Nephrology Specialist Doctor Kadir Gökhan ATILGAN touched upon the damage caused by smoking on the kidneys.
Cigarette ; It is one of the leading causes of preventable death and disease. Among these, the conditions that we know best to worsen with smoking are: atherosclerosis, which is called atherosclerosis, and atherosclerotic heart diseases, vascular occlusions in the brain or legs, and cancers. In another case that has been studied for many years, smoking and nicotine increase the development of kidney disease and show its contribution to the progression of existing kidney disease. Studies up to 2007 showed a clinical relationship. In these studies, increase in urinary protein excretion and increase in disease progression in patients with Polycystic Kidney Disease, and in a few other studies, renal functions were reported to be impaired in patients with Lupus Nephritis, in diseases characterized by protein excretion in the urine and/or blood in the urine, which we call Glomerulonephritis. In addition, deterioration in diabetes and hypertension, which are the biggest causes of kidney failure, and also in the nephropathy associated with these diseases, has also been clinically demonstrated. In hypertensive patients, cigarette smoking causes temporary increases in blood pressure, and there is a related decrease in blood flow velocity in the kidney and, accordingly, a decrease in glomerular filtration rate. In 2001, in the journal Nature Medicine, Heeschen.C et al. showed that nicotine increases angiogenesis through the Nicotinic ACh Receptor (NACnR) in the vessel wall. This situation brings with it atherosclerosis and related hypertension, and consequently an increase in morbidity and mortality. Based on this study, Edgar James et al. in 2007 conducted a study to examine the presence of NAChR in kidney tissue and the extent of its damage to the kidney. As a result of the study, the presence of NAChR in the vascular origin mesangial cells in the glomerular component, which is the filtering part of the kidney cell that we define as the nephron, has been demonstrated under laboratory conditions. Based on this, it has been reported that nicotine causes mesangial cell increase through this receptor. In addition, reactive oxygen radicals take place as strong mediators in these reactions. Reactive oxygen radicals cause an increase in the connective tissue substance called fibronectin together with the increase in mesangial cells via the growth factors Angiotensin-2, PDGF and TGF-beta. To sum up, nicotine through NAChR and reactive oxygen radicals in the glomerular part of the nephron, which is the building block of the kidney, which filters; By triggering an increase in mesangial cells and an increase in connective tissue in the intercellular space, it narrows the filtering area of the kidney, reduces its functions, and advances the failure process. As a result, the continuation of smoking or nicotine exposure will result in chronic kidney disease. A systemic disease that may cause diabetes, hypertension or other kidney failure, which will be added to this picture, will accelerate the process of chronic kidney failure and dialysis.
