title: Cigarette Smoking and Chronic Kidney Disease in African Americans in the Jackson Heart Study.
abstract: Controversy exists regarding the association of cigarette smoking and renal dysfunction, particularly among African Americans, who are disproportionately affected by chronic kidney disease; therefore, we evaluated the relationship between cigarette smoking and rapid renal function (RRF) decline in the Jackson Heart Study.
  
  
  
  Rates of RRF decline were determined among 3648 African American participants enrolled at baseline in the Jackson Heart Study. RRF decline was defined as an absolute decline of estimated glomerular filtration rate of 30% from visit 1 to visit 3. There were 422 current, 659 past, and 2567 never smokers identified at visit 1. After adjustment for age, sex, body mass index, diabetes, hypertension, cholesterol, physical activity, education, alcohol consumption, and prevalent cardiovascular disease, current smokers demonstrated a significantly higher incidence of RRF decline compared with never smokers (incidence rate ratio 1.83, 95% CI 1.31-2.56). Current smokers using 1 to 19 and ≥20 cigarettes daily had an increased incidence of RRF decline (incidence rate ratios of 1.75 [95% CI 1.18-2.59] and 1.97 [95% CI 1.17-3.31], respectively). There was a significant, progressive reduction in estimated glomerular filtration rate from visit 1 to visit 3 in current and past smokers compared with never smokers. Finally, current smokers had a 1.38-fold increase in C-reactive protein compared with never smokers, after controlling for covariates.
  
  
  
  In a large African American cohort, current cigarette smoking was independently associated with RRF decline in a dose-dependent manner. There was also evidence of increased inflammation (C-reactive protein) in current smokers, suggesting a potential mechanism for these relationships.
authors.affiliation: Division of Cardiology, University of Mississippi Medical Center, Jackson, MS mehall@umc.edu.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Hall
authors.affiliation: Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS.
authors.forename: Victoria
authors.initials: V
authors.lastname: Okhomina
authors.affiliation: Division of Nephrology, University of Mississippi Medical Center, Jackson, MS.
authors.forename: Mohit
authors.initials: M
authors.lastname: Agarwal
authors.affiliation: Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, MS.
authors.forename: John E
authors.initials: JE
authors.lastname: Hall
authors.affiliation: Division of Nephrology, University of Mississippi Medical Center, Jackson, MS.
authors.forename: Albert W
authors.initials: AW
authors.lastname: Dreisbach
authors.affiliation: Division of Nephrology, University of Mississippi Medical Center, Jackson, MS.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Juncos
authors.affiliation: Division of Cardiology, University of Mississippi Medical Center, Jackson, MS.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Winniford
authors.affiliation: Department of Otolaryngology and Communicative Disorders, University of Mississippi Medical Center, Jackson, MS.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Payne
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Rose M
authors.initials: RM
authors.lastname: Robertson
authors.affiliation: Division of Cardiovascular Medicine, University of Louisville, KY.
authors.forename: Aruni
authors.initials: A
authors.lastname: Bhatnagar
authors.affiliation: Division of Nephrology, University of Washington, Seattle, WA.
authors.forename: Bessie A
authors.initials: BA
authors.lastname: Young
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000378:metabolism; D000073865:Cigarette Smoking / Q000009:adverse effects* / Q000208:ethnology / Q000503:physiopathology; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein
keywords: African Americans; chronic kidney disease; cigarette smoking