Understanding the Risks of Smoking and Kidney Disease

If you have CKD and you smoke, you have control over one of the biggest risks to your kidney (and overall) health. Studies have shown that quitting smoking may slow the decline of kidney health and even reverse some of the risks brought on by tobacco use.^1,2

Smoking and kidney disease is a hazardous combination. According to the Centers for Disease Control and Prevention (CDC), at least 16 million people in the US live with a disease linked to smoking—one of which is CKD.³ Smoking also causes cardiovascular disease, which raises the risk of death for people living with CKD. Many people with CKD die from heart disease before they progress to end stage renal disease (ESRD), and some studies have shown that smoking causes CKD to progress faster.¹

The World Health Organization (WHO) and the CDC have confirmed that smoking causes harm to almost every organ in the body.^3,4 Both organizations cite long lists of health problems and diseases connected to smoking. Having CKD can make some conditions more severe, including the following—and many more:^5,6

• Cancers of the kidneys, lungs, bladder, stomach, liver, mouth, throat, pancreas, cervix, colon, and other organs

• Lung and heart disease

• Stroke

• High blood pressure

• Diabetes

• CKD

• Chronic obstructive pulmonary disease (COPD)

• Gum disease

• Asthma

• Pregnancy complications

Smoking can negatively affect your health in other ways—the most serious risk being death. Smoking results in about 1,300 deaths per day (nearly 500,000 annually) in the US, and smokers die about 10 years earlier than nonsmokers, on average.³

Smokers and people who breathe secondhand smoke increase their risk of developing diseases and conditions that can lead to CKD or make it worse. Cardiovascular disease, which can be caused by smoking, does terrible things to your body’s veins and arteries.⁷ Damage to your cardiovascular system can directly harm your kidneys, affecting their ability to filter your blood. Examples of these harmful effects include:

• Decreased blood flow to the kidneys and other organs
• Peripheral arterial disease, which narrows blood vessels, including those in the kidneys
• Arteriosclerosis, which thickens and hardens arteries, including renal arteries

If you have CKD, you’re already vulnerable to the following health problems, and—based on information from the CDC—smoking increases the risks even more.³ These conditions can cause CKD to progress faster and may eventually lead to kidney failure:^1,8

• Heart disease
• High blood pressure
• Diabetes
• A weakened immune system
• Interference with blood pressure medications⁴

Whether you smoke or not, secondhand smoke can also affect your health and the health of those around you. The CDC has reported that exposure to secondhand smoke increases the probability of developing heart disease or having a stroke, both of which are already risk factors for people living with CKD. Between heart disease and stroke, there are roughly 42,000 deaths each year in the US related to secondhand smoke exposure.⁹

Secondhand smoke can also contribute to:

• Asthma attacks
• Lung cancer
• Sudden infant death syndrome (SIDS)
• Ear infections and respiratory problems in children
• Health problems in newborns

When you decide to stop smoking, you’re taking a step that can help preserve the health of your kidneys, lower your risk of diseases and other health problems, and enhance your quality of life. From increasing your breathing ability to boosting your energy level to preserving your kidney function, it can make a big difference in how you look and feel.

When kidney disease gets worse over time, changes in kidney health are measured in stages. Stages of CKD are calculated using the estimated glomerular filtration rate (eGFR), which shows how well your kidneys are cleaning your blood. Stage 1 (GFR 90 or higher) is the least severe, with no loss of kidney function. Stage 5 (eGFR 15 or lower) means the kidneys have failed or are close to failing, requiring either dialysis or a kidney transplant. For smokers with CKD, one of the notable advantages of quitting is the increased chance of keeping the kidney function you have left while lowering the possibility of kidney failure.

In fact, the CDC shows that quitting in the early stages of CKD can slow the disease’s progression and reduce the risk of cardiovascular disease.¹ An article in the American Journal of Nephrology explored several studies that showed the reduction in GFR for people who quit smoking was cut in half compared to those who continued to smoke over a 5-year period.¹⁰

Stopping smoking can improve tobacco-related health concerns, and the longer you stay off tobacco, the lower your risk for diseases. That means fewer health problems, some of which (heart disease, stroke, kidney cancer) are CKD-related. These encouraging statistics from the CDC show that after quitting the following can happen²:

• In minutes: Your heart rate drops.

• In 24 hours: Nicotine has left your bloodstream.

• In days: Your blood’s carbon monoxide level is the same as that of nonsmokers.

• In 1 year or less: Coughing and shortness of breath are reduced.

• In 1 to 2 years: Heart attack risk is lowered dramatically.

• In 3 to 6 years: Added risk of coronary heart disease is reduced by half.

• In 5 to 15 years: 50% reduction in risk for kidney and other cancers 

• In 15 to 20 years: Reduced risk of coronary heart disease and cancers similar to nonsmokers.

Quitting smoking has benefits that may enhance your quality of life, your appearance, and certain health conditions. These benefits might also make it easier to manage CKD and some of the stress that can come with it. According to the CDC, after stopping smoking, you may experience these and many more improvements:¹¹

• More energy
• A stronger immune system, which means fewer illnesses
• Stress reduction
• Better mental health
• Whiter teeth
• Clearer skin
• Better vision and hearing
• Lower cholesterol
• Positive changes in sexual health
• Saving money

Quitting smoking may sound like a difficult task, especially if you’re a longtime smoker living with CKD. But there are many resources that can assist you. If you’re trying to quit, consider one or more of these options to help reach your goal.

• Quit help lines—These confidential services provide coaching and encouragement over the phone to help you stop smoking.
• Guides to quit smoking—You can follow self-guided courses on your own. They are available through medical, physician, and organization websites.
• Programs—The American Lung Association, American Heart Association, and other groups have free stop smoking programs, as do the US government and some states.
• Apps—Smartphone apps can help support your efforts to stop smoking. One free example is quitSTART, provided by smokefree.gov and the National Cancer Institute.
• Social media—Support groups are available on social media platforms. Smokefree.gov offers tips and assistance through its social media community, SmokefreeUS.
• Nicotine replacement therapies (NRTs)—The CDC reports that NRTs are safe to use and recommends them to make quitting easier. These come in gums, lozenges, pills, and patches, and most insurance plans cover the cost. As always, you should talk to your doctor before taking any new medications.

Smoking and kidney disease are linked in many ways, and continuing to smoke can decrease kidney health. By quitting, you may restore some of your body’s natural functions and slow the progress of CKD. You’ll also reduce your chances of developing other diseases and stop exposing family, friends, and coworkers to secondhand smoke.

With the right tools and support from your support network, smoking is a risk factor you can control and conquer. If you need help quitting, find a program, guide, app, or medicine that works for you. You can do this.