Smoking may speed diabetics' kidney decline

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Smoking may speed diabetics' kidney decline

NEW YORK, Feb 27 (Reuters Health) - Diabetic kidney disease may worsen

quickly despite therapy if patients continue to smoke, new research

shows.

The study of 33 type 2 diabetics with kidney disease showed that

smokers' kidney function declined more rapidly than nonsmokers', despite

drug treatment with ACE inhibitors. These drugs, which lower blood

pressure, have been shown to slow the progression of diabetic kidney

disease, or nephropathy.

But in this study, doctors at Texas Tech University Health Sciences

Center in Lubbock found that even though ACE inhibitors lowered smokers'

blood pressure, these patients still saw their kidney function go

downhill. Nonsmokers' kidney health also declined, but to a lesser

degree, according to findings published in the February issue of the

American Journal of Kidney Diseases.

" Treating diabetic nephropathy with improved blood pressure control and

ACE inhibitor therapy fails to eradicate the untoward effects of

cigarette smoking, " conclude Drs. Temduang Chuahirun and E.

Wesson.

And although this study doesn't prove it, they add, smoking cessation

might slow the progression of kidney disease toward total kidney failure

in diabetics on ACE inhibitors.

Diabetes is a leading cause of kidney failure. Exactly why smoking might

speed the decline in kidney function is not fully clear, according to

the Texas researchers. But, among other things, cigarette smoking is

known to increase resistance in the kidney's blood vessels and to

increase blood levels of certain compounds that cause blood vessels to

constrict.

Whatever the mechanism, Chuahirun and Wesson note, it seems " prudent " to

get patients to quit smoking as one way to prevent total kidney failure.

SOURCE: American Journal of Kidney Diseases 2002;39:376-382.