[Effects of active and passive smoking on chronic kidney disease in patients with type 2 diabetes mellitus]

Abstract

Objective: This study aimed to assess the effects of active and passive smoking on chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM).

Methods: Seven hundred and five patients with T2DM were recruited in the study and were divided into three groups based on smoking status as active smokers, passive smokers and non-smokers. Twenty-four hour urinary albumin excretion (24hUAE) was measured, and estimate glomerular filtration rate (eGFR) was calculated with age and blood creatinine levels.

Results: (1)The proportion of CKD in T2DM in the present study was 31.63% (223/705) with 28.6% (22/77) , 30.0% (15/50) and 29.6% (73/247) for non-smokers, passive smokers and active smokers in men, and 29.9% (40/134), 35.9% (66/184) and 7/13 for non-smokers, passive smokers and active smokers in women, respectively. In comparison with non-smokers, a higher risk of CKD was found in both passive and active smokers (OR = 1.07 and OR = 1.05 in men; OR = 1.31 and OR = 2.74 in women, respectively). (2) Compared with non-smokers, passive smokers had a significant higher risk for albuminuria in women (OR = 2.02, P = 0.016) . (3) After adjusting for gender, age, duration of T2DM, BMI, systolic blood pressure, glycosylated hemoglobin A1C and lipids, there was a significant decrease in eGFR between active and never smokers (P = 0.018) or passive smokers (P = 0.000) in women. No differences could be found in eGFR between each smoking statues in men.

Conclusions: Smoking exposure alone confers a high risk for CKD in patients with T2DM. Our results highlight an importance in implementation of a smoke-free environment for patients with T2DM.