TOPIC DISCUSSION: Smoking and Kidney Disease

Does chronic smoking predispose you to kidney disease? Why not? perhaps an ischemic related injury from chronic ischemia would make sense. Or athrescloerotic disease that can be seen in the entire body affects the kidney vessels as well.  There has been a Glomerulonephritis described in non diabetic smokers as well. A nice review is linked here from JASN in 2007.The authors in that paper described the largest series, describing 23 cases allowing recognition of common clinical and pathologic features. The patients were most frequently older caucasian men who presented with renal failure and proteinuria. Most of them had in common was history of smoking and hypertension. The pathology shows many of the characteristic findings of diabetic nephropathy including diffuse mesangial expansion with nodules, microaneurysms, capsular drops, and hyaline arteriolosclerosis. We have to remember to rule out other causes of nodular GN, like amyloid, immunotactoid and mainly hidden diabetes.


Regardless a nice read!