Kidney Week

Abstract: PUB555

Impact of Smoking Intensity and Initiation Age on Cardio-Cerebrovascular Disease and Mortality Risk in Patients with CKD: A Nationwide Population-Based Cohort Study

Session Information

• Publication Only

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Jung, Sehyun, Gyeongsang National University Hospital, Jinju, Korea (the Republic of)

Sehyun Jung, MD

• Kim, Seong Geun, Inje University Sanggye Paik Hospital, Nowon-gu, Seoul, Korea (the Republic of)

Seong Geun Kim, MD

• Cho, Semin, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Gyeonggi-do, Korea (the Republic of)

Semin Cho, MD

• Huh, Hyuk, Inje University Busan Paik Hospital, Busan, Busan, Korea (the Republic of)

Hyuk Huh, MD

• Koh, Jung Hun, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Jung Hun Koh, MD

• Cho, Jeongmin, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Gyeonggi-do, Korea (the Republic of)

Jeongmin Cho, MD

• Kim, Minsang, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Minsang Kim

• Kang, Min Woo, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Min Woo Kang

• Kang, Eunjeong, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Eunjeong Kang, MD, PhD

• Park, Sehoon, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Sehoon Park, MD, PhD

• Kim, Yaerim, Keimyung University Daegu Dongsan Hospital, Daegu, Korea (the Republic of)

Yaerim Kim, MD, PhD

• Kim, Dong Ki, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Dong Ki Kim, MD, PhD

• Han, Kyungdo, Soongsil University Department of Statistics and Actuarial Science, Dongjak-gu, Seoul, Korea (the Republic of)

Kyungdo Han, PhD

• Lee, Soojin, Eulji University Uijeongbu Eulji Medical Center, Uijeongbu, Gyeonggi-do, Korea (the Republic of)

Soojin Lee, MD, PhD

Background

Tobacco use is a significant modifiable risk factor for numerous diseases. While previous research had shown the adverse health outcomes related to smoking, the impact of smoking initiation age and intensity on chronic kidney disease (CKD) patients remains further investigation.

Methods

We conducted a retrospective cohort study with National Health Insurance Database of South Korea, encompassing 652,223 adults aged 20 and above, who underwent national health screening in 2009. Participants with CKD were identified, and their smoking status, smoking initiation age, pack-years, and clinical outcomes were assessed. Cox regression analysis was employed to investigate the association between smoking parameters and the risk of cardio-cerebrovascular diseases (CCVDs) and all-cause mortality, adjusting for potential confounders.

Results

The risks of CCVDs and all-cause deaths according to the smoking initiation age and pack years were assessed. Among CKD patients, higher pack-years and younger smoking initiation ages were associated with elevated risks of CCVDs and all-cause mortality. Participants with pack years < 20 and smoking initiation age below 20 exhibited an increased risk of all-cause death (HR 1.83; 95% CI 1.67-2.00). Among high-risk groups (with 30, 40, and 50 pack years), those with smoking initiation age below 20 showed elevated risk of CCVDs and all-cause death (Figure 1).

Conclusion

Our findings highlight the importance of smoking cessation in CKD patients, as early initiation and higher intensity of smoking are associated with heightened risks of CCVDs and all-cause mortality. Encouraging smoking cessation, particularly in younger individuals, may mitigate the burden of cardiovascular diseases and mortality among CKD population.