Kidney function and tobacco smoke exposure in US adolescents

Esther Garciá-Esquinas, Lauren Loeffler, Virginia Marie Weaver, Jeffrey J. Fadrowski, Ana Navas Acien

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND OBJECTIVE: Active smoking and secondhand smoke (SHS) are known risk factors for kidney disease in adults. We evaluated the association between exposure to active smoking or SHS and kidney function in US adolescents. METHODS: This is a cross-sectional study in 7516 adolescents aged 12-17 who participated in NHANES 1999-2010 and had serum creatinine and cotinine measures. Active smoking was defined as self-reported smoking or serum cotinine concentrations >10 ng/mL. SHS was defined as nonactive smokers who self-reported living with ≥1 smokers or serum cotinine concentrations ≥ 0.05 ng/mL. Kidney function was determined by using the chronic kidney disease in children estimated glomerular filtration rate (eGFR) equation. RESULTS: Median (interquartile range) eGFR and serum cotinine concentrations were 96.8 (85.4-109.0) mL/minute per 1.73 m2 and 0.07 (0.03-0.59) ng/mL, respectively. After multivariable adjustment, eGFR decreased 1.1 mL/minute per 1.73 m2 (95% confidence interval [CI]: 21.8 to 20.3) per interquartile range increase in serum cotinine concentrations. The mean (95%CI) difference in eGFR for serum cotinine tertiles 1, 2, and 3 among children exposed to SHS compared to unexposed were 20.4 (21.9 to 1.2), 20.9 (22.7 to 0.9), and 22.2 (24.0 to 20.4) mL/ minute per 1.73 m2, respectively (P = .03). The corresponding values among tertiles of active smokers compared to unexposed were 0.2 (22.2 to 2.6), 21.9 (23.8 to 0.0), and 22.6 (24.6 to 20.6) mL/minute per 1.73 m2 (P = .01). CONCLUSIONS: Tobacco smoke exposure was associated with decreased eGFR in US adolescents, supporting the possibility that tobacco smoke effects on kidney function begin in childhood.

Original languageEnglish (US)
JournalPediatrics
Volume131
Issue number5
DOIs
StatePublished - May 2013

Fingerprint

Cotinine
Smoke
Tobacco
Glomerular Filtration Rate
Tobacco Smoke Pollution
Kidney
Smoking
Serum
Confidence Intervals
Social Adjustment
Nutrition Surveys
Kidney Diseases
Chronic Renal Insufficiency
Creatinine
Cross-Sectional Studies

Keywords

  • Adolescents
  • Cotinine
  • Creatinine
  • Secondhand smoke
  • Smoking
  • Tobacco smoke pollution

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Kidney function and tobacco smoke exposure in US adolescents. / Garciá-Esquinas, Esther; Loeffler, Lauren; Weaver, Virginia Marie; Fadrowski, Jeffrey J.; Navas Acien, Ana.

In: Pediatrics, Vol. 131, No. 5, 05.2013.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND AND OBJECTIVE: Active smoking and secondhand smoke (SHS) are known risk factors for kidney disease in adults. We evaluated the association between exposure to active smoking or SHS and kidney function in US adolescents. METHODS: This is a cross-sectional study in 7516 adolescents aged 12-17 who participated in NHANES 1999-2010 and had serum creatinine and cotinine measures. Active smoking was defined as self-reported smoking or serum cotinine concentrations >10 ng/mL. SHS was defined as nonactive smokers who self-reported living with ≥1 smokers or serum cotinine concentrations ≥ 0.05 ng/mL. Kidney function was determined by using the chronic kidney disease in children estimated glomerular filtration rate (eGFR) equation. RESULTS: Median (interquartile range) eGFR and serum cotinine concentrations were 96.8 (85.4-109.0) mL/minute per 1.73 m2 and 0.07 (0.03-0.59) ng/mL, respectively. After multivariable adjustment, eGFR decreased 1.1 mL/minute per 1.73 m2 (95{\%} confidence interval [CI]: 21.8 to 20.3) per interquartile range increase in serum cotinine concentrations. The mean (95{\%}CI) difference in eGFR for serum cotinine tertiles 1, 2, and 3 among children exposed to SHS compared to unexposed were 20.4 (21.9 to 1.2), 20.9 (22.7 to 0.9), and 22.2 (24.0 to 20.4) mL/ minute per 1.73 m2, respectively (P = .03). The corresponding values among tertiles of active smokers compared to unexposed were 0.2 (22.2 to 2.6), 21.9 (23.8 to 0.0), and 22.6 (24.6 to 20.6) mL/minute per 1.73 m2 (P = .01). CONCLUSIONS: Tobacco smoke exposure was associated with decreased eGFR in US adolescents, supporting the possibility that tobacco smoke effects on kidney function begin in childhood.",
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N2 - BACKGROUND AND OBJECTIVE: Active smoking and secondhand smoke (SHS) are known risk factors for kidney disease in adults. We evaluated the association between exposure to active smoking or SHS and kidney function in US adolescents. METHODS: This is a cross-sectional study in 7516 adolescents aged 12-17 who participated in NHANES 1999-2010 and had serum creatinine and cotinine measures. Active smoking was defined as self-reported smoking or serum cotinine concentrations >10 ng/mL. SHS was defined as nonactive smokers who self-reported living with ≥1 smokers or serum cotinine concentrations ≥ 0.05 ng/mL. Kidney function was determined by using the chronic kidney disease in children estimated glomerular filtration rate (eGFR) equation. RESULTS: Median (interquartile range) eGFR and serum cotinine concentrations were 96.8 (85.4-109.0) mL/minute per 1.73 m2 and 0.07 (0.03-0.59) ng/mL, respectively. After multivariable adjustment, eGFR decreased 1.1 mL/minute per 1.73 m2 (95% confidence interval [CI]: 21.8 to 20.3) per interquartile range increase in serum cotinine concentrations. The mean (95%CI) difference in eGFR for serum cotinine tertiles 1, 2, and 3 among children exposed to SHS compared to unexposed were 20.4 (21.9 to 1.2), 20.9 (22.7 to 0.9), and 22.2 (24.0 to 20.4) mL/ minute per 1.73 m2, respectively (P = .03). The corresponding values among tertiles of active smokers compared to unexposed were 0.2 (22.2 to 2.6), 21.9 (23.8 to 0.0), and 22.6 (24.6 to 20.6) mL/minute per 1.73 m2 (P = .01). CONCLUSIONS: Tobacco smoke exposure was associated with decreased eGFR in US adolescents, supporting the possibility that tobacco smoke effects on kidney function begin in childhood.

AB - BACKGROUND AND OBJECTIVE: Active smoking and secondhand smoke (SHS) are known risk factors for kidney disease in adults. We evaluated the association between exposure to active smoking or SHS and kidney function in US adolescents. METHODS: This is a cross-sectional study in 7516 adolescents aged 12-17 who participated in NHANES 1999-2010 and had serum creatinine and cotinine measures. Active smoking was defined as self-reported smoking or serum cotinine concentrations >10 ng/mL. SHS was defined as nonactive smokers who self-reported living with ≥1 smokers or serum cotinine concentrations ≥ 0.05 ng/mL. Kidney function was determined by using the chronic kidney disease in children estimated glomerular filtration rate (eGFR) equation. RESULTS: Median (interquartile range) eGFR and serum cotinine concentrations were 96.8 (85.4-109.0) mL/minute per 1.73 m2 and 0.07 (0.03-0.59) ng/mL, respectively. After multivariable adjustment, eGFR decreased 1.1 mL/minute per 1.73 m2 (95% confidence interval [CI]: 21.8 to 20.3) per interquartile range increase in serum cotinine concentrations. The mean (95%CI) difference in eGFR for serum cotinine tertiles 1, 2, and 3 among children exposed to SHS compared to unexposed were 20.4 (21.9 to 1.2), 20.9 (22.7 to 0.9), and 22.2 (24.0 to 20.4) mL/ minute per 1.73 m2, respectively (P = .03). The corresponding values among tertiles of active smokers compared to unexposed were 0.2 (22.2 to 2.6), 21.9 (23.8 to 0.0), and 22.6 (24.6 to 20.6) mL/minute per 1.73 m2 (P = .01). CONCLUSIONS: Tobacco smoke exposure was associated with decreased eGFR in US adolescents, supporting the possibility that tobacco smoke effects on kidney function begin in childhood.

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KW - Secondhand smoke

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