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Cigarette smoking and glomerular filtration rate in insulin‐treated diabetics without manifest nephropathy
Author(s) -
EKBERG Dr.G.,
GREFBERG N.,
LARSSON L.O.,
VAARA I.
Publication year - 1990
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1990.tb00220.x
Subject(s) - medicine , glomerular hyperfiltration , renal function , albuminuria , diabetes mellitus , snuff , blood pressure , body mass index , microalbuminuria , diabetic nephropathy , endocrinology , nephropathy , urology , pathology
. A sample of 120 insulin‐treated diabetics, 20‐40 years of age, with a glomerular filtration rate (GFR) exceeding −2 SD of the age‐adjusted value and without albuminuria > 300 mg 24 h −1 , and with a diastolic blood pressure not > 90 mmHg, were studied in order to evaluate the possible effect of smoking on glomerular filtration rate. The patients reported their smoking habits, use of oral snuff, use of alcohol, physical exercise and heredity for hypertension in a simple questionnaire. GFR was assessed with 51 Cr‐EDTA‐clearance and glomerular hyperfiltration was defined as a value exceeding + 2 SD of the age‐adjusted normal value. We found a significantly higher prevalence of glomerular hyperfiltration in smokers than in non‐smokers (41% vs. 18%), but no increased prevalence in users of oral snuff. In cigarette smokers a multivariate analysis revealed that GFR was positively related to body mass index (BMI), and negatively related to the number of cigarettes smoked per week and the mean blood pressure. In non‐smokers GFR was dependent only on age. We conclude that in insulin‐treated diabetics glomerular hyperfiltration is related to smoking, and that the GFR in smoking diabetics is directly dependent on the smoke doses. As glomerular hyperfiltration is regarded as a risk factor for diabetic nephropathy, our findings should be relevant to preventive measures in clinical work.