Both smoking and secondhand smoke risk factors for development of kidney stones

The researchers utilized a representative sample of the Taiwanese in a longitudinal study to examine the impacts of smoking and secondhand smoke on the development of KSD and found both factors were associated with a higher incidence of KSD.

"Our study suggests that both smoking and second-hand smoke are risk factors for developing KSD and that the impact of SHS is not inferior to that of smoking," they reported.

Kidney stone disease is a common renal disease around the world and the prevalence rates vary from 7-13% in North America, 5 to 9% in Europe, and 1–5% in Asia. Secondhand smoke and tobacco use are risk factors for kidney stone disease. The hypothesis is that tobacco produces chemicals that increase vasopressin and oxidative stress, leading to reduced urine output and contributing to stone formation.

Studies have shown that SHS and smoking are both risk factors for the formation of kidney stones. However, there is no comparison of the risks between smoking and SHS. Therefore, Jiun-Hung Geng, Kaohsiung Medical University, Kaohsiung, Taiwan, and colleagues aimed to examine the effects of smoking and SHS on the development of kidney stone disease in a longitudinal cohort study.

For this purpose, the researchers analyzed 25,256 volunteers with no history of KSD who participated in the Taiwan Biobank. A self-administered questionnaire was used to survey the presence of underlying and follow-up KSD. They were categorized into three groups based on smoking and SHS exposure, accessed with survey questionnaires; ever-smokers, never-smokers with SHS exposure, and never-smokers with no SHS exposure groups.

The study revealed the following findings:

· Kidney stone disease was noted in 2.0%, 3.3% and 4.1% subjects in the never-smokers with no SHS exposure, never-smokers with SHS exposure and ever-smokers groups, respectively, with a mean follow-up of 4 years.

· The odds ratio (OR) of KSD was higher in the never-smokers with SHS exposure (OR, 1.622) and ever-smokers groups (OR, 1.282) than in the never-smokers with no SHS exposure group after adjustment of confounders.

· Never-smokers with SHS exposure had similar effects on the development of KSD than ever-smokers (OR, 1.223).

"Our study suggests that both smoking and secondhand smoke are independent risk factors for developing KSD and that the impact of SHS is not inferior to that of smoking, raising the need for smoke-free environments" the researchers concluded.

Reference:

Chen, YH., Lee, JI., Shen, JT. et al. The impact of secondhand smoke on the development of kidney stone disease is not inferior to that of smoking: a longitudinal cohort study. BMC Public Health 23, 1189 (2023). https://doi.org/10.1186/s12889-023-16116-6