Cigarette smoking may accelerate the progression of IgA nephropathy.

Publisher: BioMed Central Country of Publication: England NLM ID: 100967793 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2369 (Electronic) Linking ISSN: 14712369 NLM ISO Abbreviation: BMC Nephrol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2000-

Disease Progression*; Cigarette Smoking/*adverse effects ; Glomerulonephritis, IGA/*complications; Adult ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Glomerulonephritis, IGA/physiopathology ; Humans ; Hypertension/complications ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/etiology ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Propensity Score ; Proportional Hazards Models ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors

Background: Whether cigarette smoking is associated with the progression of immunoglobulin A nephropathy (IgAN) remains uncertain; therefore, we aimed to evaluate the effect of cigarette smoking on the prognosis of IgAN.
Methods: We divided 1239 IgAN patients from West China Hospital of Sichuan University who met the inclusion criteria into smoker (current or former) and non-smoker groups. The endpoint was end-stage renal disease (ESRD: eGFR < 15 mL/min/1.73 m ² or undergoing renal replacement treatment) and/or eGFR decreased by > 50%. Kaplan-Meier, correlation, logistic regression and Cox proportional hazards analyses were performed. The association between cigarette smoking and IgAN was further verified by propensity-score-matched cohort analysis.
Results: During the mean follow-up period of 61 months, 19% (40/209) of the smoker group and 11% (110/1030) of the non-smoker group reached the study endpoint (p < 0.001). Multivariate Cox regression analysis revealed that cigarette smoking (hazard ratio (HR) = 1.58; p = 0.043) was an independent risk factor predicting poor renal progression in IgAN, and that IgAN patients with chronic kidney disease (CKD) stage 3-4 were more susceptible to cigarette smoking (p < 0.001). After propensity score matching (PSM), a significant correlation between cigarette smoking and renal outcomes in IgAN patients was seen. Furthermore, Spearman's correlation test revealed that smoking dose was negatively correlated with eGFR (r = 0.141; p < 0.001) and positively related with proteinuria (r = 0.096; p = 0.001).
Conclusions: Cigarette smoking is an independent risk factor for IgAN progression, especially for advanced patients.

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Keywords: Cigarette smoking; IgA nephropathy; Propensity score matching; Renal survival

Date Created: 20210630 Date Completed: 20220207 Latest Revision: 20220207

20240628

PMC8244187

10.1186/s12882-021-02453-4

34187402