Faculty of Medicine, University of Toronto, Toronto, Canada.
Faculty of Medicine, University of Ottawa, Ottawa, Canada.
BMC Nephrol. 2024 Nov 26;25(1):424. doi: 10.1186/s12882-024-03845-y.
Chronic kidney disease (CKD) demonstrates a complex interaction with tobacco exposure and sex differences, where females and males may experience varying risks and outcomes. This study aims to investigate how sex differences mediate the relationship between tobacco exposure and CKD development, with a secondary focus on regional variability and social determinants of health.
Comprehensive searches on MEDLINE, EMBASE, clinicaltrials.gov, and MedRxiv until October 6, 2022, were conducted. Eligibility criteria involved any study that reported primary data on the prevalence of CKD, with information pertaining to both sex and tobacco exposure.
Data retrieved include patient socio-demographic characteristics, general study information, diagnostic methods, social determinants of health, and the cause of CKD (e.g., tobacco-related or non-tobacco-related).
Studies were selected through a comprehensive search using key terms such as "chronic kidney disease," "smoking," and "sex differences," which identified 3,025 articles, of which 28 were selected for full texts after screening titles, abstracts. Among the 28 included studies, smoking was consistently identified as a significant risk factor for CKD, with notable disparities related to sex, socioeconomic status, race, and urban versus rural settings. Significant geographical variability in CKD prevalence was observed, ranging from 2.5% to 68.1%, with the highest prevalence in Asia. However, due to high heterogeneity and methodological limitations, a meta-analysis of CKD prevalence stratified by sex and tobacco exposure was not feasible.
The findings emphasize the need for further research to comprehend the intricate relationship between, tobacco exposure, sex, and CKD management, as well as the consideration of cultural, geographical, socioeconomic, political, and structural factors when understanding the pathophysiology and management of CKD.
慢性肾脏病（CKD）表现出与烟草暴露和性别差异的复杂相互作用，女性和男性可能面临不同的风险和结果。本研究旨在探讨性别差异如何调节烟草暴露与 CKD 发展之间的关系，并关注区域差异和健康的社会决定因素。
对 MEDLINE、EMBASE、clinicaltrials.gov 和 MedRxiv 进行了全面搜索，截至 2022 年 10 月 6 日。纳入标准为报告 CKD 患病率的原始数据的任何研究，这些研究需提供有关性别和烟草暴露的信息。
提取的数据包括患者的社会人口统计学特征、一般研究信息、诊断方法、健康的社会决定因素以及 CKD 的病因（例如，与烟草相关或非与烟草相关）。
通过使用“慢性肾脏病”、“吸烟”和“性别差异”等关键词进行全面搜索，共确定了 3025 篇文章，经过标题和摘要筛选后，有 28 篇文章被选入全文。在纳入的 28 项研究中，吸烟被一致确定为 CKD 的重要危险因素，且与性别、社会经济地位、种族以及城市与农村环境之间存在显著差异。CKD 患病率存在显著的地域差异，范围从 2.5%到 68.1%，亚洲的患病率最高。然而，由于高度异质性和方法学限制，无法对按性别和烟草暴露分层的 CKD 患病率进行荟萃分析。
研究结果强调需要进一步研究以了解烟草暴露、性别与 CKD 管理之间的复杂关系，并在理解 CKD 的病理生理学和管理时考虑文化、地理、社会经济、政治和结构因素。
