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. 2019 Apr 5;14(4):515-522.
doi: 10.2215/CJN.09540818. Epub 2019 Mar 7.

Secondhand Smoke and CKD

Jong Hyun Jhee  1   2 , Young Su Joo  1 , Youn Kyung Kee  3 , Su-Young Jung  2 , Seohyun Park  2 , Chang-Yun Yoon  2 , Seung Hyeok Han  2 , Tae-Hyun Yoo  2 , Shin-Wook Kang  2   4 , Jung Tak Park  2
Affiliations

Secondhand Smoke and CKD

Jong Hyun Jhee et al. Clin J Am Soc Nephrol. .

Abstract

Background and objectives: Active smoking is associated with higher risk of various diseases. However, the risk of CKD development in nonsmokers exposed to secondhand smoke is not well elucidated. We aimed to investigate the association between secondhand smoke exposure and the risk of CKD development among never-smokers.

Design, setting, participants, & measurements: A total of 131,196 never-smokers with normal kidney function, who participated in the Korean Genome and Epidemiology Study from 2001 to 2014, were analyzed. The participants were classified into three groups on the basis of frequency of secondhand smoke exposure, assessed with survey questionnaires; no exposure, <3 days per week, and ≥3 days per week. The association between secondhand smoke and CKD, defined as eGFR<60 ml/min per 1.73 m2, was examined in the cross-sectional analysis. In addition, the risk of incident CKD development was analyzed in a longitudinal cohort of 1948 participants without CKD at baseline, which was a subset of the main cohort.

Results: The mean age of participants was 53 years, and 75% were women. Prevalent CKD was observed in 231 (1.8%), 64 (1.7%), and 2280 (2.0%) participants in the ≥3 days per week, <3 days per week, and no exposure groups. The odds ratio (OR) of prevalent CKD was significantly higher in the groups exposed to secondhand smoke than the no exposure group (<3 days per week: OR, 1.72; 95% confidence interval [95% CI], 1.30 to 2.27; and ≥3 days per week: OR, 1.44; 95% CI, 1.22 to 1.70). During a mean follow-up of 104 months, CKD occurred in 319 (16%) participants. Multivariable Cox analysis revealed that the risk for CKD development was higher in participants exposed to secondhand smoke than the no exposure group (<3 days per week: hazard ratio, 1.59; 95% CI, 0.96 to 2.65; and ≥3 days per week: hazard ratio, 1.66; 95% CI, 1.03 to 2.67).

Conclusions: Exposure to secondhand smoke was associated with a higher prevalence of CKD as well as development of incident CKD.

Keywords: Confidence Intervals; Cross-Sectional Studies; Epidemiologic Studies; Follow-Up Studies; Odds Ratio; Prevalence; Renal Insufficiency, Chronic; Risk; Smokers; Smoking; Tobacco Smoke Pollution; chronic kidney disease; clinical epidemiology; glomerular filtration rate; risk factors.

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Figures

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Graphical abstract
Figure 1.
Figure 1.
Study participants were grouped according to secondhand smoke exposure frequency. *Presence of underlying kidney disease was surveyed through a questionnaire asking whether the participants had been previously diagnosed with CKD.
Figure 2.
Figure 2.
Time to CKD development was longer in secondhand smoke non-exposed than exposed participants. Kaplan–Meier plot of incident CKD development according to secondhand smoke exposure frequency in 1948 participants with follow-up data.
See this image and copyright information in PMC

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