People have long understood that secondhand smoke exposure can cause cancer, emphysema and heart disease, and a new study shows that the exposure to other people’s tobacco exhalations can also increase a person’s risk of chronic kidney disease (CKD) and eventual kidney failure.
The study, Secondhand Smoke and CKD, published in the Clinical Journal of American Society of Nephrology, shows that secondhand smoke can actually cause CKD in addition to worsening symptoms for people living with CKD.
“The findings suggest that the association of CKD with secondhand smoke may be as bad as smoking yourself,” said Dugan Maddux, Vice President of Kidney Disease Initiatives for Fresenius Medical Care North America. “It’s likely that we’re going to see more efforts to educate the public about CKD risk in particular when we talk about secondhand smoke.”
The new Korean study analyzing 131,196 nonsmokers found that participants with three days or more per week of exposure were 66 percent more likely to develop CKD than those with no exposure. Those with fewer than three days of exposure per week were still 59 percent more likely to develop CKD than those with no exposure.
"Secondhand smoke exposure at home or in the workplace is still prevalent despite legislative actions prohibiting public smoking. This exposure was found to be clearly related with CKD, even with less-frequent amounts of secondhand smoke exposure," said Dr. Jung Tak Park, MD, PhD, who led the study.
The study also suggests that non-smokers are at risk for direct vascular and kidney injuries from secondhand smoke and nicotine. Researchers found the nicotine in secondhand smoke directly damages the podocyte cells that play a role in filtering blood in the kidneys to move waste products along to urine. Secondhand smoke may also cause oxidation and stress on the lungs, impacting the circulatory system, and in turn, the kidneys.
“Kidney disease and cardiovascular disease often go hand-in-glove as comorbidities, making patients who suffer from one more at risk for developing the other,” said Maddux.
Secondhand smoke contains more than 7,000 chemicals, including hundreds that are toxic and about 70 that can cause cancer, according to the U.S. Department of Health and Human Services. Laws in 26 U.S. states have reduced secondhand smoke exposure by banning smoking in public places, including parks, restaurants and bars.
“We’ve all benefited from these laws,” said Dr. Maddux. “One of our messages to people living with CKD is that no matter what, the better your overall health is, the better your CKD health outcomes will be.”
Nephrologists continue to recommend that people living with CKD and those at risk of CKD quit smoking if they do smoke. Fresenius Kidney Care clinics offer smoking cessation programs for patients.
Breakthrough scientific genomic and proteomic tests hold the promise to help predict disease and identify personalized and individualized treatments. Fresenius Medical Care North America is supporting information sharing between nephrologists and cardiologists. The aim is to broaden knowledge across the two fields, improving outcomes for patients facing CKD and cardiovascular disease, both of which can be caused or worsened by secondhand smoke.