title: The association of alcohol and smoking with CKD in a Japanese nationwide cross-sectional survey.
abstract: Chronic kidney disease (CKD) is characterized by a reduced glomerular filtration rate (GFR) and proteinuria. Modifiable lifestyle factors such as smoking and alcohol contribute to CKD. Recent cohort studies have shown that moderate alcohol consumption attenuates the decline of the GFR and smoking has been previously shown to be associated with CKD. However, the association of smoking and alcohol consumption on CKD is not entirely clear. To examine whether there is evidence to assume that smoking is an effective modifier of the association between CKD and alcohol consumption, we conducted a cross-sectional study of a population of people who presented for a health checkup under a program that targets the insured population aged ≧40 years using data from the Specific Health Check and Guidance in Japan between April 2008 and March 2009. Of the 506 807 participants aged ⩾40 years, 292 013 (57.6%) were included in the present analysis. Outcomes were kidney dysfunction, as an eGFR of <60 ml/min/1.73 m2, and proteinuria. In nonsmokers, drinking a small amount was associated with a lower prevalence of proteinuria, but in smokers, the association between alcohol and proteinuria was not observed. The analysis regarding eGFR <60 ml/min/1.73 m2revealed that in both smokers and nonsmokers, alcohol consumption was inversely associated with the risk of CKD. Mild to moderate alcohol consumption might be associated with a lower risk of CKD (proteinuria and eGFR), especially among nonsmokers, because smoking might have modified the potential benefits of alcohol to prevent CKD.
authors.affiliation: Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Matsumoto
authors.affiliation: Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nagasawa
authors.affiliation: Osaka University Health Care Center, Osaka, Japan.|Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Yamamoto
authors.affiliation: Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Shinzawa
authors.affiliation: Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Hasuike
authors.affiliation: Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kuragano
authors.affiliation: Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Isaka
authors.affiliation: Department of Internal Medicine, Division of Kidney and Dialysis, Hyogo College of Medicine, Hyogo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakanishi
authors.affiliation: Steering Committee for the 'Research on the Positioning of Chronic Kidney Disease in Specific Health Check and Guidance in Japan', Tokyo, Japan.
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Iseki
authors.affiliation: Steering Committee for the 'Research on the Positioning of Chronic Kidney Disease in Specific Health Check and Guidance in Japan', Tokyo, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Yamagata
authors.affiliation: Steering Committee for the 'Research on the Positioning of Chronic Kidney Disease in Specific Health Check and Guidance in Japan', Tokyo, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuruya
authors.affiliation: Steering Committee for the 'Research on the Positioning of Chronic Kidney Disease in Specific Health Check and Guidance in Japan', Tokyo, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Steering Committee for the 'Research on the Positioning of Chronic Kidney Disease in Specific Health Check and Guidance in Japan', Tokyo, Japan.
authors.forename: Shouichi
authors.initials: S
authors.lastname: Fujimoto
authors.affiliation: Steering Committee for the 'Research on the Positioning of Chronic Kidney Disease in Specific Health Check and Guidance in Japan', Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Asahi
authors.affiliation: Osaka University Health Care Center, Osaka, Japan.|Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.|Steering Committee for the 'Research on the Positioning of Chronic Kidney Disease in Specific Health Check and Guidance in Japan', Tokyo, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Moriyama
authors.affiliation: Steering Committee for the 'Research on the Positioning of Chronic Kidney Disease in Specific Health Check and Guidance in Japan', Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D044466:Asian People; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology*