Secondhand smoke exposure is associated with proteinuria in children with chronic kidney disease

Abiodun Omoloja, Judith Jerry-Fluker, Derek Ng, Alison Gump Abraham, Susan Furth, Bradley A. Warady, Mark Mitsnefes

Research output: Contribution to journalArticle

Abstract

Background: In adults with chronic kidney disease (CKD), cigarette smoking is associated with an increased risk for CKD progression and transplant failure. In children, secondhand smoke (SHS) exposure has been associated with elevated blood pressure. There are no studies on the prevalence and effect of SHS exposure in CKD. Methods: Subjects were enrolled in the Chronic Kidney Disease in Children (CKiD) Study, an observational cohort of 366 children aged 1 to 16 years with CKD. Secondhand smoke exposure was obtained via questionnaire. SHS exposure was also determined based on urine cotinine (Ucot) measurements (1 ng/mL ≤ Ucot <75 ng/mL). The cross-sectional association of SHS exposure with proteinuria was assessed. Results: Using Ucot, 22 % of subjects were exposed to SHS. SHS exposure was significantly associated with lower maternal education and African American race, and a greater prevalence of nephrotic range proteinuria and left ventricular hypertrophy. In a multivariate model (including sex, age, race, maternal education, income level, private insurance status, abnormal birth history and CKD diagnosis), the prevalence odds of nephrotic range proteinuria was 2.64, (95 % confidence interval 1.08, 6.42) higher in children exposed to SHS compared to those unexposed. Conclusions: In our cohort of children with CKD, SHS exposure was common (22 %) and independently associated with nephrotic range proteinuria. Exposure to SHS may be an important factor to consider in CKD progression.

Original languageEnglish (US)
Pages (from-to)1243-1251
Number of pages9
JournalPediatric Nephrology
Volume28
Issue number8
DOIs
StatePublished - Aug 2013

Fingerprint

Tobacco Smoke Pollution
Chronic Renal Insufficiency
Proteinuria
Cotinine
Urine
Disease Progression
Education
Reproductive History
Insurance Coverage
Maternal Age
Left Ventricular Hypertrophy
African Americans
Observational Studies
Cohort Studies
Cross-Sectional Studies
Smoking
Mothers
Confidence Intervals
Blood Pressure
Transplants

Keywords

  • Chronic kidney disease progression
  • Pediatric chronic kidney disease
  • Proteinuria
  • Secondhand smoke exposure
  • Tobacco use
  • Urine cotinine

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Secondhand smoke exposure is associated with proteinuria in children with chronic kidney disease. / Omoloja, Abiodun; Jerry-Fluker, Judith; Ng, Derek; Abraham, Alison Gump; Furth, Susan; Warady, Bradley A.; Mitsnefes, Mark.

In: Pediatric Nephrology, Vol. 28, No. 8, 08.2013, p. 1243-1251.

Research output: Contribution to journalArticle

Omoloja, Abiodun ; Jerry-Fluker, Judith ; Ng, Derek ; Abraham, Alison Gump ; Furth, Susan ; Warady, Bradley A. ; Mitsnefes, Mark. / Secondhand smoke exposure is associated with proteinuria in children with chronic kidney disease. In: Pediatric Nephrology. 2013 ; Vol. 28, No. 8. pp. 1243-1251.
@article{f44ebb3e0da14b3d88f85064142dac20,
title = "Secondhand smoke exposure is associated with proteinuria in children with chronic kidney disease",
abstract = "Background: In adults with chronic kidney disease (CKD), cigarette smoking is associated with an increased risk for CKD progression and transplant failure. In children, secondhand smoke (SHS) exposure has been associated with elevated blood pressure. There are no studies on the prevalence and effect of SHS exposure in CKD. Methods: Subjects were enrolled in the Chronic Kidney Disease in Children (CKiD) Study, an observational cohort of 366 children aged 1 to 16 years with CKD. Secondhand smoke exposure was obtained via questionnaire. SHS exposure was also determined based on urine cotinine (Ucot) measurements (1 ng/mL ≤ Ucot <75 ng/mL). The cross-sectional association of SHS exposure with proteinuria was assessed. Results: Using Ucot, 22 {\%} of subjects were exposed to SHS. SHS exposure was significantly associated with lower maternal education and African American race, and a greater prevalence of nephrotic range proteinuria and left ventricular hypertrophy. In a multivariate model (including sex, age, race, maternal education, income level, private insurance status, abnormal birth history and CKD diagnosis), the prevalence odds of nephrotic range proteinuria was 2.64, (95 {\%} confidence interval 1.08, 6.42) higher in children exposed to SHS compared to those unexposed. Conclusions: In our cohort of children with CKD, SHS exposure was common (22 {\%}) and independently associated with nephrotic range proteinuria. Exposure to SHS may be an important factor to consider in CKD progression.",
keywords = "Chronic kidney disease progression, Pediatric chronic kidney disease, Proteinuria, Secondhand smoke exposure, Tobacco use, Urine cotinine",
author = "Abiodun Omoloja and Judith Jerry-Fluker and Derek Ng and Abraham, {Alison Gump} and Susan Furth and Warady, {Bradley A.} and Mark Mitsnefes",
year = "2013",
month = "8",
doi = "10.1007/s00467-013-2456-1",
language = "English (US)",
volume = "28",
pages = "1243--1251",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",
number = "8",

}

TY - JOUR

T1 - Secondhand smoke exposure is associated with proteinuria in children with chronic kidney disease

AU - Omoloja, Abiodun

AU - Jerry-Fluker, Judith

AU - Ng, Derek

AU - Abraham, Alison Gump

AU - Furth, Susan

AU - Warady, Bradley A.

AU - Mitsnefes, Mark

PY - 2013/8

Y1 - 2013/8

N2 - Background: In adults with chronic kidney disease (CKD), cigarette smoking is associated with an increased risk for CKD progression and transplant failure. In children, secondhand smoke (SHS) exposure has been associated with elevated blood pressure. There are no studies on the prevalence and effect of SHS exposure in CKD. Methods: Subjects were enrolled in the Chronic Kidney Disease in Children (CKiD) Study, an observational cohort of 366 children aged 1 to 16 years with CKD. Secondhand smoke exposure was obtained via questionnaire. SHS exposure was also determined based on urine cotinine (Ucot) measurements (1 ng/mL ≤ Ucot <75 ng/mL). The cross-sectional association of SHS exposure with proteinuria was assessed. Results: Using Ucot, 22 % of subjects were exposed to SHS. SHS exposure was significantly associated with lower maternal education and African American race, and a greater prevalence of nephrotic range proteinuria and left ventricular hypertrophy. In a multivariate model (including sex, age, race, maternal education, income level, private insurance status, abnormal birth history and CKD diagnosis), the prevalence odds of nephrotic range proteinuria was 2.64, (95 % confidence interval 1.08, 6.42) higher in children exposed to SHS compared to those unexposed. Conclusions: In our cohort of children with CKD, SHS exposure was common (22 %) and independently associated with nephrotic range proteinuria. Exposure to SHS may be an important factor to consider in CKD progression.

AB - Background: In adults with chronic kidney disease (CKD), cigarette smoking is associated with an increased risk for CKD progression and transplant failure. In children, secondhand smoke (SHS) exposure has been associated with elevated blood pressure. There are no studies on the prevalence and effect of SHS exposure in CKD. Methods: Subjects were enrolled in the Chronic Kidney Disease in Children (CKiD) Study, an observational cohort of 366 children aged 1 to 16 years with CKD. Secondhand smoke exposure was obtained via questionnaire. SHS exposure was also determined based on urine cotinine (Ucot) measurements (1 ng/mL ≤ Ucot <75 ng/mL). The cross-sectional association of SHS exposure with proteinuria was assessed. Results: Using Ucot, 22 % of subjects were exposed to SHS. SHS exposure was significantly associated with lower maternal education and African American race, and a greater prevalence of nephrotic range proteinuria and left ventricular hypertrophy. In a multivariate model (including sex, age, race, maternal education, income level, private insurance status, abnormal birth history and CKD diagnosis), the prevalence odds of nephrotic range proteinuria was 2.64, (95 % confidence interval 1.08, 6.42) higher in children exposed to SHS compared to those unexposed. Conclusions: In our cohort of children with CKD, SHS exposure was common (22 %) and independently associated with nephrotic range proteinuria. Exposure to SHS may be an important factor to consider in CKD progression.

KW - Chronic kidney disease progression

KW - Pediatric chronic kidney disease

KW - Proteinuria

KW - Secondhand smoke exposure

KW - Tobacco use

KW - Urine cotinine

UR - http://www.scopus.com/inward/record.url?scp=84879927342&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879927342&partnerID=8YFLogxK

U2 - 10.1007/s00467-013-2456-1

DO - 10.1007/s00467-013-2456-1

M3 - Article

C2 - 23584848

AN - SCOPUS:84879927342

VL - 28

SP - 1243

EP - 1251

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

IS - 8

ER -