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Abstract: PO1871

Tobacco Exposure in the Nephrotic Syndrome Study Network (NEPTUNE)

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Wang, Linda, Cohen Children's Medical Center, Queens, New York, United States
  • Meyers, Kevin E.C., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Sethna, Christine B., Cohen Children's Medical Center, Queens, New York, United States

Group or Team Name

  • NEPTUNE Cardiovascular Working Group
Background

Tobacco exposure is associated with cardiovascular disease (CVD) risk and chronic kidney disease (CKD) progression. Risks of tobacco exposure in proteinuric glomerulopathies are not known. The objectives were to describe the prevalence of tobacco exposure and determine the longitudinal associations between tobacco exposure and CVD risk factors and kidney outcomes in adults and children with proteinuric glomerulopathies in NEPTUNE.

Methods

Tobacco exposure was self-reported at study enrollment as non-smoker, active smoker, past smoker and passive smoker. Baseline characteristics were compared by t-test, ANOVA and chi square. Using adjusted generalized estimating equations and time-varying Cox survival analysis, tobacco exposure was analyzed for association with blood pressure (BP), lipids, urine protein:creatinine ratio (UPCR), glomerular filtration rate (eGFR), complete remission (UPCR <0.3), kidney failure (eGFR <15 or Kidney Replacement Therapy [KRT]) and CKD progression (40% eGFR decline and eGFR <90, or KRT).

Results

Included were 371 adults (45.9±16.0 yrs.; 60.6% M; 23.0% black, eGFR 66.4 [IQR 42, 91]) and 192 children (9.8±5.0 yrs; 57.3% M; 39.4% black, eGFR 93.1 [IQR 78,114]) with median 45 (IQR 27,55) months of follow up. Among adults, there were 14.6% active smokers, 29.1% past smokers and 4.9% passive smokers. In children, percentages were 0.5%, 1.6%, and 16.7%, respectively. In adults, there were significant differences in age, sex, race, and employment among groups. In children, non-smokers were significantly older than passive smokers (10.1±4.9 vs 8.0±4.9, p<0.01). Tobacco exposure was associated with greater total cholesterol in adults and UPCR in children in adjusted models (Table).

Conclusion

In NEPTUNE, tobacco exposure was associated with higher levels of cholesterol in adults and proteinuria in children.

Funding

  • NIDDK Support