Dataset Information

Self-Reported Tobacco, Alcohol, and Illicit Drug Use and Progression of Chronic Kidney Disease.

ABSTRACT:

Background and objectives

Previous studies suggest that tobacco, alcohol, and illicit drug use is associated with CKD. We examined the associations of substance use with CKD progression and all-cause mortality among patients with CKD.

Design, setting, participants, & measurements

The Chronic Renal Insufficiency Cohort Study is a prospective, longitudinal cohort study among 3939 participants with CKD in the United States. Self-reported tobacco smoking, alcohol drinking, marijuana use, and hard illicit drug (cocaine, heroin, or methamphetamine) use were obtained at baseline and annual follow-up visits. CKD progression was defined as incident ESKD or halving of eGFR. Substance use was modeled as the cumulative average exposure to capture both recent and long-term use in multivariable time-dependent Cox regression.

Results

Over a median 5.5-year follow-up, 1287 participants developed CKD progression, and 1001 died. Baseline proportions of tobacco smoking, alcohol drinking, marijuana use, and hard illicit drug use were 13%, 20%, 33%, and 12%, respectively. Compared with nonsmoking throughout follow-up, multivariable-adjusted hazard ratios for persistent tobacco smoking were 1.02 (95% confidence interval, 0.86 to 1.21) for CKD progression and 1.86 (95% confidence interval, 1.54 to 2.24) for all-cause mortality. Compared with nondrinking throughout follow-up, multivariable-adjusted hazard ratios for persistent alcohol drinking were 1.06 (95% confidence interval, 0.88 to 1.29) for CKD progression and 0.73 (95% confidence interval, 0.58 to 0.91) for all-cause mortality. Compared with nonuse throughout follow-up, multivariable-adjusted hazard ratios for persistent marijuana use were 0.94 (95% confidence interval, 0.82 to 1.07) for CKD progression and 1.11 (95% confidence interval, 0.96 to 1.30) for all-cause mortality. Compared with nonuse throughout follow-up, multivariable-adjusted hazard ratios for persistent hard illicit drug use were 1.25 (95% confidence interval, 1.00 to 1.55) for CKD progression and 1.41 (95% confidence interval, 1.10 to 1.81) for all-cause mortality.

Conclusions

Hard illicit drug use is associated with higher risk of CKD progression and all-cause mortality, tobacco smoking is associated with higher risk of all-cause mortality, and alcohol drinking is associated with lower risk of all-cause mortality among patients with CKD.

SUBMITTER: Bundy JD

PROVIDER: S-EPMC6032576 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Self-Reported Tobacco, Alcohol, and Illicit Drug Use and Progression of Chronic Kidney Disease.

Bundy Joshua D JD Bazzano Lydia A LA Xie Dawei D Cohan Janet J Dolata Jacqueline J Fink Jeffrey C JC Hsu Chi-Yuan CY Jamerson Kenneth K Lash James J Makos Gail G Steigerwalt Susan S Wang Xue X Mills Katherine T KT Chen Jing J He Jiang J

Clinical journal of the American Society of Nephrology : CJASN 20180607 7

<h4>Background and objectives</h4>Previous studies suggest that tobacco, alcohol, and illicit drug use is associated with CKD. We examined the associations of substance use with CKD progression and all-cause mortality among patients with CKD.<h4>Design, setting, participants, & measurements</h4>The Chronic Renal Insufficiency Cohort Study is a prospective, longitudinal cohort study among 3939 participants with CKD in the United States. Self-reported tobacco smoking, alcohol drinking, marijuana u ...[more]

PMID: 29880471

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Dataset Information

Self-Reported Tobacco, Alcohol, and Illicit Drug Use and Progression of Chronic Kidney Disease.

Background and objectives

Design, setting, participants, & measurements

Results

Conclusions

Publications

Self-Reported Tobacco, Alcohol, and Illicit Drug Use and Progression of Chronic Kidney Disease.

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