Renal impairment in chronic cigarette smokers.

To determine the effect of chronic cigarette smoking on renal function, a cross-sectional study was carried out with 30 subjects who had no known vascular disease risk factor other than cigarette smoking, and 24 age- and sex-matched controls without any vascular risk factor including cigarette smoking. Renal function by radionuclide studies of renal plasma flow, GFR, and plasma endothelin- 1 concentration was determined. Compared with nonsmokers, smokers had a renal function impairment characterized by a normal GFR and a significant reduction in renal plasma flow as reflected by MAG3 clearance (199.20 ± 58.85 ml/min per 1.73 m2 versus 256.54 ± 60.14 mI/mm per 1.73 m2; t = 3.52, P < 0.001). MAG1 clearance was significantly correlated with age and smoking. The renal dysfunction was associated with an in- crease in plasma endothelin-l concentration (21.56 ± 1.15 pmollL versus 25.01 ± 3.21 pmollL; t = 5.00, P < 0.001). Former smokers as well had similar, although milder, abnor- malities. In conclusion, cigarette smokers manifest an impair- ment of renal function, suggesting that smoke may have a detrimental effect on renal function. (J Am Soc Nephrol 9: 562-567, 1998)