Smoking chronic kidney disease

In a large prospective population sample, primarily a cancer research project (CLUE study), Haroun [42] noted that smoking accounted for no less than 30% of the "attributable risk" of chronic kidney disease (CKD), defined as serum creatinine > 2 mg/ dl, and this was particularly true in the elderly. 

For diabetic patients with chronic kidney disease (CKD) stages 1-11 (Creatinine clearance betwem normal and 60 mL/min/1.73 m ), stage-independent actions such as control of cardiovascular risk factors (hypertension, hyperlipidemia, and smoking), avoidance of drug toxicity and diagnostic injury, control of progression, and reduction of proteinuria are essential. 

Each year more than 440,000 deaths, or 20% of the total deaths in the United States, are caused by smoking. Cigarette smoking substantially increases the risk of (1) cardiovascular diseases such as stroke, sudden death, and heart attack, (2) nonmalignant respiratory diseases including emphysema, asthma, chronic bronchitis, and chronic obstructive pulmonary disease, (3) lung cancer, and (4) other cancers (e.g., mouth, pharynx, larynx, esophagus, stomach, pancreas, uterus, cervix, kidney, ureter, and bladder). 

A medical and work history, despite common perceptions, is probably the most important part of an examination. Most diagnoses of disease in medicine are made by the history. Laboratory tests are nsed to confirm past illnesses and injuries. Doctors are interested in the history of lung, heart, kidney, liver, and other chronic diseases for the individual and family. Doctors will also be concerned abont symptoms indicating heart or lung disease and smoking habits. 

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