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Supplement Article
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Effects of Smoking on Systemic and Intrarenal Hemodynamics: Influence on Renal Function

Stephan R. Orth
JASN January 2004, 15 (1 suppl) S58-S63; DOI: https://doi.org/10.1097/01.ASN.0000093461.36097.D5
Stephan R. Orth
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Abstract

ABSTRACT. In recent years, it has become apparent that smoking has a negative impact on renal function, being one of the most important remediable renal risk factors. It has been shown clearly that the risk for high-normal urinary albumin excretion and microalbuminuria is increased in smoking compared with nonsmoking subjects of the general population. Data from the Multiple Risk Factor Intervention Trial indicate that at least in men, smoking increases the risk to reach end-stage renal failure. Smoking is particularly “nephrotoxic” in older subjects, subjects with essential hypertension, and patients with preexisting renal disease. Of interest, the magnitude of the adverse renal effect of smoking seems to be independent of the underlying renal disease. Death-censored renal graft survival is decreased in smokers, indicating that smoking also damages the renal transplant. Cessation of smoking has been shown to reduce the rate of progression of renal failure both in patients with renal disease and in patients with a renal transplant. The mechanisms of smoking-induced renal damage are only partly understood and comprise acute hemodynamic (e.g., increase in BP and presumably intraglomerular pressure) and chronic effects (e.g., endothelial cell dysfunction). Renal failure per se leads to an increased cardiovascular risk. The latter is further aggravated by smoking. Particularly, survival of smokers with diabetes on hemodialysis is abysmal.

  • © 2004 American Society of Nephrology
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Journal of the American Society of Nephrology: 15 (1 suppl)
Journal of the American Society of Nephrology
Vol. 15, Issue 1 suppl
1 Jan 2004
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Effects of Smoking on Systemic and Intrarenal Hemodynamics: Influence on Renal Function
Stephan R. Orth
JASN Jan 2004, 15 (1 suppl) S58-S63; DOI: 10.1097/01.ASN.0000093461.36097.D5

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Effects of Smoking on Systemic and Intrarenal Hemodynamics: Influence on Renal Function
Stephan R. Orth
JASN Jan 2004, 15 (1 suppl) S58-S63; DOI: 10.1097/01.ASN.0000093461.36097.D5
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    • Epidemiologic Evidence for Smoking-Induced Renal Functional Impairment
    • Pathohistological Findings in the Kidney of Smokers
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More in this TOC Section

  • Angiotensin-Converting Enzyme Inhibitors versus AT1 Receptor Antagonist in Cardiovascular and Renal Protection: The case for AT1 Receptor Antagonist
  • Clinical Usefulness of Ambulatory Blood Pressure Monitoring
  • Novel Cardiovascular Risk Factors in End-Stage Renal Disease
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