Tobacco, alcohol, and illicit drug use and progression of chronic kidney disease A study examined the associations of substance use with chronic kidney disease (CKD) progression and all-cause mortality among patients with CKD.
The Chronic Renal Insufficiency Cohort Study is a prospective, longitudinal cohort study among 3,939 participants with CKD in the United States. Self-reported tobacco smoking, alcohol drinking, marijuana use, and hard illicit drug use were obtained at baseline and annual follow-up visits. CKD progression was defined as incident end atage kidney disease or halving of estimated glomerular filtration rate.
Over a median 5.5-year follow-up, 1,287 participants developed CKD progression, and 1001 died. Baseline proportions of tobacco smoking, alcohol drinking, marijuana use, and hard illicit drug use were 13%, 20%, 33%, and 12%, respectively. Compared with non-smoking throughout follow-up, multivariableadjusted hazard ratios (HR) for persistent tobacco smoking were 1.02 for CKD progression and 1.86 for all-cause mortality. Compared with nondrinking throughout follow-up, HR for persistent alcohol drinking were 1.06 for CKD progression and 0.73 for all-cause mortality. Compared with non-use throughout follow-up, HR for persistent marijuana use were 0.94 for CKD progression and 1.11 for all-cause mortality. Compared with non-use throughout follow-up, HR for persistent hard illicit drug use were 1.25 for CKD progression and 1.41 for all-cause mortality.
The study concludes that hard illicit drug use is associated with higher risk of CKD progression and all-cause mortality, tobacco smoking is associated with higher risk of all-cause mortality, and alcohol drinking is associated with lower risk of all-cause mortality among patients with CKD.
Source: Self-Reported Tobacco, Alcohol, and Illicit Drug Use and Progression of Chronic Kidney Disease. Bundy JD, Bazzano LA, Xie D, Cohan J, Dolata J, Fink JC, Hsu CY, Jamerson K, Lash J, Makos G, Steigerwalt S, Wang X, Mills KT, Chen J, He J; CRIC Study Investigators. Clin J Am Soc Nephrol. 2018 Jun 7. pii: CJN.11121017.