title: Smoking has no impact on survival and it is not associated with ACE gene I/D polymorphism in hemodialysis patients.
abstract: BACKGROUND
  The relationship between smoking and mortality in patients on hemodialysis is controversial. Earlier studies showed that the insertion/deletion (I/D) polymorphism of the ACE gene might have an effect on mortality. The aim of this study was to test the impact of smoking on survival and whether this association was influenced by ACE gene I/D polymorphism in patients on maintenance hemodialysis.
  
  
  METHODS
  In this prospective, multicenter cohort study we analyzed 709 prevalent patients on maintenance hemodialysis. Patients were allocated into groups based on their smoking habit. Outcome data were collected during the 144-month follow-up period. Outcomes of current smokers and lifelong non-smokers were compared. In order to control for interactions between predictor variables, we also identified 160 matched pairs for further sub-analysis.
  
  
  RESULTS
  The vast majority of patients (67%) were non-smokers, followed by current smokers (22.2%) and ex-smokers (9.8%). Smoking had no impact on survival in the matched pair analysis ( p = 0.99). After adjustment for ACE I/D polymorphism and other co-variates, smoking had no effect on survival.
  
  
  CONCLUSIONS
  Our data suggest that smoking has no impact on survival; neither is it associated with ACE gene I/D polymorphism in hemodialysis patients.
authors.affiliation: 1 School for PhD Candidates of Aesculap Academy, Hungary.|4 Division Section of Geriatrics, 2nd Dept. of Internal Medicine, Semmelweis University Faculty of Medicine, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Kiss
authors.affiliation: 1 School for PhD Candidates of Aesculap Academy, Hungary.|2 Department of Nephrology-Hypertension and Division of Geriatrics, Saint Imre University Teaching Hospital, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Kiss
authors.affiliation: 1 School for PhD Candidates of Aesculap Academy, Hungary.|3 B. Braun Avitum Hungary CPLC Dialysis Network, Hungary.
authors.forename: Lóránt
authors.initials: L
authors.lastname: Kerkovits
authors.affiliation: 1 School for PhD Candidates of Aesculap Academy, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Paksy
authors.affiliation: 2 Department of Nephrology-Hypertension and Division of Geriatrics, Saint Imre University Teaching Hospital, Hungary.|4 Division Section of Geriatrics, 2nd Dept. of Internal Medicine, Semmelweis University Faculty of Medicine, Hungary.
authors.forename: Csaba
authors.initials: C
authors.lastname: Ambrus
mesh_terms: D005260:Female; D006801:Humans; D054643:INDEL Mutation / Q000235:genetics*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012907:Smoking / Q000009:adverse effects*; D016019:Survival Analysis
chemical_list: C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A
keywords: ACE gene I/D polymorphism; hemodialysis; mortality; smoking