Whilst many teenagers may believe that smoking cigarettes will
improve their popularity amongst friends and gain them misguided
admiration in the playground, they should also be aware of the damage
that cigarettes do to their adolescent bodies after a study has linked secondhand smoke exposure to effects on kidney function beginning in childhood.
The study, led by Esther Garcia-Esquinas, MD, of the Department of
Environmental Health Sciences at John Hopkins University Bloomberg
School of Public Health and published April 8 in the journal Pediatrics, was conducted to see if secondhand smoke exposure could be attributed to chronic kidney disease in children.
A cross-sectional study was therefore
carried out, comprising of an analysis of 7,516 adolescents aged between
12 and 17; all of whom were involved in the 1999-2010 National Health
and Nutrition Examination Survey.
The teens all had blood tests to determine any creatinine and
cotinine levels. Creatinine is a waste break-down product from muscle
tissue in the body that is filtered through the kidneys. Doctors look at
a person’s blood creatinine level as a test to determine kidney
function and the kidneys’ ability to handle creatinine is known as the
‘creatinine clearance rate’.
‘Cotinine’, an anagram of nicotine, is an alkaloid chemical contained
in tobacco and is also a product that is created by metabolising
nicotine. By measuring the levels of cotinine in an individual’s
bloodstream, it is possible to extract information on their recent use
of tobacco in addition to assessing how much secondhand smoking the
person has been exposed to.
The teens within the study who admitted that they smoked or those
with serum cotinine levels found to be over 10 ng/mL, were regarded as
‘active smokers’. Those who lived with at least one person who smoked or
had cotinine levels measuring at least 0.05 ng/mL, were classified as
being exposed to secondhand smoke. In addition, any study participants
with serum cotinine levels under 0.05 ng/mL, not living with a smoker
and had not smoked in the previous month, were viewed as being unexposed
to tobacco.
Researchers analysed the glomerular filtration rate, or eGFR, level
by looking at the creatinine levels. This helps to understand how much
blood a person’s kidneys are filtering to get a better picture of kidney
function.
It was discovered that the teens’ eGFR declined at the same rate that
their cotinine concentration in the blood increased. This pattern was
evident even after the participants’ weight was taken into account as
well as and socioeconomic and demographic factors.
Jeffrey Fadrowski, MD, MHS, co-author of the study and an assistant
professor in Pediatric Nephrology at the Johns Hopkins School of
Medicine, commented: “Small changes in the distribution of estimated
glomerular filtration rate levels in the population could have a
substantial impact in kidney-related illness, as it is well known for
changes in blood pressure levels and hypertension-related disease.
Evaluating potential secondhand smoke exposure and providing
recommendations to minimize exposure should continue to be incorporated
as part of children’s routine medical care.”
Other researchers in the study added: “Evidence from studies in adult
populations suggest that smoking, particularly heavy smoking and
cumulative smoking exposure, is an independent risk factor for chronic
kidney disease in both genders, as shown in large, prospective
observational studies.”
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