Smoking increases mortality in dialysis patients, especially from cardiovascular and respiratory causes. Consider cessation support. Read more on guideline implications.
Current and former smokers face worse outcomes while undergoing dialysis, according to a study published online Oct. 12 in Nephrology.
Sibel G. Bek, M.D., from Kocaeli University Hospital in Turkey, and colleagues used data from 56,512 adults who began dialysis (more than three months) between 1990 and 2016. Patient demographics, initial dialysis modality, presence of comorbidities, and smoking history were predictors. The primary outcome was all-cause mortality.
The researchers found that former and current smokers had a higher risk for all-cause mortality (hazard ratios, 1.10 and 1.22, respectively), as well as a higher risk for cardiovascular disease mortality (hazard ratios, 1.13 and 1.23, respectively). Similarly, smoking was associated with higher mortality from respiratory failure among current (hazard ratio, 1.59) and former (hazard ratio, 1.33) smokers.
“This study underlines the negative impact of smoking in [the] dialysis population. Evidence that smokers have a higher risk of developing cardiovascular disease and cancers while on dialysis as compared to never-smokers was added to the literature,” the authors write. “New guidelines and preventive measures should be designed according to different age groups.”
Two authors disclosed financial ties to medical and pharmaceutical companies.
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