Association of smoking with incident CKD risk in the general population: A community-based cohort study

Wonji Jo, Sangmi Lee, Young Su Joo, Ki Heon Nam, Hae Ryong Yun, Tae Ik Chang, Ea wha Kang, Tae Hyun Yoo, Seung Hyeok Han, Shin Wook Kang, Jung Tak Park

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18 Citations (Scopus)


Background Chronic kidney disease (CKD) is a public health problem, and an unfavorable lifestyle has been suggested as a modifiable risk factor for CKD. Cigarette smoking is closely associated with cardiovascular disease and cancers; however, there is a lack of evidence to prove that smoking is harmful for kidney health. Therefore, we aimed to determine the relationship between cigarette smoking and CKD among healthy middle-aged adults. Methods Using the database from the Korean Genome and Epidemiology Study, we analyzed 8,661 participants after excluding those with baseline estimated glomerular filtration rate (eGFR) <60 ml/min/1.72 m2 or proteinuria. Exposure of interest was smoking status: never-, former-, and current-smokers. Primary outcome was incident CKD defined as eGFR <60 ml/min/ 1.73 m2 or newly developed proteinuria. Results The mean age of the subjects was 52 years, and 47.6% of them were males. There were 551 (6.4%) and 1,255 (14.5%) subjects with diabetes and hypertension, respectively. The mean eGFR was 93.0 ml/min/1.73 m2. Among the participants, 5,140 (59.3%), 1,336 (15.4%), and 2,185 (25.2%) were never-smokers, former-smokers, and current-smokers, respectively. During a median follow-up of 11.6 years, incident CKD developed in 1,941 (22.4%) subjects with a crude incidence rate of 25.1 (24.0–26.2) per 1,000 person-years. The multivariable Cox regression analysis after adjustment of confounding factors showed hazard ratios (95% confidence interval) of 1.13 (0.95–1.35) and 1.26 (1.07–1.48) for CKD development in the former- and current-smokers, compared with never-smokers. Conclusion This study showed that smoking was associated with a higher risk of incident CKD among healthy middle-aged adults.

Original languageEnglish
Article numbere0238111
JournalPloS one
Issue number8 August
Publication statusPublished - 2020 Aug

Bibliographical note

Publisher Copyright:
Copyright: © 2020 Jo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

All Science Journal Classification (ASJC) codes

  • General


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