Cigarette smoking and adverse health outcomes in patients treated with maintenance dialysis.


Journal

Nephrology (Carlton, Vic.)
ISSN: 1440-1797
Titre abrégé: Nephrology (Carlton)
Pays: Australia
ID NLM: 9615568

Informations de publication

Date de publication:
Jan 2023
Historique:
revised: 01 10 2022
received: 06 08 2022
accepted: 08 10 2022
pubmed: 13 10 2022
medline: 20 12 2022
entrez: 12 10 2022
Statut: ppublish

Résumé

The association of smoking with new-onset cardiovascular disease, chronic lung disease, malignancy and mortality in dialysis is well-known. The smoking prevalence and its association with clinical outcome was assessed. Multicentre cohort study using 'ANZDATA' Registry, 57 838 adults who commenced dialysis (>3 months) between 1990 and 2016 were included. Patients' demographics, initial dialysis modality, presence of comorbidities and smoking history are predictors. The primary outcome was all-cause mortality. Secondary outcomes were smoking prevalence, cause-specific mortality, non-skin cancers, cardiovascular and chronic lung diseases. Of the 57 838 patients, 56 512 (mean age of 58.9 ± 15.1 years, 40.1% female, 43% diabetic), had data on smoking history with 13.6% current, 40.7% former and 45.6% never smokers. Former and current smokers had 10% (HR 1.10; 95% CI: 1.08, 1.13) and 22%(HR 1.22; 95% CI: 1.18, 1.26) higher risk of all-cause mortality. They were 13% (HR 1.13; 95% CI: 1.09, 1.18) and 23% (HR 1.23; 95% CI: 1.17, 1.29) for CVD mortality. Smoking was associated with higher mortality from respiratory failure (HR 1.59; 95% CI: 1.13, 2.23, p = .073 and HR 1.33; 95% CI: 1.01, 1.74, p = .042) for current and former smokers. Current and former smokers had higher risk for non-skin cancer (HR 1.30; 95% CI: 1.19, 1.42 and HR 1.24; 95% CI: 1.17, 1.32). Smoking was associated with a higher rate of death from cancer (HR 1.26; 95% CI 1.19-1.33) and chronic lung disease (HR 1.48; 95% CI 1.15-1.92). Former and current smokers had a higher adjusted risk for de novo vascular disease (PVD, CVD), CAD (adjusted RR 1.1; 95% Cl: 1.09-1.12). In dialysis patients, smoking was associated with higher rates of all-cause mortality, cardiovascular mortality, respiratory failure, chronic lung disease and malignancy along with higher risks of non-skin cancers, de novo vascular disease and chronic lung disease.

Sections du résumé

BACKGROUND BACKGROUND
The association of smoking with new-onset cardiovascular disease, chronic lung disease, malignancy and mortality in dialysis is well-known. The smoking prevalence and its association with clinical outcome was assessed.
METHODS METHODS
Multicentre cohort study using 'ANZDATA' Registry, 57 838 adults who commenced dialysis (>3 months) between 1990 and 2016 were included. Patients' demographics, initial dialysis modality, presence of comorbidities and smoking history are predictors. The primary outcome was all-cause mortality. Secondary outcomes were smoking prevalence, cause-specific mortality, non-skin cancers, cardiovascular and chronic lung diseases.
RESULTS RESULTS
Of the 57 838 patients, 56 512 (mean age of 58.9 ± 15.1 years, 40.1% female, 43% diabetic), had data on smoking history with 13.6% current, 40.7% former and 45.6% never smokers. Former and current smokers had 10% (HR 1.10; 95% CI: 1.08, 1.13) and 22%(HR 1.22; 95% CI: 1.18, 1.26) higher risk of all-cause mortality. They were 13% (HR 1.13; 95% CI: 1.09, 1.18) and 23% (HR 1.23; 95% CI: 1.17, 1.29) for CVD mortality. Smoking was associated with higher mortality from respiratory failure (HR 1.59; 95% CI: 1.13, 2.23, p = .073 and HR 1.33; 95% CI: 1.01, 1.74, p = .042) for current and former smokers. Current and former smokers had higher risk for non-skin cancer (HR 1.30; 95% CI: 1.19, 1.42 and HR 1.24; 95% CI: 1.17, 1.32). Smoking was associated with a higher rate of death from cancer (HR 1.26; 95% CI 1.19-1.33) and chronic lung disease (HR 1.48; 95% CI 1.15-1.92). Former and current smokers had a higher adjusted risk for de novo vascular disease (PVD, CVD), CAD (adjusted RR 1.1; 95% Cl: 1.09-1.12).
CONCLUSIONS CONCLUSIONS
In dialysis patients, smoking was associated with higher rates of all-cause mortality, cardiovascular mortality, respiratory failure, chronic lung disease and malignancy along with higher risks of non-skin cancers, de novo vascular disease and chronic lung disease.

Identifiants

pubmed: 36222366
doi: 10.1111/nep.14122
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

21-27

Subventions

Organisme : International Society of Nephrology Fellowship

Informations de copyright

© 2022 Asian Pacific Society of Nephrology.

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Auteurs

Sibel G Bek (SG)

Department of Nephrology, Kocaeli University Hospital, Kocaeli, Turkey.

Simone Marschner (S)

Westmead Applied Research Centre, University of Sydney, Sydney, Australia.

Kamal Sud (K)

Department of Biostatistics and Medical Informatics, Auckland University Medical School, New Zealand.
Department of Renal Medicine, Nepean and Westmead Hospitals, Sydney, Australia.

David W Johnson (DW)

Research Center, Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, Australia.
Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia.
Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia.
Research Center, Translational Research Institute, Brisbane, Australia.

Clara K Chow (CK)

Westmead Applied Research Centre, University of Sydney, Sydney, Australia.

Carmel Hawley (C)

Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia.
Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia.
Research Center, Translational Research Institute, Brisbane, Australia.

Helen Pilmore (H)

Department of Biostatistics and Medical Informatics, Auckland University Medical School, New Zealand.

Germaine Wong (G)

Department of Nephrology, The University of Sydney Medical School, Sydney, Australia.
Centre for Kidney Research, School of Public Health, University of Sydney, Sydney, Australia.

Wai Lim (W)

Nephrology Unit, Charles Gairdner Hospital, Perth, Australia.

Vincent W Lee (VW)

Westmead Applied Research Centre, University of Sydney, Sydney, Australia.
Department of Nephrology, The University of Sydney Medical School, Sydney, Australia.
Centre for Kidney Research, School of Public Health, University of Sydney, Sydney, Australia.

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