Abstract

In patients with chronic kidney disease (CKD), cigarette smoking increases the incidence of heart failure, peripheral vascular disease, progression of CKD and death. However, it is still unclear whether smoking influences new-onset of CKD in population without CKD. The aim of this study is to verify how smoking influence the new-onset of CKD in Japanese adults. ISSA-CKD retrospective phase is a retrospective cohort study using annual health checkup data in Iki Island (Nagasaki, Japan), which is located in the north of Nagasaki prefecture and has approximately 27,000 residents. The morbidity is one of the highest levels in Japan. From 2008 to 2016, a total of 7645 residents visited annual health check-ups conducted. After excluding residents who visited only 1 health check-up or with CKD at baseline, a total of 4,559 adults were included in the present analysis. Smoking status was obtained by a questionnaire, which classified them into current smoker and non-smoker (including ex-smoker). The outcome of the present analysis was new-onset of CKD, which was defined as estimated glomerular filtration rate <60mL/min/1.73m2 or proteinuria at the end of follow-up. Effects of smoking on development of CKD were evaluated using a Cox’s proportional hazards model. During a mean follow-up of 4.7 years, 744 (16.3%) new-onset CKD were observed. This association of smoking remained significant (hazard ratio 1.24; 95%CI 1.02-1.51, p=0.027) even after adjustment for other risk factors (sex, age, obese, hypertension, dyslipidemia, hyperuricemia, and diabetes mellitus) as well as age, obese, hypertension, hyperuricemia, and diabetes mellitus. Tabled 1Table. Effects of each values on incidence of new-onset chronic kidney disease (n=4559)variableHazard RatioP value95% Confidence Intervalsex0.9760.7770.823-1.156age1.0990.0011.083-1.113obese1.1950.0231.025-1.393smoking1.2450.0271.024-1.512hypertension1.2780.0021.094-1.493dyslipidemia0.9110.2280.784-1.060hyperuremia1.6170.0011.233-2.120diabetes mellitus1.4510.0031.131-1.861 Open table in a new tab The findings of the present analysis support that current cigarette smoking increases the risk of new-onset of CKD in Japanese population. In the future, we attempt to perform prospective study to clarify the relationship between smoking and CKD onset.

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