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The Link between Smoking and Kidney Disease: Understanding the Connection

Asian Institute of Nephrology and Urology | August 16, 2023

Smoking and Kidney Diseases


We all know the harmful effects of smoking on our health in multiple ways, yet we conveniently ignore such alerts for temporary pleasure. Sadly, studies have shown that smoking is among the most common preventable causes of kidney failure and premature death in the India.

Smoking and kidney disease are a hazardous combination. In the following paragraphs, we will try to understand the relationship between the two and how quitting smoking can improve one’s kidney health.

Impact of Smoking on Kidney Health: Risks and Consequences

Smoking is a significant risk factor for various kidney diseases and can contribute to their development and progression. Some kidney conditions that smoking increases the risk and worsens include:

  • Chronic Kidney Disease (CKD): Smoking is associated with the development and progression of CKD. It can accelerate the decline in kidney function and increase the risk of kidney damage over time.
  • Kidney Cancer: Smoking is a well-established risk factor for kidney cancer, also known as renal cell carcinoma. The chemicals in tobacco smoke can increase the likelihood of developing kidney tumours.
  • Kidney Stones: While the relationship is not as straightforward as with other conditions, smoking has been associated with an increased risk of developing kidney stones. Kidney stones can cause significant discomfort and damage the kidneys if left untreated.
  • Glomerular Diseases: Smoking has been linked to certain diseases that affect the glomeruli, such as IgA and membranous nephropathy.
  • Hypertension (High Blood Pressure): Smoking is a known risk factor for hypertension, and high blood pressure is a leading cause of kidney disease.
  • Diabetic Nephropathy: Smoking can worsen the complications of diabetes, including diabetic nephropathy.
  • Acute Kidney Injury (AKI): Smoking can increase the risk of acute kidney injury, a sudden and severe decline in kidney function. This can occur due to reduced blood flow to the kidneys or direct toxicity from smoking-related substances.

Unveiling the Relationship Between Smoking and Kidney Disease

Smoking is known to have a detrimental impact on various organs and systems in the body, including the kidneys. While the exact mechanisms are complex and not fully understood, researchers have identified several ways in which smoking can damage the kidneys and contribute to the development of kidney diseases:

  • Vascular Damage: Smoking causes damage to blood vessels throughout the body, including those in the kidneys. This vascular damage can reduce blood flow to the kidneys, leading to renal ischemia. Reduced blood flow can impair the kidney's ability to function properly and lead to tissue damage.
  • Formation of Kidney Stones: Smoking has been linked to an increased risk of kidney stone formation. The chemicals in cigarette smoke can alter the composition of urine, making it more conducive to the formation of crystals that can aggregate and form kidney stones.
  • Inflammation and Oxidative Stress: Cigarette smoke contains numerous harmful chemicals and toxins that can trigger inflammation and oxidative stress in the body. In the kidneys, these processes can damage the delicate structures responsible for filtering blood (glomeruli) and maintaining the balance of electrolytes and fluids.
  • Glomerular Filtration Rate (GFR) Reduction: The glomerular filtration rate (GFR) measures how well the kidneys can filter waste and excess fluids from the blood. Smoking can reduce GFR by damaging the glomerular structures involved in filtration. This reduction in GFR can lead to impaired kidney function over time.
  • Accelerated Aging: Smoking is associated with accelerated ageing of the kidneys. It can lead to premature narrowing and stiffening of the blood vessels, reducing blood flow and compromising kidney function. The ageing process is further exacerbated by the oxidative stress caused by smoking.
  • Interaction with Diabetes: Smoking can worsen the effects of diabetes on the kidneys. Both smoking and diabetes independently increase the risk of kidney disease, and their products are synergistic when combined. Smoking can worsen blood sugar control, increase inflammation, and amplify the damage to blood vessels and kidney tissue caused by diabetes.
  • Reduced Antioxidant Defence: Smoking depletes the body's natural antioxidant defences, leaving the kidneys more susceptible to oxidative stress and damage. Antioxidants help neutralise the harmful effects of free radicals, unstable molecules that can cause cellular damage.
  • Renin-Angiotensin System Dysregulation: Smoking disrupts the balance of hormones that regulate blood pressure, like renin and angiotensin, impacting renal blood flow and filtration.

Smoking Cessation for Kidney Health: Benefits and Strategies

Treatment for acute renal failure basically involves identifying the injury or illness that damaged your kidneys in the first place and then prescribe. The treatment options based on the underlying cause of kidney failure. These are the significant health benefits of quitting smoking.

  • Reduced risk of kidney damage
  • Lowered risk of kidney disease progression
  • Decreased inflammation
  • Enhanced blood pressure control
  • Improved response to treatment

Smoking cessation can improve one's quality of life, specifically for CKD patients. Here are some strategies for smoking cessation:

  • Behavioural support: Engaging in counselling, support groups or therapy to address smoking triggers and behaviours.
  • Nicotine replacement therapy: Using nicotine gums, patches or lozenges to gradually reduce nicotine dependence.
  • Prescription medications: Seeking medical guidance for drugs that curb nicotine cravings and withdrawal symptoms.
  • Lifestyle changes: Incorporating regular exercises, stress reduction, and a balanced diet to ease quitting.
  • Support systems: Enlisting the support of friends, family and healthcare professionals for encouragement and accountability.


Therefore, it’s high time to abandon that nicotine roll. Quitting smoking will improve your quality of life and reduce the risk of developing critical kidney diseases or damage. Consult an experienced kidney specialist at AINU to address kidney issues on time.


1. Is there a safe level of smoking that doesn't impact kidney health, or is any amount harmful?

No, there’s nothing called a safe level of smoking. The best option is to quit smoking to reduce the risk of developing kidney disease.

2. How does smoking specifically contribute to the development of kidney cancer?

Smoking increases the risk of renal cell carcinoma (RCC), the most common form of kidney cancer. The more you smoke, the higher the risk.

3. Does quitting smoking altogether reverse kidney damage, or are some effects irreversible?

By quitting smoking, the risks of developing severe kidney issues are reduced. The patient with kidney disease may recover quicker, experience a slow decline in kidney function, and eliminate the chances of developing acute conditions. Some dangers caused by tobacco intake may also be reversed.

4. Are there any medications or treatments that can help mitigate the adverse effects of smoking on kidney function?

ACE inhibitors or ARBs are common types of blood pressure medications that can slow the decline of kidney health and delay kidney failure. Adopting a healthy lifestyle and treatments like dialysis and kidney transplants can improve conditions for CKD patients. Consult an experienced kidney specialist at AINU to address kidney issues on time.