Kidney disease in diabetics who smoke

Smoking may put people who have diabetes and high blood pressure at increased risk of kidney disease. The list of harmful effects of cigarette smoking is long, but the results of this new study seems to add one more to the list. The study suggests that cigarette smoking increases the risk for a diabetic to develop kidney failure. In the study of people with type 2 diabetes (when the body can no longer properly use insulin and often linked to obesity) who were taking medication to control their high blood pressure, the combination of cigarette smoking and increased excretion of a protein albumin in urine seemed to speed the progression of kidney disease.Researchers at the Texas Tech Health Sciences University noted that blood pressure drugs called ACE (angiotensin-converting enzyme) inhibitors successfully prevent kidney failure in most non-smoking diabetics. That may not be the case in people with diabetes who are smokers. They followed 84 people with type 2 diabetes (31 cigarette smokers and 53 non-smokers) whose high blood pressure treatment included an ACE inhibitor.

During an average of 64 months, the increased excretion of albumin was significantly greater in smokers than in non-smokers. Furthermore, they found that the increase in albumin in the urine was closely related to the progression to kidney disease. Excreting small amounts of this protein in the urine is a sign that a person has a defect in their blood vessels, which can put them at risk of cardiovascular problems. Exactly why smoking might speed the decline in kidney function is not fully clear. But, among other things, cigarette smoking is known to increase resistance in the kidney's blood vessels and to increase blood levels of certain compounds that cause blood vessels to constrict. The present investigation is consistent with the notion that cigarette smoking increases cell-damaging oxidative stress and thereby progressive kidney damage in people with type 2 diabetes. This is a disease to be prevented rather than treated. Any intervention like smoking cessation, never starting to smoke, and/or antioxidant therapy will save countless lives as well as improve the quality of life for millions of diabetics.

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