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.

Chronic Kidney Disease ; Smoking Status ; Egfr

INTRODUCTION: Contrast-induced nephropathy (CIN) is the third most frequent source of hospital-acquired renal insufficiency. The investigation of factors and risks for CIN among patients who undergo non-coronary contrast procedures are less compared to coronary angiographic interventions.
OBJECTIVE: The aim of this study is to determine the rate and factors associated with the development of early CIN in patients who will undergo Contrast-Enhanced Computed Tomography (CECT) for non-coronary procedures.
METHODS: This is a prospective cohort study that included all patients admitted at UST Hospital for CECT of organs including coronary angiography from October 1, 2012 to October 31, 2015 (three-year study). All subjects received standard prophylaxis as recommended. CIN is present if there is elevation in the serum creatinine ? 0.5 mg/dL (44 umol/L) or a 25% rise above baseline creatinine level that is present from 24 to 48 hours after the study.
RESULTS: The cumulative incidence of CIN was at 2.0%, lower than other reported data. The diastolic blood pressure of the subjects who did not develop CIN were significantly higher than those who developed CIN (76.32 + 8.18 versus 67.50 + 5.00, mean difference = 8.82 + 4.15 mmHg, p = 0.038), such that a diastolic blood pressure of > 70 mmHg is associated with absence of CIN (p = 0.049). The development of CIN was not influenced by the procedure undertaken to study a particular organ nor the volume of contrast being used for the study. As expected, subjects with an estimated GFR of > 15 mL/min/1.73 m2 did not develop CIN (p=0.012).
CONCLUSION: The risk associated with early CIN in non-coronary CT scan procedures is minimal compared to interventions involving the coronaries. There is a significant association of diastolic blood pressure of > 70 mmHg and eGFR of ? 15 mL/min/1.73 m2 with non-development of CIN.

Human ; Male ; Female ; Middle Aged ; Adult ; Coronary Angiography ; Creatinine ; Renal Insufficiency ; Tomography, X-ray Computed ; Egfr Protein, Human ; Receptor, Epidermal Growth Factor