Kidney Week

Abstract: SA-PO0951

Active Smoking Is Associated with Greater Degrees of Arteriosclerosis and Presence of Arteriosclerosis with Hyalinosis in Renal Tissue of Patients Undergoing Nephrectomy

Session Information

• Pathology: Updates and Insights
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pathology and Lab Medicine

• 1800 Pathology and Lab Medicine

Authors

• Del Castillo Rix, Daniel Sebastian, Jackson Memorial Hospital, Miami, Florida, United States

Daniel Sebastian Del Castillo Rix, MD

• Bandes, Miguel Antonio, University of Miami Miller School of Medicine, Miami, Florida, United States

Miguel Antonio Bandes, MD

• Anzola, Enrique, University of Miami Miller School of Medicine, Miami, Florida, United States

Enrique Anzola

• Guevara, Nelson V, University of Miami Miller School of Medicine, Miami, Florida, United States

Nelson V Guevara, ScM

• Zuo, Yiqin, University of Miami Miller School of Medicine, Miami, Florida, United States

Yiqin Zuo, MD, PhD

• Contreras, Gabriel, University of Miami Miller School of Medicine, Miami, Florida, United States

Gabriel Contreras, MD, MPH

• Munoz Mendoza, Jair, University of Miami Miller School of Medicine, Miami, Florida, United States

Jair Munoz Mendoza, MD

Background

Tobacco use is a well-established risk factor for cardiovascular and chronic kidney disease, yet its specific histopathologic effects on human renal tissue remain poorly defined. We aimed to evaluate the associations between cigarette smoking with global glomerulosclerosis (GS), interstitial fibrosis (IF), arteriosclerosis (AS), and arteriolosclerosis (AoS) with hyalinosis or hyperplasia in a large cohort of patients undergoing nephrectomy for any cause.

Methods

We conducted a retrospective cross-sectional analysis of 596 patients with nephrectomy at a tertiary academic center. We used ordinal logistic regression models. Our main predictor was cigarette smoking, categorized as never, former, or active. The outcomes were degrees of GS, IF, AS, and the presence of AoS with hyalinosis or hyperplasia. We adjusted for age, sex, race, estimated glomerular filtration rate, hypertension and diabetes.

Results

We included 596 patients. The mean age was 61 ± 14 years; 63% were male, and 89% were of White race. 60% had hypertension, and 25% had diabetes mellitus. The mean eGFR was 80 ± 23 mL/min/1.73m². A total of 68 (11.4%) patients were active smokers, 237 (39.8%) were former smokers, and 291 (48.8%) patients had never smoked. In multivariable adjusted analyses, compared with never smoking (reference group), active smoking was statistically significant associated with greater degrees of AS (odds ratio [OR] 1.69 [95% confidence interval (CI), 1.01-2.84]) and with AoS with hyalinosis (OR 1.84, 95% CI 1.05–3.23) whereas former smoking was not significantly associated with AS (OR 1.08, 95% CI 0.77–1.51) or AoS with hyalinosis (OR 1.04, 95% CI 0.72–1.50). Smoking was not associated with degrees of GS, IF, or AoS with hyperplasia in multivariable adjusted models (p>0.05 for each).

Conclusion

Cigarette smoking is independently associated with greater degrees of AS and with the presence of Aos with hyalinosis in patients undergoing nephrectomy for any cause. These findings highlight the ongoing impact of tobacco on renal microstructure and reinforce the value of incorporating smoking into medical history.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025kkr3vh5f