|LETTER TO THE EDITOR
|Year : 2020 | Volume
| Issue : 4 | Page : 232-233
Smoking cessation as a tool for prevention of development and progression of kidney disease
Mariam E Omar, Mohamed E Elrggal
Department of Nephrology, Kidney and Urology Center, Alexandria, Egypt
|Date of Submission||21-Jun-2020|
|Date of Acceptance||23-Jun-2020|
|Date of Web Publication||16-Oct-2020|
Dr. Mohamed E Elrggal
23, Mohamed Safwat Street, Roushdy, Alexandria
Source of Support: None, Conflict of Interest: None
In the era of COVID-19, smoking has already been incriminated as an imminent risk for patients infected with SARS-COV-2. Patients with kidney disease are more susceptible to poor outcomes especially in the setting of immunosuppression and end stage kidney disease (ESKD). Hence, in our letter, we would like to throw the light on the association of smoking with kidney disease and the crucial role of smoking cessation in prevention of the development and progression of chronic kidney disease.
Keywords: chronic kidney disease prevention, chronic kidney disease progression, chronic kidney disease, smoking
|How to cite this article:|
Omar ME, Elrggal ME. Smoking cessation as a tool for prevention of development and progression of kidney disease. J Egypt Soc Nephrol Transplant 2020;20:232-3
|How to cite this URL:|
Omar ME, Elrggal ME. Smoking cessation as a tool for prevention of development and progression of kidney disease. J Egypt Soc Nephrol Transplant [serial online] 2020 [cited 2020 Oct 23];20:232-3. Available from: http://www.jesnt.eg.net/text.asp?2020/20/4/232/298254
In view of the current corona virus pandemic, smoking has been linked to worse outcomes and higher mortality rates in patients with COVID-19 ,. We would like to point out, from a nephrology perspective, the pivotal role of smoking cessation in primary, secondary, and tertiary prevention of kidney disease.
A tight relation has already been established between smoking and cardiovascular disease, particularly hypertension, diabetes, and chronic kidney disease (CKD) . Smoking has been significantly associated with increased risk of incident type 2 diabetes mellitus  and hypertension ,, the two most important risk factors for development of CKD. It has been associated with renal impairment and proteinuria in healthy population . Regarding primordial prevention, smoking cessation improved central  and ambulatory blood pressure  in different cohorts. Smoking cessation has been linked to increased incidence of type 2 diabetes mellitus; however, this has been attributed to postcessation weight gain .
Concerning patients at risk for CKD, smoking has been directly associated with development of incident kidney disease . It is an independent risk factor for development of diabetic nephropathy in patients with diabetes . However, in terms of primary prevention, there is no evidence regarding whether smoking cessation can prevent development of CKD in at-risk patients (i.e. patients with diabetes or hypertension).
In the setting of established CKD, smoking has been associated with CKD progression  and increased risk for end-stage kidney disease (ESKD) . Smoking cessation slowed deterioration of kidney functions and albuminuria ,,. It was even associated with better graft survival after kidney transplantation .
Finally, smoking in patients with ESKD has poor prognosis. It increases the incidence of arteriovenous fistula thrombosis , peripheral vascular disease, and congestive heart failure and is associated with increased cardiovascular morbidity, mortality , and all-cause mortality . Scarce data are present regarding the benefit of smoking cessation in patients with ESKD; however, it is reasonable to assume that its benefit for the general population and patients with CKD is also applicable to patients with ESKD. In conclusion, smoking cessation fits well in the aforementioned strategies to prevent kidney disease development and progression. Smoking cessation programs should be thoroughly addressed and incorporated in the comprehensive management of patients with CKD and ESKD ([Table 1]).
|Table 1 Summary of selected trials regarding the association of smoking with the development and progression of kidney diseases, and the association of smoking cessation with improvement in kidney condition|
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