Cigarette Smoking and Its Hazards in Kidney Transplantation

• Published in: Advances in medicine 2017-01, Vol.2017 (2017), p.1-11
• Main Authors: Azmat, Rabeea, Khalil, Muhammad Ashhad Ullah, Khamis, Said, Tan, Jackson, Khalil, Muhammad Abdul Mabood, Ullah, Arslan Rahat
• Format: Article
• Language: English
• Subjects: Chronic kidney failure; Cigarettes; Development and progression; Donation of organs, tissues, etc; Health aspects; Kidneys; Organ transplant recipients; Review; Smoking cessation programs; Transplantation
• ISSN: 2356-6752; 2314-758X
• DOI: 10.1155/2017/6213814

Cigarette smoking affects many organs. It causes vasoconstriction through activation of sympathetic nervous system which leads to elevation of blood pressure and reduction in glomerular filtration rate and filtration pressure. It also causes thickening of renal arterioles. Cigarette smoking increases the risk of microalbuminuria and accelerates progression of microalbuminuria to macroalbuminuria. Furthermore, it causes rapid loss of glomerular filtration rate in chronic kidney disease patients. After kidney donation, these factors may be injurious to the solitary kidney. Kidney donors with history of cigarette smoking are prone to develop perioperative complications, pneumonia, and wound infection. Postkidney transplantation various stressors including warm and cold ischemia time, delayed graft function, and exposure to calcineurin inhibitors may result in poor graft function. Continuation of cigarette smoking in kidney transplant recipients will add further risk. In this review, we will specifically discuss the effects of cigarette smoking on normal kidneys, live kidney donors, and kidney transplant recipients. This will include adverse effects of cigarette smoking on graft and patient survival, cardiovascular events, rejection, infections, and cancers in kidney transplant recipients. Lastly, the impact of kidney transplantation on behavior and smoking cessation will also be discussed.