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Smoking-Related Renal Histologic Injury in IgA Nephropathy Patients

 Yoon Jin Cha  ;  Beom Jin Lim  ;  Beom Suk Kim  ;  Yonhee Kim  ;  Tae Hyun Yoo  ;  Seung Hyuk Han  ;  Shin Wook Kang  ;  Kyu Hun Choi  ;  Hyeon Joo Jeong 
 Yonsei Medical Journal, Vol.57(1) : 209-216, 2016 
Journal Title
 Yonsei Medical Journal 
Issue Date
Adult ; Aged ; Case-Control Studies ; Cohort Studies ; Creatinine/blood ; Disease Progression ; Female ; Glomerulonephritis, IGA/blood ; Glomerulonephritis, IGA/diagnosis* ; Glomerulonephritis, IGA/epidemiology ; Humans ; Immunohistochemistry ; Kidney/pathology* ; Kidney Function Tests ; Kidney Glomerulus/pathology* ; Male ; Middle Aged ; Risk Factors ; Smoking/adverse effects* ; Smoking/epidemiology
IgA nephropathy ; Smoking ; alpha-smooth muscle actin ; arteriolar hyalinosis ; macrophage infiltration
PURPOSE: Smoking reportedly exerts deleterious effects on renal function; however, its effects on histology have not been clarified in patients with IgA nephropathy (IgAN). MATERIALS AND METHODS: Renal histology was evaluated in a cohort of 397 patients diagnosed with IgAN according to smoking status and dose in relation to renal function. RESULTS: Among the study cohort, which was predominantly male (88.5%), 52 patients (13%) were current smokers. These current smokers demonstrated more frequent hypertension and higher serum creatinine levels than non/ex-smokers at the time of diagnosis, which was apparent with increased smoking dose. The percentages of global glomerulosclerosis and arteriolar hyalinosis increased with increased smoking dose, whereas tubulointerstitial fibrosis or arterial intimal thickening did not. Glomerular mesangial alpha-smooth muscle actin expression were similar between current and non/ex-smokers matched for age, gender, hypertension, and histologic severity, although the number of glomerular CD68+ cells was significantly fewer in smokers. Initial serum creatinine level, estimated glomerular filtration rate (eGFR), and global glomerulosclerosis were found to be risk factors of serum creatinine doubling in both smokers and non/ex-smokers by univariate analysis during a mean follow-up of 3.8 years. CONCLUSION: In addition to dose dependent renal functional decline and hypertension, smoking contributes to renal disease progression by eliciting microvascular injury in IgAN patients.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
김범석(Kim, Beom Seok) ORCID logo https://orcid.org/0000-0002-5732-2583
유태현(Yoo, Tae Hyun) ORCID logo https://orcid.org/0000-0002-9183-4507
임범진(Lim, Beom Jin) ORCID logo https://orcid.org/0000-0003-2856-0133
정현주(Jeong, Hyeon Joo) ORCID logo https://orcid.org/0000-0002-9695-1227
차윤진(Cha, Yoon Jin) ORCID logo https://orcid.org/0000-0002-5967-4064
최규헌(Choi, Kyu Hun) ORCID logo https://orcid.org/0000-0003-0095-9011
한승혁(Han, Seung Hyeok) ORCID logo https://orcid.org/0000-0001-7923-5635
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