Cigarette smoking and kidney involvement.

Cigarette smoking has adverse effects on health causing ischemic heart disease, stroke, chronic obstructive lung disease and cancers of the respiratory and upper digestive tract, pancreas, kidney and urinary tract. Smoking causes an acute increase in mean arterial pressure and heart rate mediated by catecholamines and beta-adrenergic mechanisms. Chronic cigarette smoking reduces renal plasma flow, probably increasing synthesis of the vasoconstrictor endothelin and reducing generation of the vasodilatory endothelial nitric oxide. There is clinical evidence that cigarette smoking has important adverse effects on renal outcome in primary hypertension, diabetic nephropathy, primary glomerular diseases, systemic diseases involving the kidney and in patients on chronic hemodialysis, or after renal transplantation.