SMOKING AS A NOVEL RISK FACTOR IN THE PROGRESSION OF RENAL DISEASE

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There is a strong association of smoking tobacco with the development of renal disease manifested by enhanced progression of renal disease, proteinuria, and even end-stage renal disease. Our central hypothesis is that smoking accelerates renal progression by inducing endothelial dysfunction, inflammation, and oxidative stress leading to an increase in blood pressure and a relative decrease in renal blood flow predisposing to renal progression. We will study 50 smokers and 50 nonsmokers with varying levels of renal dysfunction serum creatinine 2.0-5.0 secondary to hypertension-associated renal disease along with 25 smokers and 25 nonsmokers with normal renal function. Project will quantify the progression of renal disease in smokers and nonsmokers and determine whether systemic and/or renal hemodynamic changes lead to loss of renal function. Project will investigate the role of smoking-induced endothelial dysfunction in renal progression. Project will determine whether systemic and/or renal inflammation induced by smoking is associated with more rapid progression in renal disease. The final Project will study the role of smoking induced oxidative changes in renal progression.