title: Smoking patterns and chronic kidney disease in US Hispanics: Hispanic Community Health Study/Study of Latinos.
abstract: Intermittent smoking is prevalent among Hispanics, but little is known about whether this smoking pattern associates with increased chronic kidney disease (CKD) risk in this population. The objective of the present study is to identify patterns of exposure associated with CKD in US Hispanics.
  
  
  
  We used cross-sectional data on 15 410 participants of the Hispanics Community Health Study/the Study of Latinos, a population-based study of individuals aged 18-74 years, recruited in 2008 to 2011 from four US field centers (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA). Smoking exposure was obtained through a questionnaire. CKD was defined by an estimated glomerular filtration rate of <60 mL/min/1.73 m(2) or a urine albumin-to-creatinine ratio of ≥30 mg/g.
  
  
  
  Approximately 14% of individuals were daily and 7% were intermittent smokers, and 16% were past smokers. There was a significant interaction between smoking status and pack-years of exposure (P = 0.0003). In adjusted models, there was an increased odds of CKD among daily, intermittent and past smokers by pack-years compared with never smokers. The association of intermittent smokers was significant at 10 pack-years [odds ratio (OR) = 1.38, 95% confidence intervals (CI) 1.06, 1.81], whereas for daily smokers this association was observed at 40 pack-years (OR = 1.43, 95% CI 1.09, 1.89).
  
  
  
  Our findings of increased risk of CKD among Hispanics who are intermittent smokers support screening and smoking cessation interventions targeted to this population for the prevention of CKD. It also suggests novel mechanistic pathways for kidney toxicity that should be further explored in future studies.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Nora
authors.initials: N
authors.lastname: Franceschini
authors.affiliation: Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Yu
authors.initials: Y
authors.lastname: Deng
authors.affiliation: National Institute of Diabetes, Digestive, and Kidney Disease, Bethesda, MD, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Flessner
authors.affiliation: Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Eckfeldt
authors.affiliation: Division of Nephrology, Loyola University, Maywood, IL, USA.
authors.forename: Holly J
authors.initials: HJ
authors.lastname: Kramer
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: James P
authors.initials: JP
authors.lastname: Lash
authors.affiliation: University of Miami, Miami, FL, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lee
authors.affiliation: Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Michal L
authors.initials: ML
authors.lastname: Melamed
authors.affiliation: University of Miami, Miami, FL, USA.
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Moncrieft
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Ana C
authors.initials: AC
authors.lastname: Ricardo
authors.affiliation: Joslin Diabetes Center, Harvard University, Boston, MA, USA.
authors.forename: Sylvia E
authors.initials: SE
authors.lastname: Rosas
authors.affiliation: Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kaplan
authors.affiliation: University of Miami, Miami, FL, USA.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Raij
authors.affiliation: Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Jianwen
authors.initials: J
authors.lastname: Cai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Hispanics/Latinos; chronic kidney disease; intermittent smoking