Effect Of Cigarette Smoking On Clinical And Renal Pathology Indexs In Patients With Primary IgA Nephropathy

Objective:To investigate the effects of smoking on clinical and pathological indexes of patients with primary IgA nephropathy.Methods: 324 cases of IgA nephropathy diagnosed by first renal biopsy in our hospital were included.According to the smoking history,patients were divided into smokers and nonsmokers.Comparison of the difference of clinical indicators(Gender,age,blood pressure,24-hour urine protein,urea,creatinine,estimated glomerular filtration rate,hemoglobin,albumin,cholesterol,triglyceride,high density lipoprotein,low density lipoprotein)and pathological indicators(global sclerosis,vascular thickening,mesangial cell proliferation,capillary inner cell degree,segmengtal sclerosis and renal tubular atrophy or interstitial fibrosis)were done between the two groups to investigate the effects of smoking on clinical and pathological indexes of patients with primary IgA nephropathy.Results : 1.Among the 324 patients with IgA nephropathy,43 patients were smokers,accounting for 13.27 %,and all smokers were male,and 281 were nonsmokers,accounting for 86.73 %.2.In patients with IgA nephropathy,the age,systolic pressure,diastolic pressure,24-hour urine protein level of smokers were significantly higher than that of non-smoking group and the level of e GFR was significantly lower than that of non-smoking group(P < 0.05).Through Pearson correlation analysis of e GFR,it was found that e GFR was negatively correlated with smoking,age,systolic pressure,diastolic pressure and 24-hour urine protein(r=-0.225,P=0.000;r=-0.359,P =0.000;r=-0.429,P =0.000;r=-0.406,P =0.000;r=-0.354,P = 0.000).Univariate analysis showed that e GFR was negatively correlated with the global sclerosis,interstitial cell infiltration interstitial,fibrosis and atrophy of renal tubule(ρ=-0.464,P =0.000;ρ=-0.473,P =0.000;ρ=-0.585,P =0.000;ρ=-0.526,P =0.000).By multiple linear regression analysis of the correlation between smoking and e GFR,it is found that smoking is negatively correlated with e GFR(P < 0.05)after controlling the factors of age,blood pressure,24-hour urine protein,global sclerosis,renal tubular atrophy and interstitial fibrosis.The results suggest that smoking may be an important risk factor for decreasing e GFR in IgA patients.It is suggested that smoking is more likely to cause renal damage than non-smoking.3.In the renal pathological level,the global sclerosis,interstitial cell infiltration interstitial,fibrosis and atrophy of renal tubule in smoking patients with IgA nephropathy were significantly higher than that in non smoking(P=0.034;P =0.004;P =0.024),the difference was statistically significant.Through spearman correlation analysis of smoking and pathological indexes,smoking was significantly positively correlated with the global sclerosis,interstitial cell infiltration interstitial,fibrosis and atrophy of renal tubule(ρ=0.120,P =0.031;ρ=0.158,P =0.004;ρ=0.145,P =0.009;ρ=0.161,P =0.004).Through logistic regression analysis of the effect of smoking on the global sclerosis,infiltration and renal interstitial fibrosis / renal tubular atrophy in patients with IgA nephropathy,by which the confounding factors of age,blood pressure,24-hour urine protein were adjusted,we found that there were no significant effect of smoking in all the above factors(P > 0.05).Therefore,the results did not indicate the independent correlation between smoking and renal pathological changes.Conclusion:1.Smoking is an important factor influencing e GFR in patients with IgA nephropathy.Smoking is more likely to cause renal damage than non-smoking.2.No significant correlation between smoking and renal pathology is found in patients with IgA nephropathy.