C-reactive protein is associated with cigarette smoking-induced hyperfiltration and proteinuria in an apparently healthy population

Abstract

Although cigarette smoking is known to be an important risk factor for renal disease, the mechanism by which smoking induces progressive renal disease in a healthy population has not been established. We hypothesized that oxidative stress (measured as 8-iso-prostaglandin F 2a , 8-iso-PGF2a), inflammation (highly sensitive C-reactive protein (CRP), hs-CRP) and nitric oxide may be associated with an alteration in the estimated glomerular filtration rate (eGFR) and proteinuria in otherwise healthy smokers. A total of 649 eligible subjects were classified according to their smoking status. Plasma NOx was measured using ozone-based chemiluminescence, urinary 8-iso-PGF2a was measured using enzyme immunoassay and serum hs-CRP was measured using a latex aggregation nephelometry method. The levels of 8-iso-PGF2a and hs-CRP increased in current smokers (P¼0.001 and P¼0.029, respectively), although there was not an increase in the NOx level. The prevalence of a high eGFR increased in light smokers (odds ratio (OR) 1.15 (95% confidence interval (CI), 0.61-2.17)) and heavy smokers (OR 2.33 (95% CI, 1.06-5.10)) when compared with non-and past smokers (P for trend¼0.024). The multivariable-adjusted mean values of the eGFR in current smokers, reported from the lowest to the highest quintiles of hs-CRP levels, were 82.1, 85.1, 86.4 and 88.5 ml per min per 1.73 m 2 (P for trend¼0.027). The mean values of proteinuria were 28.6, 34.6, 37.2 and 39.5 mg g À1 creatinine (P for trend¼0.003). The correlation coefficient between hs-CRP and eGFR was increased significantly (P¼0.03) across non-(r¼0.03), past (r¼À0.17), light (r¼0.13) and heavy smokers (r¼0.31). In conclusion, cigarette smoking is a risk factor for renal function alteration in healthy smokers and is characterized by a high eGFR and a high urinary protein associated with an increase in the hs-CRP. This finding suggests that hs-CRP may help mediate the alteration of renal function in smokers.

The effects of continuing and discontinuing smoking on the development of chronic kidney disease (CKD) in the healthy middle-aged working population in Japan

“…There was a tendency for smokers to have a higher GFR than non-smokers. Our findings of a higher GFR and a lower risk of low GFR in smokers are consistent with those reported previously for general populations, especially in studies on workplaces [8][9][10]12]. Our results confirm that the elevated GFR in smokers was caused by smoking since a large reduction in GFR was observed after individuals stopped smoking.…”

“…Furthermore, many of the previous studies carried out in workplaces were cross-sectional in design [8][9][10][11][12]. The few longitudinal studies conducted in workplaces that have been conducted to date are limited to a small number of subjects [13] or to a short observational period [14].…”

A Systematic Review of Glomerular Hyperfiltration Assessment and Definition in the Medical Literature

“…If unable to have an age-adjusted control group, authors should at the minimum select from the literature a control group with characteristics similar to those of their participants and with similar GFR evaluation methods. Among the four studies reporting a GH threshold ,2 SDs of the median (of this systematic review), three used their own control group, with age adjusted to their study population (26)(27)(28). These three studies were performed in Japan and Taiwan, and GFR was indexed for body surface area, which is lower in Asian population (29).…”

The combined use of edaravone, diuretics, and nonsteroidal anti-inflammatory drugs caused acute kidney injury in an elderly patient with chronic kidney disease

“…Clinical studies have reported that long-term hypertension, diabetes, hyperuricemia, renal arteriosclerosis, ischemic heart disease, and smoking can cause CKD [18][19][20][21][22][23]. In the present patient, multiple chronic diseases and a long-term smoking habit led to the occurrence of CKD.…”