Secondhand smoke exposure tied to CKD risk

  • Jhee JH & al.
  • Clin J Am Soc Nephrol
  • 7 Mar 2019

  • International Clinical Digest
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Takeaway

  • Exposure to secondhand smoke is tied to an increased risk for chronic kidney disease (CKD) among nonsmokers.

Why this matters

  • According to CDC, ~58 million nonsmokers in the US were exposed to secondhand smoke during 2011-2012.

Study design

  • Study of 131,196 nonsmokers (mean age, 53±8 years; 75% women) participating in the 2001-2014 Korean Genome and Epidemiology study, stratified by exposure level (none [n=114,502],
  • Mean estimated glomerular filtration rate (eGFR), 92±14 mL/minute/1.73 m2.
  • Funding: Ministry for Health and Welfare, Korea; Inha University Hospital.

Key results

  • Baseline CKD (eGFR 2), rates: 1.8% with high secondhand smoke exposure, 1.7% with low exposure, and 2.0% with no exposure.
  • Odds of baseline CKD was 48% higher with secondhand smoke exposure vs no exposure (aOR=1.48; 95% CI, 1.25-1.74):   
    • Low exposure: aOR=1.72 (95% CI, 1.30-2.27).
    • High exposure: aOR=1.44 (95% CI, 1.22-1.70).
  • In a longitudinal subgroup (n=1948, 80% with exposure), rate of incident CKD was 16.4% over a mean follow-up of 8.7 years.
  • Risk for CKD development was 64% higher with secondhand smoke exposure (aHR=1.64; 95% CI, 1.03-2.60) vs no exposure:
    • Low exposure: aHR did not reach statistical significance.
    • High exposure: aHR=1.66 (95% CI, 1.03-2.67).

Limitations

  • Small sample size in low exposure group.
  • Secondhand smoke not quantified.
  • Renoprotective/toxic medications not captured.

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