Smoking is associated with renal impairment and proteinuria in the normal population: The AusDiab kidney study
Smoking is associated with renal impairment and proteinuria in the normal population: The AusDiab kidney study
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DOI：
10.1053/ajkd.2002.35677
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发表时间：
2002-10-01
影响因子：
13.2
通讯作者：
Atkins, RC
中科院分区：
文献类型：
--
作者：
Briganti, EM;Branley, P;Atkins, RC
背景：吸烟与肾脏疾病的患病率、发生和进展有关。吸烟对健康人群肾功能的影响尚不清楚。我们在一个没有空腹血糖水平受损、糖耐量受损、糖尿病或高血压的健康人群中研究了吸烟与肾损伤指标之间的关系。方法：这是一项随机选择的、基于人群的、横断面研究，涉及11，247名澳大利亚成年人。通过问卷调查确定吸烟状况。检测受试者的肾损害指标：肾损害（Cockcroft-Gault估计的肾小球滤过率小于60 mL/min/1.73 m2）和蛋白尿（尿蛋白/肌酐比值≥ 0.20 mg/mg）。结果如下：在调整了潜在的混杂因素后，男性吸烟与肾功能损害显著相关，比值比为3.59，但女性吸烟与肾功能损害无关。在收缩压正常值偏高的受试者中，吸烟与蛋白尿显著相关，比值比范围为3.64（131.5 mm Hg）至5.76（139.5 mm Hg），在2小时血糖水平正常值偏高的受试者中，比值比范围为1.76（7.0 mmol/L）至10.84（7.7 mmol/L）。终生暴露，而不是目前的吸烟水平，与较低的估计肾小球滤过率和较高的尿蛋白肌酐比值。结论：在无高血压或糖代谢异常的人群中，吸烟与肾损害和蛋白尿有关。累积吸烟量与肾损害指标之间存在剂量反应关系。结合其他研究和合理的生物学机制，这项研究表明，吸烟可能会导致肾脏损伤，即使在健康人群中也是如此。(C)2002年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
Background: Smoking has been associated with the prevalence, development, and progression of kidney disease. The effect of smoking on kidney function in the healthy population is unclear. We examined the relationship between smoking and indicators of kidney damage in a healthy population without impaired fasting glucose levels, impaired glucose tolerance, diabetes mellitus, or hypertension. Methods: This is a randomly selected, population-based, cross-sectional study of 11,247 Australian adults. Smoking status was determined by questionnaire. Subjects were tested for indicators of kidney damage: renal impairment by Cockcroft-Gault-estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) and proteinuria by urine protein-creatinine ratio of 0.20 mg/mg or greater. Results: After adjusting for potential confounding factors, smoking was significantly associated with renal impairment in men with an odds ratio of 3.59, but not in women. Smoking was significantly associated with proteinuria in subjects with high-normal systolic blood pressure, with odds ratios ranging from 3.64 at 131.5 mm Hg to 5.76 at 139.5 mm Hg, and in subjects with high-normal 2-hour glucose levels, with odds ratios ranging from 1.76 at 7.0 mmol/L to 10.84 at 7.7 mmol/L. Lifetime exposure, but not current level of smoking, correlated with lower estimated glomerular filtration rate and greater urine protein-creatinine ratio. Conclusion: Smoking is associated with renal impairment and proteinuria in a population without hypertension or abnormal glucose metabolism. A dose-response relationship was found between cumulative amount of smoking and indicators of kidney damage. In conjunction with other studies and plausible biological mechanisms, this study suggests that smoking may cause kidney damage, even in a healthy population. (C) 2002 by the National Kidney Foundation, Inc.