Association of Smoking with Chronic Kidney Disease Stages 3 to 5:A Mendelian Randomization Study  

作　　者：Zhilong Zhang Feifei Zhang Xiaomeng Zhang Lanlan Lu Luxia Zhang 

机构地区：[1]Institute of Medical Technology,Peking University Health Science Center,Beijing,China [2]National Institute of Health Data Science at Peking University,Peking University Health Science Center,Beijing,China [3]State Key Laboratory of Vascular Homeostasis and Remodeling,Peking University,Beijing,China [4]Centre for Global Health,Usher Institute,University of Edinburgh,Edinburgh,UK [5]Xiaying Primary Health Care Center,Ningbo Yinzhou No.2 Hospital,Ningbo,Zhejiang Province,China [6]Renal Division,Department of Medicine,Peking University First Hospital,Peking University Institute of Nephrology,Beijing,China [7]Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases,Chinese Academy of Medical Sciences,Beijing,China [8]Advanced Institute of Information Technology,Peking University,Hangzhou,China

出　　处：《Health Data Science》2024年第1期77-87,共11页健康数据科学(英文)

基　　金：support is acknowledged from the National Science Fund for Distinguished Young Scholars of China(grant no.72125009);the National Key Research and Development Program of China(grant no.2022YFF1203000)received by L.Z.,the National Natural Science Foundation of China(grant no.82204137);Young Elite Scientists Sponsorship Program by CAST(grant no.2023QNRC001);Peking University Medicine Sailing Program for Young Scholars’Scientiffc&Technological Innovation(grant no.BMU2023YFJHMX014)received by F.Z.

摘　　要：Background:Previous studies suggested that smoking behavior(e.g.,smoking status)was associated with an elevated risk of chronic kidney disease(CKD),yet whether this association is causal remains uncertain.Methods:We used data for half million participants aged 40 to 69 years from the UK Biobank cohort.In the traditional observational study,we used Cox proportional hazards models to calculate the associations between 2 smoking indices—smoking status and lifetime smoking index and incident CKD stages 3 to 5.Mendelian randomization(MR)approaches were used to estimate a potential causal effect.In one-sample MR,genetic variants associated with lifetime smoking index were used as instrument variables to examine the causal associations with CKD stages 3 to 5,among 344,255 UK Biobank participants with white British ancestry.We further validated our ffndings by a two-sample MR analysis using information from the Chronic Kidney Disease Genetics Consortium genome-wide association study.Results:In the traditional observational study,both smoking status[hazard ratio(HR):1.26,95%conffdence interval(CI):1.22 to 1.30]and lifetime smoking index(HR:1.22,95%CI:1.20 to 1.24)were positively associated with a higher risk of incident CKD.However,both our one-sample and two-sample MR analyses showed no causal association between lifetime smoking index and CKD(all P>0.05).The genetic instruments were validated by several statistical tests,and all sensitivity analyses showed similar results with the main model.Conclusion:Evidence from our analyses does not suggest a causal effect of smoking behavior on CKD risk.The positive association presented in the traditional observational study is possibly a result of confounding.

关 键 词：KIDNEY instrument ELEVATED 

分 类 号：R69[医药卫生—泌尿科学]