Smoking May Negate Renal Protective Effects of ACE Inhibitors

According to a new study, cigarette smoking may blunt the renal protective effects of drugs taken by patients with early chronic kidney disease (CKD) through increased oxidative stress. Findings from the study will be presented at ASN Kidney Week 2016.

Researchers from Tufts Medical Center evaluated 108 smokers and 108 non-smokers with early CKD who were taking angiotensin converting enzyme inhibitor (ACEI) drugs that slow kidney function decline. All smoking participants underwent smoking cessation. All patients were followed for 5 years after initiating ACEI treatment.

The data showed that non-smokers and smokers who quit had a slower worsening of renal function compared to those who were unsuccessful at quitting. Continuing to smoke also blocked the decrease in protein excretion in the urine that signifies renal protection in patients taking ACEI medications. Study authors explained this to be due to higher levels of oxidative stress in the kidney induced by cigarette smoking.

Bethany Roehm, MD, MS, lead author, added that “the study underscores the importance of doing all we can as clinicians to encourage our patients to stop smoking.” Findings from this small study population need to be confirmed in bigger studies as well as in studies that include patients with CKD due to other causes.

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