Renal plasma flow, filtration fraction and microalbuminuria in hypertensive patients: Effects of chronic smoking

Andronico, Giuseppe; Rome, M Noël; Cicero, Antonina Lo; Parsi, R A; Seddio, Giovanna; Ferraro-Mortellaro, R.; Buscemi, Silvio; Cerasola, Giovanni

doi:10.1111/j.1440-1797.2005.00458.x

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…In patients with hypertension, hypertensive smokers have more microalbuminuria compared to normotensive smokers and hypertensive non-smokers, further emphasizing the added deleterious effects of smoking in patients with underlying vascular disease[95]. The relationship between smoking and increased urine albumin excretion in patients with hypertension has been demonstrated in multiple other studies as well[96, 97].…”

Section: Role Of Cigarette Smoking In Human Subjectsmentioning

confidence: 99%

“…Diabetic nephropathy has also been studied extensively in regards to the deleterious effects of smoking, and it has been well established that smoking is associated with new onset of microalbuminuria, faster progression of microalbuminuria to macroalbuminuria and causes a decrease in GFR in patients with diabetes[9, 94, 95, 99–104]. One of the first reports of the association of smoking and proteinuria described a 2.8 fold higher incidence of increase urine albumin excretion in young patients with Type I DM[102].…”

Section: Role Of Cigarette Smoking In Human Subjectsmentioning

confidence: 99%

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Nicotine signaling and progression of chronic kidney disease in smokers

Jain¹,

Jaimes²

2013

Biochemical Pharmacology

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The deleterious health effects of cigarette smoking are far reaching, and it remains the most important modifiable risk factor for improving overall morbidity and mortality. In addition to being a risk factor for cancer, cardiovascular disease and lung disease, there is strong evidence, both from human and animal studies, demonstrating a role for cigarette smoking in the progression of chronic kidney disease (CKD). Clinical studies have shown a strong correlation between cigarette smoking and worsening CKD in patients with diabetes, hypertension, polycystic kidney disease, and post kidney transplant. Nicotine, in addition to its role in the addictive properties of cigarette smoking, has other biological effects via activation of non-neuronal nicotinic acetylcholine receptors (nAChRs). Several nAChR subunits are expressed in the normal kidney and blockade of the α7-nAChR subunit ameliorates the effects of nicotine in animal models of CKD. Nicotine increases the severity of renal injury in animal models including acute kidney injury, diabetes, acute nephritis and subtotal nephrectomy. The renal effects of nicotine are also linked to increased generation of reactive oxygen species and activation of pro-fibrotic pathways. In humans, nicotine induces transitory increases in blood pressure accompanied by reductions in glomerular filtration rate and effective renal plasma flow. In summary, clinical and experimental evidence indicate that nicotine is at least in part responsible for the deleterious effects of cigarette smoking in the progression of CKD. The mechanisms involved are the subject of active investigation and may result in novel strategies to ameliorate the effects of cigarette smoking in CKD.

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Section: Role Of Cigarette Smoking In Human Subjectsmentioning

confidence: 99%

Section: Role Of Cigarette Smoking In Human Subjectsmentioning

confidence: 99%

Nicotine signaling and progression of chronic kidney disease in smokers

Jain¹,

Jaimes²

2013

Biochemical Pharmacology

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“…[168][169][170][171][172][173][174][175][176] Cigarette smoking is also a major risk factor for the initial development or worsening of preexisting CKD in patients with human immunodeficiency virus infection, chronic obstructive pulmonary disease, diabetes, diabetic nephropathy, hypertension, autosomal polycystic kidney disease, primary glomerulopathies, lupus nephritis, and those who are obese or who have undergone a lung transplant. [177][178][179][180][181][182][183][184][185][186][187] In addition, smoking by either the donor or recipient has been shown to adversely influence the function and survival of transplanted kidneys and overall patient survival. 170,171,188,189 Allograft survival and function both worsen with increasing pack-years smoked.…”

Section: Hypertensionmentioning

confidence: 99%

Hypoxia: The Force that Drives Chronic Kidney Disease

Colgan

Shelley

2016

Clinical Medicine & Research

128

111

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In the United States the prevalence of end-stage renal disease (ESRD) reached epidemic proportions in 2012 with over 600,000 patients being treated. The rates of ESRD among the elderly are disproportionally high. Consequently, as life expectancy increases and the baby-boom generation reaches retirement age, the already heavy burden imposed by ESRD on the US health care system is set to increase dramatically. ESRD represents the terminal stage of chronic kidney disease (CKD). A large body of evidence indicating that CKD is driven by renal tissue hypoxia has led to the development of therapeutic strategies that increase kidney oxygenation and the contention that chronic hypoxia is the final common pathway to end-stage renal failure. Numerous studies have demonstrated that one of the most potent means by which hypoxic conditions within the kidney produce CKD is by inducing a sustained inflammatory attack by infiltrating leukocytes. Indispensable to this attack is the acquisition by leukocytes of an adhesive phenotype. It was thought that this process resulted exclusively from leukocytes responding to cytokines released from ischemic renal endothelium. However, recently it has been demonstrated that leukocytes also become activated independent of the hypoxic response of endothelial cells. It was found that this endothelium-independent mechanism involves leukocytes directly sensing hypoxia and responding by transcriptional induction of the genes that encode the β2-integrin family of adhesion molecules. This induction likely maintains the long-term inflammation by which hypoxia drives the pathogenesis of CKD. Consequently, targeting these transcriptional mechanisms would appear to represent a promising new therapeutic strategy.

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“…Patients with hypertension who smoke may have an increased risk for microalbuminuria, even before the onset of other haemodynamic disorders [34]. In our study, the subjects who smoked had higher levels of ACR.…”

Section: Discussionmentioning

confidence: 91%

Factors affecting levels of urinary albumin excretion in the general population of Spain: the Di@bet.es study

et al. 2012

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The present study was undertaken to examine the prevalence of urinary ACR (albumin/creatinine ratio) >30 mg/g and the associated clinical and environmental factors in a representative sample of the population of Spain. Di@bet.es study is a national, cross-sectional population-based survey conducted in 2009-2010. Clinical, metabolic, socio-demographic, anthropometric data and information about lifestyle habit were collected. Those subjects without KDM (known diabetes mellitus) were given an OGTT (oral glucose tolerance test). Albumin and creatinine were measured in a urinary sample and ACR was calculated. The population prevalence of ACR >30 mg/g was 7.65% (adjusted for sex and age). The prevalence of ACR >30 mg/g increased with age (P<0.001). Subjects with carbohydrate metabolism disorders had a greater prevalence of ACR >30 mg/g but after being adjusted for age, sex and hypertension, was significant only in those subjects with UKDM (unknown diabetes mellitus) {OR (odd ratio), 2.07 [95% CI (confidence interval), 1.38-3.09]; P<0.001] and KDM [OR, 3.55 (95% CI, 2.63-4.80); P<0.001]. Prevalence of ACR >30 mg/g was associated with hypertension [OR, 1.48 (95% CI, 1.12-1.95); P=0.001], HOMA-IR (homoeostasis model assessment of insulin resistance) [OR, 1.47 (95% CI, 1.13-1.92); P≤0.01], metabolic syndrome [OR, 2.17 (95% CI, 1.72-2.72); P<0.001], smoking [OR, 1.40 (95% CI, 1.06-1.83); P≤0.05], physical activity [OR, 0.68 (95% CI, 0.54-0.88); P≤0.01] and consumption of fish [OR, 0.38 (95% CI, 0.18-0.78); P≤0.01]. This is the first study that reports the prevalence of ACR >30 mg/g in the Spanish population. The association between clinical variables and other potentially modifiable environmental variables contribute jointly, and sometimes interactively, to the explanation of prevalence of ACR >30 mg/g. Many of these risk factors are susceptible to intervention.

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Renal plasma flow, filtration fraction and microalbuminuria in hypertensive patients: Effects of chronic smoking

Abstract: In hypertensive patients, smoking does not modify typical renal haemodynamic changes of arterial hypertension; however, it significantly increases the albumin excretion rate.

Cited by 10 publications

References 22 publications

Nicotine signaling and progression of chronic kidney disease in smokers

Nicotine signaling and progression of chronic kidney disease in smokers

Hypoxia: The Force that Drives Chronic Kidney Disease

Factors affecting levels of urinary albumin excretion in the general population of Spain: the Di@bet.es study

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