Impact of tobacco smoking on pulmonary and kidney function after successful kidney transplantation – A single-centre pilot study

Eliza Wasilewska; Paulina  Wołoszyk; Sylwia Małgorzewicz; Andrzej Chamienia; Ewa Jassem; Alicja Dębska-Ślizień

doi:10.18388/abp.2020_5619

Eliza Wasilewska Department of Allergology and Pulmonology, Medical University of Gdansk, Gdansk, Poland
Paulina Wołoszyk Department of Internal and Pediatric Nursing, Medical University of Gdansk, Gdansk, Poland https://orcid.org/0000-0002-4878-3329
Sylwia Małgorzewicz Department of Clinical Nutrition, Medical University of Gdansk, Gdansk, Poland https://orcid.org/0000-0001-8773-9649
Andrzej Chamienia Department of Internal and Pediatric Nursing, Medical University of Gdansk, Gdansk, Poland
Ewa Jassem Department of Allergology and Pulmonology, Medical University of Gdansk, Gdansk, Poland https://orcid.org/0000-0003-4239-4776
Alicja Dębska-Ślizień Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland

DOI: https://doi.org/10.18388/abp.2020_5619

Abstract

The all consequences of tobacco smoking on the lungs and kidney function in kidney transplant recipients are unknown. We investigate the impact of tobacco smoking on lung and kidney functions in kidney transplantation recipients. Methods: Finally, 55 patients were evaluated after kidney transplantation (age 50.8±13.4). Pulmonary function was performed using spirometer Pneumo Screen; anthropometry with body composition using electronic scale, dynamometer, and multi-frequency bioimpedance analysis. Biochemical parameters were measured in serum, eGFR was calculated according to the CKD-EPI formula. Results: Smoking history was reported by 23 kidney transplant recipients (42%); among them 12 (22%) were current smokers (mean pack-years=28.3±15.2). There were significant differences of spirometry parameters (FEV1, FEV1/FVC, MMEF% predictive value) between non-smokers vs active smokers (p<0.003; p<0.005; p<0.04; respectively). Current smokers presented significantly lower eGFR and higher IL-6 serum levels compare to both-past smokers and non-smokers (p<0.02; p<0.04 respectively), the other biochemical parameters did not differ between these groups. The pack-years positively correlated with MRC dyspnoe scale and triglycerides, and negatively with HDL cholesterol levels. Conclusions: Active tobacco smoking was relatively common in kidney transplant recipients and was associated with poorer pulmonary function, systemic inflammation, and its possible impact on kidney graft. Other parameters of inflammation associated with renal function should be studied in active smokers before and after kidney transplantation. Effective smoking cessation programs are required in patients before and after kidney transplantation.