二手烟与慢性肾脏病。

Secondhand Smoke and CKD.

机构信息

Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.

Institute of Kidney Disease Research and.

出版信息

Clin J Am Soc Nephrol. 2019 Apr 5;14(4):515-522. doi: 10.2215/CJN.09540818. Epub 2019 Mar 7.

DOI:10.2215/CJN.09540818

PMID:30846462

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6450336/

Abstract

BACKGROUND AND OBJECTIVES

Active smoking is associated with higher risk of various diseases. However, the risk of CKD development in nonsmokers exposed to secondhand smoke is not well elucidated. We aimed to investigate the association between secondhand smoke exposure and the risk of CKD development among never-smokers.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A total of 131,196 never-smokers with normal kidney function, who participated in the Korean Genome and Epidemiology Study from 2001 to 2014, were analyzed. The participants were classified into three groups on the basis of frequency of secondhand smoke exposure, assessed with survey questionnaires; no exposure, <3 days per week, and ≥3 days per week. The association between secondhand smoke and CKD, defined as eGFR<60 ml/min per 1.73 m, was examined in the cross-sectional analysis. In addition, the risk of incident CKD development was analyzed in a longitudinal cohort of 1948 participants without CKD at baseline, which was a subset of the main cohort.

RESULTS

The mean age of participants was 53 years, and 75% were women. Prevalent CKD was observed in 231 (1.8%), 64 (1.7%), and 2280 (2.0%) participants in the ≥3 days per week, <3 days per week, and no exposure groups. The odds ratio (OR) of prevalent CKD was significantly higher in the groups exposed to secondhand smoke than the no exposure group (<3 days per week: OR, 1.72; 95% confidence interval [95% CI], 1.30 to 2.27; and ≥3 days per week: OR, 1.44; 95% CI, 1.22 to 1.70). During a mean follow-up of 104 months, CKD occurred in 319 (16%) participants. Multivariable Cox analysis revealed that the risk for CKD development was higher in participants exposed to secondhand smoke than the no exposure group (<3 days per week: hazard ratio, 1.59; 95% CI, 0.96 to 2.65; and ≥3 days per week: hazard ratio, 1.66; 95% CI, 1.03 to 2.67).

CONCLUSIONS

Exposure to secondhand smoke was associated with a higher prevalence of CKD as well as development of incident CKD.

摘要

背景与目的

主动吸烟与多种疾病的风险增加相关。然而，暴露于二手烟的不吸烟者发生慢性肾脏病（CKD）的风险尚不清楚。本研究旨在探讨二手烟暴露与从不吸烟者 CKD 发生风险之间的关系。

设计、地点、参与者和测量：对 2001 年至 2014 年期间参加韩国基因与流行病学研究的 131196 例肾功能正常的从不吸烟者进行了分析。根据调查问卷评估的二手烟暴露频率将参与者分为三组：无暴露、每周<3 天和每周≥3 天。在横断面分析中，研究了二手烟与 CKD（定义为 eGFR<60 ml/min/1.73 m）之间的关系。此外，在基线时无 CKD 的 1948 例参与者的纵向队列中分析了 CKD 发病风险，该队列是主要队列的一个子集。

结果

参与者的平均年龄为 53 岁，75%为女性。在每周≥3 天、每周<3 天和无暴露组中，分别有 231（1.8%）、64（1.7%）和 2280（2.0%）例患者存在 CKD。与无暴露组相比，暴露于二手烟的患者发生 CKD 的比值比（OR）显著更高（每周<3 天：OR，1.72；95%置信区间[95%CI]，1.30 至 2.27；每周≥3 天：OR，1.44；95%CI，1.22 至 1.70）。在平均 104 个月的随访期间，有 319 例（16%）患者发生 CKD。多变量 Cox 分析显示，与无暴露组相比，暴露于二手烟的患者发生 CKD 的风险更高（每周<3 天：风险比，1.59；95%CI，0.96 至 2.65；每周≥3 天：风险比，1.66；95%CI，1.03 至 2.67）。