N, Wang DH, Takaki J, Takemoto K, Wang B, Sugiyama H, Sato Y, Takigawa T, Takahashi N, Kanbara S, Hitomi Y, Nakamura H, Ogino K. C-reactive protein is associated with cigarette smoking-induced hyperfiltration and proteinuria in an apparently healthy population. Hypertens Res 2010; 33:1129-36. [DOI: 10.1038/hr.2010.154] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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ABC de la nefropatía diabética: UNA guía práctica para el médico general. REVISTA MÉDICA CLÍNICA LAS CONDES 2010. [DOI: 10.1016/s0716-8640(10)70573-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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