eprintid: 1490303
rev_number: 28
eprint_status: archive
userid: 608
dir: disk0/01/49/03/03
datestamp: 2016-05-07 21:10:58
lastmod: 2021-09-18 21:49:20
status_changed: 2016-11-15 18:10:07
type: article
metadata_visibility: show
creators_name: Staplin, N
creators_name: Haynes, R
creators_name: Herrington, WG
creators_name: Reith, C
creators_name: Cass, A
creators_name: Fellström, B
creators_name: Jiang, L
creators_name: Kasiske, BL
creators_name: Krane, V
creators_name: Levin, A
creators_name: Walker, R
creators_name: Wanner, C
creators_name: Wheeler, DC
creators_name: Landray, MJ
creators_name: Baigent, C
creators_name: Emberson, J
creators_name: SHARP Collaborative Group, .
title: Smoking and Adverse Outcomes in Patients With CKD: The Study of Heart and Renal Protection (SHARP)
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
divisions: G93
keywords: Cigarette smoking, Study of Heart and Renal Protection (SHARP), cancer, cause-specific mortality, chronic kidney disease (CKD), disease progression, end-stage renal disease (ESRD), estimated glomerular filtration rate (eGFR), risk factor, tobacco, vascular events, vascular morbidity
note: Copyright © 2016 The Authors. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is an open access article under the CC BY license https://creativecommons.org/licenses/by/4.0/
abstract: BACKGROUND: The absolute and relative importance of smoking to vascular and nonvascular outcomes in people with chronic kidney disease (CKD), as well its relevance to kidney disease progression, is uncertain. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: 9,270 participants with CKD enrolled in SHARP. PREDICTOR: Baseline smoking status (current, former, and never). OUTCOMES: Vascular events, site-specific cancer, ESRD, rate of change in estimated glomerular filtration rate (eGFR), and cause-specific mortality. RESULTS: At baseline, 1,243 (13%) participants were current smokers (median consumption, 10 cigarettes/day); 3,272 (35%), former smokers; and 4,755 (51%), never smokers. Median follow-up was 4.9 years. Vascular event rates were 36% higher for current than never smokers (2,317 events; relative risk [RR], 1.36; 95% CI, 1.19-1.55), reflecting increases in both atherosclerotic (RR, 1.49; 95% CI, 1.26-1.76) and nonatherosclerotic (RR, 1.25; 95% CI, 1.05-1.50) events. Cancer was 37% higher among current smokers (632 events; RR, 1.37; 95% CI, 1.07-1.76), with the biggest RRs for lung (RR, 9.31; 95% CI, 4.37-19.83) and upper aerodigestive tract (RR, 4.87; 95% CI, 2.10-11.32) cancers. For 6,245 patients not receiving dialysis at baseline, ESRD incidence did not differ significantly between current and never smokers (2,141 events; RR, 1.02; 95% CI, 0.89-1.17), nor did estimated rate of change in eGFR (current smokers, -1.77±0.14 [SE]; never smokers, -1.70±0.07mL/min/1.73m(2) per year). All-cause mortality was 48% higher among current smokers (2,257 events; RR, 1.48; 95% CI, 1.30-1.70), with significant increases in vascular (RR, 1.35; 95% CI, 1.07-1.69) and nonvascular (RR, 1.60; 95% CI, 1.34-1.91) causes of death, especially cancer (RR, 2.32; 95% CI, 1.58-3.40) and respiratory (RR, 2.25; 95% CI, 1.51-3.35) mortality. LIMITATIONS: Smoking status not assessed during follow-up. CONCLUSIONS: In this study of patients with CKD, smoking significantly increased the risks for vascular and nonvascular morbidity and mortality, but was not associated with kidney disease progression. The associations with vascular and neoplastic disease are in keeping with those observed in the general population and are likely modifiable by cessation.
date: 2016-09
date_type: published
official_url: http://dx.doi.org/10.1053/j.ajkd.2016.02.052
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
article_type_text: Journal Article
verified: verified_manual
elements_id: 1128041
doi: 10.1053/j.ajkd.2016.02.052
pii: S0272-6386(16)00699-5
lyricists_name: Wheeler, David
lyricists_id: DWHEE12
full_text_status: public
publication: American Journal of Kidney Diseases
volume: 68
number: 3
pagerange: 371-380
issn: 1523-6838
citation:        Staplin, N;    Haynes, R;    Herrington, WG;    Reith, C;    Cass, A;    Fellström, B;    Jiang, L;                                         ... SHARP Collaborative Group, .; + view all <#>        Staplin, N;  Haynes, R;  Herrington, WG;  Reith, C;  Cass, A;  Fellström, B;  Jiang, L;  Kasiske, BL;  Krane, V;  Levin, A;  Walker, R;  Wanner, C;  Wheeler, DC;  Landray, MJ;  Baigent, C;  Emberson, J;  SHARP Collaborative Group, .;   - view fewer <#>    (2016)    Smoking and Adverse Outcomes in Patients With CKD: The Study of Heart and Renal Protection (SHARP).                   American Journal of Kidney Diseases , 68  (3)   pp. 371-380.    10.1053/j.ajkd.2016.02.052 <https://doi.org/10.1053/j.ajkd.2016.02.052>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/1490303/1/Staplin%20Smoking%20and%20Adverse%20Outcomes%20in%20Patients%20With%20CKD.pdf
document_url: https://discovery.ucl.ac.uk/id/eprint/1490303/7/Staplin%20Smoking%20and%20Adverse%20Outcomes%20in%20Patients%20With%20CKD%20Tables.pdf
document_url: https://discovery.ucl.ac.uk/id/eprint/1490303/8/Staplin%20Smoking%20and%20Adverse%20Outcomes%20in%20Patients%20With%20CKD%20Figures.pdf
document_url: https://discovery.ucl.ac.uk/id/eprint/1490303/9/Staplin%20Smoking%20and%20Adverse%20Outcomes%20in%20Patients%20With%20CKD%20Supplementary%20data%20S1.pdf