What is kidney disease?
The kidneys are located just under the rib cage, with each on either side of the spine. Their main role is to filter out water and dissolved substances or toxins from the blood to produce urine. In addition to that, hormones are produced and secreted by the kidneys to maintain blood pressure levels and the rate of new red blood cell generation. Any damage to the kidney which interferes with its filtering system is considered kidney disease, and problems could include injuries, cysts, stones, or infections. Several types of kidney diseases can manifest in an individual: the most common ones are chronic kidney disease, kidney stones, glomerulonephritis, and urinary tract infections. Collectively, any type of kidney disease may eventually lead to other health problems, such as weak bones, nerve damage, and malnourishment.1
Symptoms of kidney disease
- Oedema – kidney dysfunction affects the number of extra fluids and sodium being discarded from the body, causing the retention of water mainly within the hands, feet, and/or legs.
- Increased blood pressure – due to the accumulation of water within the body, there is more fluid within the blood, causing the pressure within the patient's vascular system to increase progressively.
- Changes in urination habits – the pain purpose of the kidney is to produce urine, so any threat to their role directly causes urination issues, with the urine displaying abnormal characteristics.2
- Itching – an imbalance of minerals and nutrients can trigger irritation.
- Fatigue – the build-up of toxins and other harmful substances can affect red blood cell levels causing weakness, shortness of breath and decreased appetite.
- Back pain – localised back pain is associated with the inflammation of the kidneys.
- Puffy eyes – proteins that leak into the urine can present as puffiness around the eyes.
- Malnutrition – caused by abnormal levels of phosphorus, calcium, or vitamin D.
Causes of kidney disease
There are many various reasons why a person can develop kidney disease. Often, the top reasons exhibited by many patients involve high blood pressure and diabetes. Such conditions have the tendency to progress into further dangerous complications where the kidneys are put under a lot of stress to function harder, increasing the risk of damage to their structure.2
Unrestrained high blood pressure is one of the leading root causes of kidney failure in adults worldwide. Hypertension may trigger injury to the small blood vessels and the structural filters in the kidney, making it much more difficult to dispose of bodily waste in the urine.
Diabetes, on the other hand, causes diabetic nephropathy, in which excess glucose also damages the kidney filtering system, which sustains a high level of pressure contributing to further dysfunction.
How does smoking affect your kidneys?
Increases risk of kidney disease
It has been long established that active chronic smoking is a proven contributing risk factor for many diseases, including kidney disorders such as chronic kidney disease. One study that compared smoker and non-smoker patients who had non-insulin-dependent diabetes mellitus showed that the qualified risk of developing proteinuria was more than two times higher in heavy smokers than in participants who never smoked.3
Smoking encourages fibrosis mechanisms in the kidney, which causes an accelerated destructive response and makes it easier for more dysfunction to occur. In addition, specific compounds called glycotoxins in cigarettes provide a more rapid progression into chronic kidney disease as mutations in DNA methylation processes get more common, especially in diabetes patients.4
Both people assigned male at birth (AMAB) and people assigned female at birth (AFAB) experience the same signs of kidney disease, but its progression could be different depending on each patient. It has been found that infections of the kidney and urinary tract are more common in people AFAB, as they are at a greater overall risk of end-stage renal disease.2
Decreases blood flow to the kidneys
The vasoconstrictive properties of nicotine lead to a rise in renal blood pressure, which directly decreases the rate of glomerular filtration of the blood. Therefore, the amount of blood being transported toward the kidneys is compromised.4 With time and chronic smoking, the continuous constriction of blood vessels results in the stiffness of the walls, making them much less elastic, which decreases the quantity of blood reaching the organ.
It can make symptoms of kidney disease worse
The nicotine present in cigarettes contains a large number of toxins and other dangerous chemicals, which collectively exert harmful effects on the kidney and its structure. Therefore, any previous symptoms associated with kidney disease would eventually increase greatly due to the deteriorating cycle of kidney dysfunction, allowing more damage to happen. Hence, it is estimated that initial histological modifications in smokers will result in faster future degeneration of kidney function, which is the main reason for the development of chronic kidney disease.4
Microalbuminuria is when the amount of albumin protein in the urine is higher than usual, and the risk of this condition is highly increased with smoking. Additionally, the time taken for the individual to progress into albuminuria or proteinuria is significantly shortened, especially with the onset of diabetes, causing the kidney disease to rapidly advance into end-stage renal disease.3
Manage kidney disease by quitting smoking
Because many risk factors contribute to renal disease, it is very difficult to avoid them all, as not all can be controlled. However, smoking is a modifiable risk factor, meaning that the individual can take specific measures to change them. Adopting a healthier lifestyle by quitting smoking would significantly aid in preventing many underlying causes and triggers of kidney disease, as well as lessening the chances of developing other types of chronic diseases.
Tips for quitting smoking
Quitting an active, long-term habit such as smoking can be very difficult, but it is not impossible. With the correct steps, support, and patience, you can adopt a much healthier lifestyle. Some tips to keep in mind when trying to quit are:
- List all of the important reasons to quit
- Inform your close ones that you're quitting to keep you accountable
- Make a rational plan to follow when you are tempted to smoke
- List your smoking triggers and how you can avoid them
- Exercise away the urge
- Join a support group to get a sponsor and receive additional advice or counseling
Summary
Chronic kidney disease affects many different people on a global scale, as it is a leading cause of mortality with age. One of the most important methods to manage the progression of the disease is to control the modifiable risk factors, especially smoking. Habitual smoking has one of the strongest correlations with the development of chronic kidney disease, along with the presence of hypertension and diabetic nephropathy. Constant check-ups are important to monitor kidney functions whenever signs such as abnormal urine, oedema, and malnutrition manifest, which would allow an early diagnosis and treatment.
References
- Kidney health and kidney disease basics: causes and questions [Internet]. Healthline. 2018.
- Fresenius Kidney Care. Chronic Kidney Disease Symptoms [Internet].
- Yacoub R, Habib H, Lahdo A, Al Ali R, Varjabedian L, Atalla G, et al. Association between smoking and chronic kidney disease: a case control study. BMC Public Health [Internet]. 2010 Nov 25;10(1).
- Van Laecke S, Van Biesen W. Smoking and chronic kidney disease: seeing the signs through the smoke? Nephrology Dialysis Transplantation. 2017 Feb 16;32(3):403–5.
