Abstract
Cigarette smoking affects many organs. It causes vasoconstriction through activation of sympathetic nervous system which leads to elevation of blood pressure and reduction in glomerular filtration rate and filtration pressure. It also causes thickening of renal arterioles. Cigarette smoking increases the risk of microalbuminuria and accelerates progression of microalbuminuria to macroalbuminuria. Furthermore, it causes rapid loss of glomerular filtration rate in chronic kidney disease patients. After kidney donation, these factors may be injurious to the solitary kidney. Kidney donors with history of cigarette smoking are prone to develop perioperative complications, pneumonia, and wound infection. Postkidney transplantation various stressors including warm and cold ischemia time, delayed graft function, and exposure to calcineurin inhibitors may result in poor graft function. Continuation of cigarette smoking in kidney transplant recipients will add further risk. In this review, we will specifically discuss the effects of cigarette smoking on normal kidneys, live kidney donors, and kidney transplant recipients. This will include adverse effects of cigarette smoking on graft and patient survival, cardiovascular events, rejection, infections, and cancers in kidney transplant recipients. Lastly, the impact of kidney transplantation on behavior and smoking cessation will also be discussed.
Highlights
Cigarette smoking is common worldwide, despite the numerous deterrent measures that have been put in place over the decades
The present review focuses on adverse effects of smoking in normal kidneys, kidney donors, and kidney transplant recipient and effect of kidney transplantation on smoking cessation
Kidney donors with history of cigarette smoking should be referred to smoking cessation clinics
Summary
Cigarette smoking is common worldwide, despite the numerous deterrent measures that have been put in place over the decades. Tobacco use causes nearly 6 million deaths per year, and current trends show that tobacco use will cause more than 8 million deaths annually by 2030 [2]. Smokers die 10 years earlier than nonsmokers [3]. The association of cigarette smoking with cardiovascular diseases, chronic obstructive pulmonary disease, and cancers is well known. Cigarette smoking increases the risk of coronary heart disease and stroke by 2–4 times and that of lung cancer by 25 times [4]. Cigarette smoking causes chronic obstructive pulmonary disease (COPD) and smokers are 12 to 13 times more likely to die from COPD than nonsmokers [4]. The present review focuses on adverse effects of smoking in normal kidneys, kidney donors, and kidney transplant recipient and effect of kidney transplantation on smoking cessation
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