Smoking Is Associated With Progression of Diabetic Nephropathy

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  • Peter T Sawicki
    Department of Nutrition and Metabolic Diseases, World Health Organization Collaborating Center for Diabetes, Heinrich-Heine University Düsseldorf, Germany
  • Ulrike Didjurgeit
    Department of Nutrition and Metabolic Diseases, World Health Organization Collaborating Center for Diabetes, Heinrich-Heine University Düsseldorf, Germany
  • Ingrid Mühlhauser
    Department of Nutrition and Metabolic Diseases, World Health Organization Collaborating Center for Diabetes, Heinrich-Heine University Düsseldorf, Germany
  • Ralf Bender
    Department of Nutrition and Metabolic Diseases, World Health Organization Collaborating Center for Diabetes, Heinrich-Heine University Düsseldorf, Germany
  • Lutz Heinemann
    Department of Nutrition and Metabolic Diseases, World Health Organization Collaborating Center for Diabetes, Heinrich-Heine University Düsseldorf, Germany
  • Michael Berger
    Department of Nutrition and Metabolic Diseases, World Health Organization Collaborating Center for Diabetes, Heinrich-Heine University Düsseldorf, Germany

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<jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>To investigate the association between cigarette smoking and the progression of diabetic nephropathy.</jats:p> </jats:sec> <jats:sec> <jats:title>RESEARCH DESIGN AND METHODS</jats:title> <jats:p>A prospective, follow-up study over one year was conducted in a sequential sample of 34 smokers, 35 nonsmokers, and 24 ex-smokers with type I diabetes, hypertension, and diabetic nephropathy. Progression of renal disease was defined according to the stage of nephropathy as an increase in proteinuria or serum creatinine or a decrease in the glomerular filtration rate.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Progression of nephropathy was less common in nonsmokers (11%) than in smokers (53%) and patients who had quit smoking (33%), P &gt; 0.001. In a stepwise logistic regression analysis, cigarette pack years, 24-h sodium excretion, and GHb were independent predictive factors for the progression of diabetic nephropathy. Because blood pressure (BP) was well controlled in these patients and most values were within a normotensive range, neither standing, sitting, nor supine BP values were associated with progression of nephropathy.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Cigarette smoking represents an important factor associated with progression of nephropathy in treated hypertensive type I diabetic patients.</jats:p> </jats:sec>

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  • Diabetes Care

    Diabetes Care 17 (2), 126-131, 1994-02-01

    American Diabetes Association

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