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논문분류	춘계학술대회 초록집
제목	Risk for Proteinuric Chronic Kidney Disease in Cigarette Smokers: Analysis of the 2017 2020 National Health and Nutrition Examination Survey
저자	Tatchaya Kanthajan
출판정보	2024; 2024(1):
키워드
초록	Objectives: Cigarette smoking is one of the risk factors for CKD. The magnitude of the association in the representative population is unknown. We aim to examine the association between the amount of smoking and CKD. Methods: A cross-sectional study using 2017-2020 NHANES included participants with a self-reported history of ever smoking. The association between the quartile (Q) of smoking and the CKD stage was examined by multiple ordinal logistic regression. Results: Of 9,533 adult participants, mean±SD age was 50±19 years and 51% were female. Median (IQR) of smoking was 200 (56, 528) pack years (P-Y) with a mean of each quartile of 24±16, 120±42, 350±90, and 1,034±528 pack years, respectively (Figure 1). Median eGFR was 89 (68, 116) and the level of eGFR for each smoking quartile is shown in Figure 2. Compared to patients with the Q1, the odds of higher CKD stages versus stage 1 CKD were 2.3, 2.9, and 4.9 times higher in patients with the Q2-Q4, respectively (95%CI: Q2 1.7, 2.9; Q3 2.3, 3.8; and Q4 3.8, 6.5). After adjusting for age, gender, race (Whites vs non-Whites), obesity status, ACR (≤30 and >30 mg/g of creatinine) and interaction term between smoking quartile and ACR, the magnitude of the association was lower, but the direction remains (OR (95%CI): Q2 1.7 (1.3, 2.2), Q3 1.8 (1.4, 2.5), Q4 1.9 (1.4, 2.7)). In addition, ACR was identified as an effect modifier with a higher CKD stage observed in patients with ACR >30 mg/g of creatinine in Q4 (OR (95%CI) 4.9 (2.1, 11.4), Pinteraction <0.001). Conclusions: The cumulative amount of smoking is positively associated with the odds of a higher stage of CKD, particularly in heavy smokers with microalbuminuria. Smoking cessation should be implemented to mitigate the risk of CKD, especially in those with proteinuria.
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