Adverse effect of Tobacco smoke on Renal disease in young healthy medical students: A cross sectional comparative study.

Abstract

Objectives: To compare the effect of active and secondhand smoke to unexposed smoke and to renal functions in young healthy Medical Students. Study Design: Cross sectional study comparative. Setting: Mohi-ud-din Islamic-Medical-College Mirpur AJ&K. Period: Fanuary-2018 to February-2019. Material & Methods: 350 healthy medical students aged 17-19 years were divided into active, secondhand and unexposed to smoke on basis of serum cotinine levels. The estimated GFR was measured by Modification of Diet in Renal Disease equation, albuminuria by albumin to urinary creatinine ratio, BMI by body weight (kg) to height (m2) and blood pressure by mercury manometer. The chronic kidney disease was classified into low, moderate and high risk according to Kidney Disease: Improving-Global Outcomes-2012-guidelines. Results: Out of 350 participants, 49 were active and 126 were of secondhand smoke. Most were male, overweight or obese, have high systolic and diastolic pressure and decreased eGFR. The CKD prevalence was 8.2%, eGFR <60ml/min/1.73 m² noticed in 19% and albuminuria in 26.4% of the participants. The proteinuria in active smokers in comparison with unexposed showed a high OR-5.67-(95%CI-17.17-40.49), cotinine levels >10 ng/mL; OR-5.520-(95%CI-3.67-3.91), systolic BP >140 mmHg; OR-2.50-(95%CI- 0.142-4.968); moderate to severely decreased eGFR, OR-2.478-(95%CI-0.124-4.391) and with high creatinine levels OR-4.300-(95%CI 2.432–7.603). The decreased eGFR showed Odds for obese OR-1.113(95%CI-2.391-5.197), active smokers OR-0.145(95%CI-0.029-0.721) and for systolic blood pressure >140 mmHg OR-6.892-(95%CI-1.414-2.235). Conclusion: Tobacco smoke exposure was associated with proteinuria and decreased eGFR effecting kidney functions in adolescents.