P0819THE EFFECT OF SMOKING UPON CKD IN A JAPANESE NATIONWIDE 6-YEARS FOLLOW UP SERVEY

Abstract Background and Aims Cigarette Smoking is one of important risks for cardiovascular diseases, and also smoking had been reported to have harmful effect upon Choric kidney Diseases. Our group had reported that smoking canceled the beneficial effect caused by alcohol drinking using Japanese Nationwide Survey cross-sectional data (Matsumoto-A et al Hypertension Res, 2017). In this cohort study, we aimed to reveal the effect of smoking upon incidence of proteinuria and decline of kidney function using longitudinal large cohort of general population in Japan. Method The present nationwide longitudial survey included members of the general Japanese population who underwent the Specific Health Check and Guidance in Japan between April 2008 and March 2014. 149,260 who were not lack of essential data without chronic kidney diseases and whose kidney function was 60≦eGFR<120mL/min/1.73m2 were enrolled in this analysis. Demographic, physical, and laboratory data included age, sex, body mass index (BMI; weight [kg]/height2 [m2]), mean arterial pressure (MAP, diastolic blood pressure + [systolic blood pressure - diastolic blood pressure]/3), serum concentration of creatinine (enzymatic method), and levels of hemoglobin A1c, triglycerides, high-density lipoprotein (HDL) cholesterol, uric acid, and urinary protein as detected by a dipstick test. Proteinuria was defined as 1+ or more of urinary protein. We made statistical analysis using Kaplan-Meier analysis, Log-rank test, Cox proportional hazard method using STAT ver15. As outcomes, incidence of proteinuria (more than (1+) by dip stick, decline of eGFR more than 15 mL/min/1.73m2 from baseline kidney function were used. Results Smoker had significantly higher incidence rate of proteinuria than non-smoker (p<0.001). Smoker also had significantly higher incidence decline of kidney function more than 15ml/min than non-smoker (p<0.001). Smoking was significantly risk both for proteinuria (Hazard Rate 1.24(95％CI 1.15-1.34, p<0.001)) and for decline of kidney function HR 1.24(95％CI 1.16-1.31, p<0.001) in multivariate analyses. After stratification of four groups using smoking status and incidence of proteinuria during study periods. Smoker with incident proteinuria had significantly higher rate of decline of kidney function than non-smoker without incident proteinuria both in male (figure 1) and in female (Figure 2) Conclusion Smoking was risk for proteinuria and decline of kidney function. Moreover, smoker with incident proteinuria had worst kidney prognosis.