Table 2. The Effects of Smoking on Proteinuria or Albuminuria in Healthy Populations.
| Authors | Year | Study Design (LOE) | Main Outcomes | Qualitya / Commentb |
|---|---|---|---|---|
| Metcalf PA,et al.(19) | 1993 | Cross-sectional in 5,670 people aged 40-78 years in a community of New Zealand(III) | Mantel-Haenszel OR for slight albuminuria (29-299 mg/l in men and 30-299 mg/l in women) in current smokers vs. never smokers was 1.37 (1.01~1.88) adjusted for age, gender, ethnicity, alcohol and exercise. | B/ Not excluding DM patients |
| Goetz FC,et al.(14) | 1997 | 5-yr follow up in 455 adults in a U.S. community (IIa) | Prevalence of increased urinary albumin(≥15μg/min) was twofold more frequent in current smokers (13%) than in ex- and never smokers (7%) at the baseline measurement adjusted for age, gender, BMI and DM, but this difference was not significant. | C/ Small number of subjects |
| Cirillo M,et al.(13) | 1998 | Cross-sectional in 677 men and 890 women in an Italian community (III) | Number of cigarettes consumed per day was correlated with overnight urinary albumin excretion adjusted for age, BMI and alcohol OR for microalbuminuria (20-199μg/min) in male and female current smokers vs. non- smokers was 1.99 (0.97~4.07) and 1.91 (0.73~4.96) respectively adjusted for the confounders. | C/ Ex-smoking was not considered |
| Pinto-Sietsma SJ,et al.(21) | 2000 | Cross-sectional in 7,476 adults in a Dutch community (III) | OR for microalbuminuria (30-300 mg/24h) in current smokers consuming up to 20 cigarettes per day and in those consuming more vs. never smokers was 1.92 (1.54~2.39) and 2.15 (1.52~3.03) respectively adjusted for age, gender, BMI, BP, FPG and alcohol. | A |
| Halimi JM,et al.(15) | 2000 | Cross-sectional in 28,409 French participants in a health screening (III) | OR for proteinuria (dipstick) was 2.03 (1.43~2.93) in normotensive current smokers and 2.36 (1.14~5.32) in hypertensive smokers vs. nonsmokers adjusted for age, gender and BP. | B/ Dipstick for proteinuria |
| Tozawa M,et al.(23) | 2002 | 22-yr follow-up in 3,403 male and 2,000 female Japanese participants in health screening (IIa) | OR for incident proteinuria (dipstick) in male and female current smokers vs. nonsmokers was1.28 (0.96~1.72) and 1.30 (0.44~3.80) respectively adjusted for age, obesity, hypertension and DM. | C/ Short period of observation |
| Briganti EM,et al.(12) | 2002 | Population-based Case-control study in 11,247 adults in an Australian community(III) | OR for proteinuria (≥ 0.2 mg/mg.Cr) in current smokers was 1.58 (0.53~4.75), not significant, but it was significant, 3.64 when SBP of 131.5 mmHg or higher or, 1.76 when 2-h post-loaded glucose was 126mg/dl or above. | C/ Ex-smoking was not considered |
| Yamada Y,et al.(24) | 2004 | Cross-sectional in 11,569 male and 4,715 female Japanese workers(III) | OR for proteinuria (dipstick) was 1.11 (1.15~1.63) at each level of BI (0, 1;BI:1-199, 2;BI:200-499, 3;BI:500-799, 4;BI:800-) adjusted for age, gender, DM and BP. OR for proteinuria in smokers aged 50 years or older with a BI of 500 or above and a normal high BP was 5.44 (2.27~13.0). | B/ Dipstick for proteinuria |
| Hogan SL,et al.(16) | 2007 | Cross-sectional in 15,169 adults from U.S. communities (III) | In hypertensive subjects, OR for albuminuria (≥ 17μg/mg.Cr in men and ≥ 25μg/mg.Cr in women) was 1.85 (1.29~2.64) in current smokers vs. never smokers adjusted for age, gender. No significant effects of smoking were found in normotensive subjects. | B/ Not excluding DM patients |
| Zhang L,et al.(26) | 2008 | Cross-sectional in 13,925 adults in communities in China(III) | OR for albuminuria (≥ 17μg/mg.Cr in men and ≥25μg/mg.Cr in women) was 0.94 (0.78~1.13) in current smokers vs. nonsmokers adjusted for age, gender, obesity, DM, hyper tension and hyperlipidemia. | B/ Ex-smoking was not considered |
| Ishizaka N,et al.(17) | 2008 | Cross-sectional in 7,078 Japanese male participants in health screening (III) | OR for albuminuria (≥ 30 mg/g.Cr) in current smokers consuming 20-39 cigarettes per day and those consuming more was 1.56 (1.17~2.08) and 1.88 (0.99~3.55) respectively in comparison with never smokers adjusted for age, BP and FPG. | B/ Not excluding DM patients |
| Yoon HJ,et al.(25) | 2009 | Cross-sectional in 35,228 Korean participants in health screening (III) | OR for proteinuria (dipstick) in current smokers consuming more than 20 cigarettes per day or more vs. nonsmokers was 1.33 (1.09~1.64) in men and 1.89 (0.91~3.87) in women adjusted for age, BMI, BP, FPG. | B/ Dipstick for albuminuria |
| Krol E,et al.(18) | 2010 | Cross-sectional in 2,469 Polish adults in a community (III) | OR for albuminuria (a dipstick) in male current smokers vs. nonsmokers was 1.58 (1.07~2.33)adjusted for age, BMI, DM and hypertension, but not significant in female subjects. | B/ Not-randomized selection of the subjects |
| O'Seaghdha CM,et al.(20) | 2010 | Observational cohort-study in 1,916 inhabitants in a U.S. community(IIa) | OR for albuminuria (≥ 17μg/mg.Cr in men and ≥ 25μg/mg.Cr in women) in current smokers vs. nonsmokers was 2.09 (1.36~3.22) adjusted for age, gender, DM and baseline urinary albumin. | b/ Not-randomized selection of the the subjects |
| Sauriasari R,et al.(22) | 2010 | Cross-sectional in 290 male and 359 female Japanese participants in health screening (III) | OR for proteinuria (≥ 49.4 mg/g.Cr) in smokers consuming 20 pack-years or more vs. never smokers was 1.56 (0.79~3.09) adjusted for age, gender, BMI and BP. | C/ Small number of subjects |
| Noborisaka Y,et al.(7) | 2011 | Cross-sectional in 990 middle-aged Japanese men from a chemical plant (III) | OR for proteinuria (a dipstick) in men who have a BI of 400-599 and those have a BI of 600 or higher was 2.94(1.01~8.55) and 3.61(1.29~10.1), respectively, adjusted for age, BMI, high BP, high FPG and high serum lipids. | B/ Dipstick for proteinuria |
Abbreviations: BI, Brinkman Index, BMI, body mass index, BP, blood pressure; Cr, creatinine; DM, diabetes mellitus;.FPG, fasting plasma glucose; LOE, level of evidence defined by AHCPR (1993); OR, odds ratio
aQuality: For the definition, refer to text and Table 1.
bComment: The main reason for grading the article as B or C.