Smoking and risk of incident end-stage kidney disease in general population: A Nationwide Population-based Cohort Study from Korea
Smoking and risk of incident end-stage kidney disease in general population: A Nationwide Population-based Cohort Study from Korea
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DOI：
10.1038/s41598-019-56113-7
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发表时间：
2019-12-20
影响因子：
4.6
通讯作者：
Kim, Soo Wan
中科院分区：
文献类型：
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作者：
Choi, Hong Sang;Han, Kyung-Do;Kim, Soo Wan
我们分析了韩国国家健康保险服务(NHIS)的数据，以调查吸烟是否会增加终末期肾病(ESKD)的风险。这项以全国人群为基础的回溯性队列研究包括23,232,091名参与者的数据，他们在2009至2012年间至少接受了一次健康检查。基线时记录吸烟情况。到2016年12月，通过韩国国家健康保险服务数据库中的ICD-10代码和特殊医疗援助代码确定了ESKD的发病率。使用多变量调整的COX比例风险模型来评估吸烟与ESKD发病率之间的关联。总体而言，24.6%的参与者是当前吸烟者；13.5%和61.9%的参与者分别是既往吸烟者和不吸烟者。总体而言，在随访期内发生了45,143例ESKD。与非吸烟者相比，当前吸烟者(危险比[HR]，1.39；95%可信区间[CI]，1.35-1.43)和既往吸烟者(HR，1.09；95%可信区间，1.06-1.12)调整后的ESKD风险显著增加。患ESKD的风险与吸烟持续时间、每天吸烟的数量和吸烟年限成正比。总而言之，在韩国普通人群中，吸烟与ESKD的风险更大相关；这种风险随着吸烟持续时间、每天吸烟的数量和包装年限的增加而增加。
We analyzed data from the Korean National Health Insurance Service (NHIS) to investigate whether smoking increases the risk of end-stage kidney disease (ESKD). This retrospective nationwide population-based cohort study included the data of 23,232,091 participants who underwent at least one health examination between 2009 and 2012. Smoking status was recorded at baseline. The incidence of ESKD was identified via ICD-10 codes and special medical aid codes from the Korean National Health Insurance Service database till December 2016. A Cox proportional-hazards model with multivariable adjustment was used to evaluate the association between smoking and ESKD incidence. Overall, 24.6% of participants were current smokers; 13.5% and 61.9%, were ex- and non-smokers, respectively. Overall, 45,143 cases of ESKD developed during the follow-up period. Current smokers (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.35-1.43) and ex-smokers (HR, 1.09; 95% CI, 1.06-1.12) demonstrated a significant increase in the adjusted risk of ESKD compared to non-smokers. The risk of ESKD was directly proportional to the smoking duration, number of cigarettes smoked daily, and pack-years. In conclusion, smoking is associated with a greater risk of ESKD in the general Korean population; the risk increases with an increase in the smoking duration, number of cigarettes smoked daily, and pack-years.