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ASN: Smoking May Negate Some Benefits of Rx Therapy in CKD

Possibly because cigarette smoking causes oxidative stress

FRIDAY, Nov. 18, 2016 (HealthDay News) — Cigarette smoking may decrease the effectiveness of medication taken during early stages of chronic kidney disease, according to research presented at the annual meeting of the American Society of Nephrology (Kidney Week), held from Nov. 15 to 20 in Chicago.

Bethany Roehm, M.D., of Tufts Medical Center in Boston, and colleagues tracked 108 smokers and 108 nonsmokers taking angiotensin-converting enzyme inhibitors for early chronic kidney diseases. Researchers enrolled all the smokers in a quit-smoking program, and 25 quit. The study participants were tracked for five years.

The researchers found that kidney function worsened faster in smokers compared to nonsmokers and those who quit. Smokers also showed signs that the medication wasn’t protecting their kidneys as well, possibly because cigarette smoking caused oxidative stress.

“It has practically become dogma that if you have a patient with high blood pressure and chronic kidney disease that you start them on an angiotensin-converting enzyme inhibitor, and we are often comforted as clinicians that we are doing something to help slow progression of their kidney disease in doing this,” Roehm said in a news release from the American Society of Nephrology. “But our data suggest that this may not be the case for smokers, and our study underscores the importance of doing all we can as clinicians to encourage our patients to stop smoking.”

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