ANOTHER REASON TO QUIT
New research suggests that smoking cessation may reduce the risk for kidney failure.
Written by Julie Toland
Two Texas Tech University Health Sciences Center researchers are investigating yet another area in which quitting smoking can greatly improve health, particularly for African-Americans.
Texas Tech School of Medicine faculty members Donald Wesson, M.D., and Jan Simoni, D.V.M., Ph.D., are studying the connection between smoking and kidney failure and have been awarded a grant for their proposal, "Smoking Cessation and the Risk of Diabetes-Related Kidney Disease in African Americans."
"The study at Texas Tech will focus particularly but not exclusively on African-Americans because this population group has a higher risk for diabetes-related kidney failure," said Wesson, chairman of the Department of Internal Medicine.
The Texas Higher Education Coordinating Board awarded the grant for fiscal year 2000 and 2001 under the Minority Health Research and Education Grant Program. The program was established by the 76th Legislature with proceeds from the Texas tobacco lawsuit settlement. Proposals were selected for funding based on peer reviews and legislative intent to support health research and educational programs that address minority health issues.
Wesson and Simoni, research assistant professor in the Department of Surgery, hope to determine whether smoking cessation specifically reduces an individual's risk for developing diabetes-related kidney failure. The two scientists have collaborated on several research projects since 1995. "Up to now, Dr. Wesson and I have studied 600 patients together," said Simoni, who will focus in particular on analytical aspects of this study. "The research will employ the most advanced laboratory techniques which were developed and perfected in our laboratory."
Wesson points out that advances in treating kidney disease have been slow in coming. "Scientific studies show that smoking cessation improves many aspects of our health," he said. "While strides have been made in decreasing the incidence of some types of cardiovascular disease, that has not happened with kidney failure."
Cardiovascular disease describes diseases that are caused by abnormalities in blood vessels of the body. The most common diseases in this category are heart attack and stroke that are caused by diseased blood vessels in the heart and brain, respectively. Medical science has produced strategies that have successfully reduced the incidence of these two diseases in recent years.
Kidney failure is caused by diseased blood vessels in this organ, making it a form of cardiovascular disease. Yet contrary to heart attack and stroke, the incidence of kidney failure continues to increase, Wesson said. Individuals who progress to complete kidney failure require replacement therapy in the form of kidney dialysis or kidney transplant to continue to live.
"Medical scientists do not fully understand why the strategies that have successfully reduced the incidence of heart attack and stroke, including improved diet and better blood pressure control, have not also decreased the incidence of kidney failure," Wesson said. "Because medical researchers at Texas Tech Health Sciences Center have shown that cigarette smoking worsens the risk of kidney failure in some individuals already at risk for it, they decided to explore if smoking cessation reduces the risk of kidney failure."
Diabetes is the single biggest cause of complete kidney failure in the United States, Wesson said. And African Americans with diabetes are more likely to develop complete kidney failure than are diabetics from other U.S. population groups.
"Cigarette smoking increases the chance of developing diabetes-related kidney disease," Wesson said. "In other words, if you're diabetic and you smoke, you have a greater chance of developing kidney disease than if you're diabetic and you don't smoke.
"If smoking cessation does reduce the risk for kidney failure, health care providers would then have another effective way to reduce a diabetic's chances to develop complete kidney failure," Wesson said. "This would not only help these patients avoid the sickness and other problems that accompany kidney failure, but would also avoid the tremendous expense associated with all forms of kidney replacement therapy."
However, smoking cessation is not easy. Nicotine is one of the most addictive substances there is and patients who smoke have a very difficult time trying to stop. Individuals who will participate as study subjects will undergo very aggressive smoking cessation measures that includes using effective drugs combined with counseling, Wesson said.
"It's a win-win situation for individual diabetic smokers who participate in this study," Wesson said. "If smoking cessation does indeed decrease the risk of kidney failure, we would have identified an additional effective strategy to avoid the devastating effects of complete kidney failure. If smoking cessation does not reduce this risk, many of the participating patients will have successfully stopped smoking and will enjoy the many associated health benefits that have already been proven."
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