Introduction: Smoking is prevalent among Filipinos, but little is known about whether this is associated with the rapid decline of the renal function among patients with existing chronic kidney disease (CKD). The purpose of this study is to investigate whether or not there is a direct relationship of smoking to the progression of CKD requiring patient to be on dialysis/renal replacement therapy.

Methods: A cross-sectional, retrospective study design was used. All CKD 5D patients of the Amang Rodriguez Memorial Medical Center (ARMMC) Hemodialysis (HD) Unit in the month of July to August, 2019 were included, if they are > 18yo, regardless of their co-morbidities. Excluded are those with acute kidney injury (AKI), and iatrogenic, surgical or trauma complications that cause renal dysfunction. Charts were reviewed and 55 patients qualified. Smoking status were grouped according to the US Centers for Disease Control (CDC) smoking definitions, either never, former and current smoker. Estimated glomerular filtration rate (eGFR) Creatinine were computed using the CKD-Epi formula 3-yr, 2-yr, 1-yr and 0-yr prior to HD. The main outcome measure was whether and what among the smoking status hastens the progression of CKD. Descriptive statistical analyses were done along with one-way variance, two-way variance, and chi-square.

Results: Most of the smokers were males (p < 0.001). Most of the participants had diabetes as the primary illness. All of the participants had same endpoint of having eGFR < 15 at the time of dialysis initiation. There was a significant progressive decrease from eGFR3 to eGFR0 in all smoking status. Current smokers have the highest significant reduction in eGFR (p <0.001).

Conclusion: Smoking hastens the progression of CKD among Filipinos. With that, we support the smoking cessation campaign of the ARMMC and the DOH. In addition, further work up is suggested to determine the primary mechanistic pathway of smoking that affects the renal cells.