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Smoking and Kidney Function in Persons without Diabetes
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What is the problem and what is known about it so far?
It is known that persons with diabetes who smoke tobacco develop diabetes-related kidney disease sooner than those who do not, and kidney disease worsens more quickly in diabetic persons who smoke. Little is known, however, about the effect of smoking on kidney function in people without diabetes.
Why did the researchers do this particular study?
To examine whether tobacco smoking is related to problems with kidney function in persons who do not have diabetes.
Who was studied?
Nearly 8000 persons who were participating in the PREVEND (Prevention of REnal and Vascular ENd stage Disease) Study, a large study in the Netherlands that is exploring ways to prevent kidney disease. To be in the PREVEND Study, people had to be 28 to 75 years old, live in the city of Groningen, send in a urine sample, and fill out a short questionnaire.
How was the study done?
The researchers divided the 7746 participants into four groups: those who had never smoked, those who currently smoked 20 or fewer cigarettes per day, those who currently smoked more than 20 cigarettes per day, and those who had quit smoking more than 1 year ago. All of the participants underwent special tests of kidney function. One test looked at the amount of a substance called albumin in the urine (albuminuria), and another test measured how quickly another substance, creatinine, appeared in the urine (creatinine clearance). Higher levels of albumin in the urine and lower creatinine clearance indicate worse kidney function.
What did the researchers find?
Compared with nonsmokers, both light and heavy current smokers had more albuminuria and lower creatinine clearance, indicating worse kidney function. These differences remained even after the researchers accounted for blood pressure and several other factors known to influence kidney function. Persons who had quit smoking had slightly higher albumin levels, indicating slightly abnormal kidney function, but the condition was much less severe than in current smokers.
What were the limitations of the study?
Although this study showed that kidney function is worse in smokers than in nonsmokers, it did not follow study participants over time to see who actually became ill because of kidney problems. In addition, it is not known whether the relationship between smoking and kidney function would be the same in people from other geographic areas.
What are the implications of the study?
Smoking is associated with worse kidney function even in persons who do not have diabetes.
Article and Author Information
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The summary below is from the full report titled “Smoking Is Related to Albuminuria and Abnormal Renal Function in Nondiabetic Persons.” It is in the 17 October 2000 issue of Annals of Internal Medicine (volume 133, pages 585-591). The authors are SJ Pinto-Sietsma, J Mulder, WMT Janssen, HL Hillege, D de Zeeuw, and PE de Jong.
- Copyright ©2004 by the American College of Physicians
