Smoking-related renal histologic injury in IgA nephropathy patients

Yoon Jin Cha, Beom Jin Lim, Beom Suk Kim, Yonhee Kim, TaeHyun Yoo, SeungHyeok Han, Shin-Wook Kang, Kyu Hun Choi, Hyeon Joo Jeong

Research output: Contribution to journalArticle

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Abstract

Purpose: Smoking reportedly exerts deleterious effects on renal function; however, its effects on histology have not been clarified in patients with IgA nephropathy (IgAN). Materials and Methods: Renal histology was evaluated in a cohort of 397 patients diagnosed with IgAN according to smoking status and dose in relation to renal function. Results: Among the study cohort, which was predominantly male (88.5%), 52 patients (13%) were current smokers. These current smokers demonstrated more frequent hypertension and higher serum creatinine levels than non/ex-smokers at the time of diagnosis, which was apparent with increased smoking dose. The percentages of global glomerulosclerosis and arteriolar hyalinosis increased with increased smoking dose, whereas tubulointerstitial fibrosis or arterial intimal thickening did not. Glomerular mesangial alpha-smooth muscle actin expression were similar between current and non/ex-smokers matched for age, gender, hypertension, and histologic severity, although the number of glomerular CD68+ cells was significantly fewer in smokers. Initial serum creatinine level, estimated glomerular filtration rate (eGFR), and global glomerulosclerosis were found to be risk factors of serum creatinine doubling in both smokers and non/ex-smokers by univariate analysis during a mean follow-up of 3.8 years. Conclusion: In addition to dose dependent renal functional decline and hypertension, smoking contributes to renal disease progression by eliciting microvascular injury in IgAN patients.

Original languageEnglish
Pages (from-to)209-216
Number of pages8
JournalYonsei medical journal
Volume57
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

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Immunoglobulin A
Smoking
Kidney
Wounds and Injuries
Creatinine
Hypertension
Histology
Serum
Tunica Intima
Glomerular Filtration Rate
Smooth Muscle
Disease Progression
Actins
Fibrosis
Cohort Studies

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Cha, Yoon Jin ; Lim, Beom Jin ; Kim, Beom Suk ; Kim, Yonhee ; Yoo, TaeHyun ; Han, SeungHyeok ; Kang, Shin-Wook ; Choi, Kyu Hun ; Jeong, Hyeon Joo. / Smoking-related renal histologic injury in IgA nephropathy patients. In: Yonsei medical journal. 2016 ; Vol. 57, No. 1. pp. 209-216.
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Smoking-related renal histologic injury in IgA nephropathy patients. / Cha, Yoon Jin; Lim, Beom Jin; Kim, Beom Suk; Kim, Yonhee; Yoo, TaeHyun; Han, SeungHyeok; Kang, Shin-Wook; Choi, Kyu Hun; Jeong, Hyeon Joo.

In: Yonsei medical journal, Vol. 57, No. 1, 01.01.2016, p. 209-216.

Research output: Contribution to journalArticle

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AU - Cha, Yoon Jin

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AU - Kim, Beom Suk

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AU - Yoo, TaeHyun

AU - Han, SeungHyeok

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AU - Choi, Kyu Hun

AU - Jeong, Hyeon Joo

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N2 - Purpose: Smoking reportedly exerts deleterious effects on renal function; however, its effects on histology have not been clarified in patients with IgA nephropathy (IgAN). Materials and Methods: Renal histology was evaluated in a cohort of 397 patients diagnosed with IgAN according to smoking status and dose in relation to renal function. Results: Among the study cohort, which was predominantly male (88.5%), 52 patients (13%) were current smokers. These current smokers demonstrated more frequent hypertension and higher serum creatinine levels than non/ex-smokers at the time of diagnosis, which was apparent with increased smoking dose. The percentages of global glomerulosclerosis and arteriolar hyalinosis increased with increased smoking dose, whereas tubulointerstitial fibrosis or arterial intimal thickening did not. Glomerular mesangial alpha-smooth muscle actin expression were similar between current and non/ex-smokers matched for age, gender, hypertension, and histologic severity, although the number of glomerular CD68+ cells was significantly fewer in smokers. Initial serum creatinine level, estimated glomerular filtration rate (eGFR), and global glomerulosclerosis were found to be risk factors of serum creatinine doubling in both smokers and non/ex-smokers by univariate analysis during a mean follow-up of 3.8 years. Conclusion: In addition to dose dependent renal functional decline and hypertension, smoking contributes to renal disease progression by eliciting microvascular injury in IgAN patients.

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