Smoking is a risk factor for the progression of idiopathic membranous nephropathy.
Smoking is a risk factor for the progression of idiopathic membranous nephropathy.
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DOI：
10.1371/journal.pone.0100835
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Maruyama S
中科院分区：
文献类型：
--
作者：
Yamaguchi M;Ando M;Yamamoto R;Akiyama S;Kato S;Katsuno T;Kosugi T;Sato W;Tsuboi N;Yasuda Y;Mizuno M;Ito Y;Matsuo S;Maruyama S
多项研究表明，吸烟是慢性肾脏疾病的风险因素。然而，目前尚不清楚吸烟是否同样会增加膜性肾病的进展风险。这项研究使用了名古屋肾病综合征队列研究(N-NSCS)，包括来自日本10个肾病中心的171名特发性膜性肾病(IMN)患者。通过调整临床相关因素的多变量COX比例风险模型，评估吸烟与预后之间的剂量-反应关系。主要结果是估计的肾小球滤过率(EGFR)下降了30%。次要结果是蛋白尿首次完全缓解(CR)。在观察期内(中位数为37个月；四分位数范围为16-71个月)，37名患者(21.6%)的EGFR下降了30%，2名患者(1.2%)进展为终末期肾病。发生CR者103例(60.2%)。多变量COX比例风险模型显示，当前吸烟(调整后的危险比[HR]，7.81[95%可信区间(CI)，3.17-19.7])、女性(调整后的HR，3.58[95%CI，1.87-8.00])、年龄(调整后的HR，每10年1.71[95%CI，1.13-2.62])、每天吸烟的数量(调整后的HR，1.61[95%CI，1.23-2.09]每10根香烟)，累积吸烟≥40年(调整后HR，5.56[95%CI，2.17-14.6])与EGFR值下降30%相关。然而，吸烟与CR无关。吸烟是IMN进展的一个重要的和剂量依赖的危险因素。应该鼓励所有吸烟的IMN患者戒烟。
Multiple studies have shown cigarette smoking to be a risk factor for chronic kidney disease. However, it is unknown whether smoking similarly increases the risk for progression of membranous nephropathy. This study used the Nagoya Nephrotic Syndrome Cohort Study (N-NSCS), including 171 patients with idiopathic membranous nephropathy (IMN) from 10 nephrology centers in Japan. The dose-response relationships between cigarette smoking and the outcomes were assessed by using multivariate Cox proportional hazards models adjusted for clinically relevant factors. The primary outcome was a 30% decline in the estimated glomerular filtration rate (eGFR). The secondary outcome was first complete remission (CR) of proteinuria. During the observation period (median, 37 months; interquartile range, 16–71 months), 37 (21.6%) patients developed a 30% decline in eGFR and 2 (1.2%) progressed to ESRD. CR occurred in 103 (60.2%) patients. Multivariate Cox proportional hazards models revealed current smoking (adjusted hazard ratio [HR], 7.81 [95% confidence interval (CI), 3.17–19.7]), female sex (adjusted HR, 3.58 [95% CI, 1.87–8.00]), older age (adjusted HR, 1.71 [95% CI, 1.13–2.62] per 10 years), the number of cigarettes smoked daily (adjusted HR, 1.61 [95% CI, 1.23–2.09] per 10 cigarettes daily), and cumulative smoking of ≥40 pack-years (adjusted HR, 5.56 [95% CI, 2.17–14.6]) to be associated with a 30% decline in eGFR. However, smoking was not associated with CR. Smoking is a significant and dose-dependent risk factor for IMN progression. All patients with IMN who smoke should be encouraged to quit.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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DOI：
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发表时间：
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