Open AccessAssociation of smoking with incident CKD risk in the general population: A community-based cohort study
Author(s) -
Wonji Jo,
Sang-mi Lee,
Young Su Joo,
Ki Heon Nam,
HaeRyong Yun,
Tae Ik Chang,
Ea Wha Kang,
TaeHyun Yoo,
Seung Hyeok Han,
Shin Wook Kang,
Sun-Hee Park
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0238111
Subject(s) - medicine , hazard ratio , kidney disease , renal function , confounding , proportional hazards model , diabetes mellitus , proteinuria , confidence interval , population , cohort study , cohort , epidemiology , incidence (geometry) , risk factor , rate ratio , environmental health , endocrinology , kidney , physics , optics
Background Chronic kidney disease (CKD) is a public health problem, and an unfavorable lifestyle has been suggested as a modifiable risk factor for CKD. Cigarette smoking is closely associated with cardiovascular disease and cancers; however, there is a lack of evidence to prove that smoking is harmful for kidney health. Therefore, we aimed to determine the relationship between cigarette smoking and CKD among healthy middle-aged adults. Methods Using the database from the Korean Genome and Epidemiology Study, we analyzed 8,661 participants after excluding those with baseline estimated glomerular filtration rate (eGFR)<60 ml/min/1.72 m 2 or proteinuria. Exposure of interest was smoking status: never-, former-, and current-smokers. Primary outcome was incident CKD defined as eGFR <60 ml/min/1.73 m 2 or newly developed proteinuria. Results The mean age of the subjects was 52 years, and 47.6% of them were males. There were 551 (6.4%) and 1,255 (14.5%) subjects with diabetes and hypertension, respectively. The mean eGFR was 93.0 ml/min/1.73 m 2 . Among the participants, 5,140 (59.3%), 1,336 (15.4%), and 2,185 (25.2%) were never-smokers, former-smokers, and current-smokers, respectively. During a median follow-up of 11.6 years, incident CKD developed in 1,941 (22.4%) subjects with a crude incidence rate of 25.1 (24.0–26.2) per 1,000 person-years. The multivariable Cox regression analysis after adjustment of confounding factors showed hazard ratios (95% confidence interval) of 1.13 (0.95–1.35) and 1.26 (1.07–1.48) for CKD development in the former- and current-smokers, compared with never-smokers. Conclusion This study showed that smoking was associated with a higher risk of incident CKD among healthy middle-aged adults.