Nav: Home

In kidney disease patients, illicit drug use linked with disease progression and death

June 07, 2018

Highlights
  • Among individuals with chronic kidney disease, hard illicit drug use was associated with higher risks of kidney disease progression and early death.
  • Tobacco smoking was associated with a higher risk of early death.
  • Alcohol drinking was associated with a lower risk of early death.
Washington, DC (June 7, 2018) -- In a study of patients with chronic kidney disease (CKD), persistent substance use--especially of hard illicit drugs--was linked with higher risks of CKD progression and early death. The findings appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).

CKD is common in the United States, and affected patients are at higher risk for poor health outcomes such as end-stage kidney disease, cardiovascular disease, and premature death. Identifying the lifestyle factors that contribute to worsening kidney function and death is important for helping patients improve their health. A team led by Jiang He, MD, PhD and Joshua Bundy, PhD, MPH (Tulane University School of Public Health and Tropical Medicine) investigated whether these factors might include tobacco, alcohol, and illicit drug use.

The researchers examined information from the Chronic Renal Insufficiency Cohort Study, a prospective longitudinal cohort study among 3939 participants with CKD in the United States. Self-reported information on tobacco smoking, alcohol drinking, marijuana use, and hard illicit drug (cocaine, heroin, or methamphetamine) use was obtained at the start of the study and at annual follow-up visits.

Over a median follow-up of 5.5-years, 1287 participants experienced 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.

Among the major findings:
  • Compared with non-smoking throughout follow-up, persistent tobacco smoking was linked with an 86% higher risk of dying.
  • Compared with non-drinking throughout follow-up, persistent alcohol drinking was linked with a 27% lower risk of dying.
  • Compared with non-use of marijuana throughout follow-up, persistent marijuana use was not significantly linked with risk CKD progression or dying.
  • Compared with non-use of hard illicit drug use throughout follow-up, persistent drug use was linked with a 25% higher risk for CKD progression and a 41% higher risk of dying.
"The US is in the midst of an opioid epidemic, which has led to increases in the use and abuse of heroin. Additionally, efforts for the decriminalization and legalization of illicit drugs, especially marijuana, are gaining traction--for example, more than half of US states currently allow medicinal and/or recreational use of marijuana," said Dr. He. "It is important to try to quantify the long-term health consequences of substance use, especially among vulnerable populations such as patients with chronic conditions like CKD, who are at high risk for poor health outcomes."
-end-
Study co-authors include Lydia Bazzano, MD, PhD, Dawei Xie, PhD, Janet Cohan, MSN, Jacqueline Dolata, MBA, Jeffrey C. Fink, MD, MS, Chi-yuan Hsu, MD, MSc, Kenneth Jamerson, MD, James Lash, MD, Gail Makos, MSN, Susan Steigerwalt, MD, Xue Wang, MS, Katherine T. Mills, PhD, MSPH, Jing Chen, MD, and the CRIC Study Investigators.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Self-reported Tobacco, Alcohol, and Illicit Drug Use and Progression of Chronic Kidney Disease," will appear online at http://cjasn.asnjournals.org/ on June 7, 2018, doi: 10.2215/CJN.11121017.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has more than 18,000 members representing 112 countries. For more information, please visit http://www.asn-online.org or contact the society at 202-640-4660.

American Society of Nephrology

Related Smoking Articles:

Smoking rates falling in adults, but stroke survivors' smoking rates remain steady
While the rate of Americans who smoke tobacco has fallen steadily over the last two decades, the rate of stroke survivors who smoke has not changed significantly.
What is your risk from smoking? Your network knows!
A new study from researchers at Penn's Annenberg School for Communication found that most people, smokers and non-smokers alike, were nowhere near accurate in their answers to questions about smoking's health effects.
Want to quit smoking? Partner up
Kicking the habit works best in pairs. That's the main message of a study presented today at EuroPrevent 2019, a scientific congress of the European Society of Cardiology (ESC).
Smoking and mortality in Asia
In this analysis of data from 20 studies conducted in China, Japan, South Korea, Singapore, Taiwan and India with more than 1 million participants, deaths associated with smoking continued to increase among men in Asia grouped by the years in which they were born.
Predictors of successfully quitting smoking among smokers registered at the quit smoking clinic at a public hospital in northeastern Malaysia
In the current issue of Family Medicine and Community Health, Nur Izzati Mohammad et al. consider how cigarette smoking is one of the risk factors leading to noncommunicable diseases such as cardiovascular and respiratory system diseases and cancer.
Restaurant and bar smoking bans do reduce smoking, especially among the highly educated
Smoking risk drops significantly in college graduates when they live near areas that have completely banned smoking in bars and restaurants, according to a new study in the American Journal of Epidemiology.
How the UK smoking ban increased wellbeing
Married women with children reported the largest increase in well-being following the smoking bans in the UK in 2006 and 2007 but there was no comparable increase for married men with children.
Smoking study personalizes treatment
A simple blood test is allowing Vanderbilt University Medical Center (VUMC) researchers to determine which patients should be prescribed varenicline (Chantix) to stop smoking and which patients could do just as well, and avoid side effects, by using a nicotine patch.
A biophysical smoking gun
While much about Alzheimer's disease remains a mystery, scientists do know that part of the disease's progression involves a normal protein called tau, aggregating to form ropelike inclusions within brain cells that eventually strangle the neurons.
A case where smoking helped
A mutation in the hemoglobin of a young woman in Germany was found to cause her mild anemia.
More Smoking News and Smoking Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Teaching For Better Humans 2.0
More than test scores or good grades–what do kids need for the future? This hour, TED speakers explore how to help children grow into better humans, both during and after this time of crisis. Guests include educators Richard Culatta and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#556 The Power of Friendship
It's 2020 and times are tough. Maybe some of us are learning about social distancing the hard way. Maybe we just are all a little anxious. No matter what, we could probably use a friend. But what is a friend, exactly? And why do we need them so much? This week host Bethany Brookshire speaks with Lydia Denworth, author of the new book "Friendship: The Evolution, Biology, and Extraordinary Power of Life's Fundamental Bond". This episode is hosted by Bethany Brookshire, science writer from Science News.
Now Playing: Radiolab

Dispatch 3: Shared Immunity
More than a million people have caught Covid-19, and tens of thousands have died. But thousands more have survived and recovered. A week or so ago (aka, what feels like ten years in corona time) producer Molly Webster learned that many of those survivors possess a kind of superpower: antibodies trained to fight the virus. Not only that, they might be able to pass this power on to the people who are sick with corona, and still in the fight. Today we have the story of an experimental treatment that's popping up all over the country: convalescent plasma transfusion, a century-old procedure that some say may become one of our best weapons against this devastating, new disease.   If you have recovered from Covid-19 and want to donate plasma, national and local donation registries are gearing up to collect blood.  To sign up with the American Red Cross, a national organization that works in local communities, head here.  To find out more about the The National COVID-19 Convalescent Plasma Project, which we spoke about in our episode, including information on clinical trials or plasma donation projects in your community, go here.  And if you are in the greater New York City area, and want to donate convalescent plasma, head over to the New York Blood Center to sign up. Or, register with specific NYC hospitals here.   If you are sick with Covid-19, and are interested in participating in a clinical trial, or are looking for a plasma donor match, check in with your local hospital, university, or blood center for more; you can also find more information on trials at The National COVID-19 Convalescent Plasma Project. And lastly, Tatiana Prowell's tweet that tipped us off is here. This episode was reported by Molly Webster and produced by Pat Walters. Special thanks to Drs. Evan Bloch and Tim Byun, as well as the Albert Einstein College of Medicine.  Support Radiolab today at Radiolab.org/donate.