Impact of Smoke Exposure on Kidney Stone Formation: A Systematic Review
DOI:
https://doi.org/10.11594/bjurology.2025.006.02.1Keywords:
kidney stones, nephrolithiasis, smoke, smokingAbstract
Introduction. Nephrolithiasis, or kidney stone disease (KSD), involves crystal formation in the kidneys and may increase the risk of end-stage renal failure. More than 1 in 5 of the Indonesian population identifies as smokers. Smoking is known to be the culprit of multisystem disease and conditions. In the urologic field, smoking is thought to increase the risk of nephrolithasis; nonetheless, this association has not yet been extensively studied. This study aims to assess the association between smoking and nephrolithiasis.
Methods. A systematic search was conducted in PubMed, Cochrane, Scopus, and ResearchGate (October 10–12, 2024), including systematic reviews, meta-analyses, cohort, case-control, and cross-sectional studies. Studies found were then underwent quantitative analysis using RevMan version 5.4.
Results. Seven studies showed a significant association between smoking and nephrolithiasis; two found no link. Quantitative analysis from five studies showed that smoking exposure was associated with a significantly increased risk of nephrolithiasis (OR 2.36, 95% CI 1.18–4.73, p = 0,02, I2 = 98%).
Conclusion. Smoke exposure is significantly linked to increased risk of nephrolithiasis.
Keywords: kidney stones, nephrolithiasis, smoke, smoking
References
Drabiščák E, Dorko E, Vargovčák M, Velk Ľ, Rimárová K, Andraščíková Š, Knap V. Analysis of potential risk factors associated with urolithiasis. Cent Eur J Public Health. 2022 Jun;30(Supplement):S37-S42. doi: 10.21101/cejph.a6812.
Stamatelou K, Goldfarb DS. Epidemiology of kidney stones. Healthcare (Basel). 2023 Feb 2;11(3):424. doi: 10.3390/healthcare11030424.
Holipah H, Sulistomo HW, Maharani A. Tobacco smoking and risk of all-cause mortality in Indonesia. PLoS One. 2020 Dec 1;15(12):e0242558. doi: 10.1371/journal.pone.0242558.
Badan Kebijakan Pembangunan Kesehatan. Survei kesehatan indonesia (SKI) dalam angka. Kementerian Kesehatan Republik Indonesia; 2023.
Meilissa Y, Nugroho D, Luntungan NN, Dartanto T. The 2019 economic cost of smoking-attributable diseases in Indonesia. Tob Control. 2022 Sep;31(Suppl 2):s133-s139. doi: 10.1136/tobaccocontrol-2021-056890.
Huang Y, Wang H, Xu C, Zhou F, Su H, Zhang Y. Associations between smoke exposure and kidney stones: results from the NHANES (2007-2018) and Mendelian randomization analysis. Front Med (Lausanne). 2023 Aug 10;10:1218051. doi: 10.3389/fmed.2023.1218051.
Antidiuretic: Halimi JM, Mimran A. Renal effects of smoking: potential mechanisms and perspectives. Nephrol Dialysis Transplantation. 2000;15(7):938–40. doi: 10.1093/ndt/15.7.938.
Obata T, Tomaru K, Nagakura T, Izumi Y, Kawamoto T. Smoking and oxidant stress: assay of isoprostane in human urine by gas chromatography-mass spectrometry. J Chromatogr B Biomed Sci Appl. 2000;746(1):11-5. doi: 10.1016/s0378-4347(00)00182-1.
Khan SR. Renal tubular damage/dysfunction: key to the formation of kidney stones. Urol Res. 2006;34(2):86-91. doi: 10.1007/s00240-005-0016-2.
Schwaderer AL, Raina R, Khare A, Safadi F, Moe SM, Kusumi K. Comparison of Risk Factors for Pediatric Kidney Stone Formation: The Effects of Sex. Front Pediatr. 2019 Feb 12;7:32. doi: 10.3389/fped.2019.00032.
Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, et al. Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis. Adelaide (AU): Joanna Briggs Institute; 2020. Available from: https://jbi.global/critical-appraisal-tools
Tamadon MR, Nassaji M, Ghorbani R. Cigarette smoking and nephrolitiasis in adult individuals. Nephrourol Mon. 2013 Winter;5(1):702-5. doi: 10.5812/numonthly.5251.
Hamano S, Nakatsu H, Suzuki N, Tomioka S, Tanaka M, Murakami S. Kidney stone disease and risk factors for coronary heart disease. Int J Urol. 2005 Oct;12(10):859-63. doi: 10.1111/j.1442-2042.2005.01160.x.
Dongre AR, Rajalakshmi M, Deshmukh PR, Thirunavukarasu MR, Kumar R. Risk Factors for Kidney Stones in Rural Puducherry: Case-Control Study. J Clin Diagn Res. 2017 Sep;11(9):LC01-LC05. doi: 10.7860/JCDR/2017/29465.10561.
Zhao A, Dai M, Chen YJ, Chang HE, Liu AP, Wang PY. Risk factors associated with nephrolithiasis: a case-control study in China. Asia Pac J Public Health. 2015 Mar;27(2):NP414-24. doi: 10.1177/1010539512445189.
Guo L, Liu L, Sun Y, Xue L, Gong X, Wang Y, et al. Prevalence and related factors of nephrolithiasis among medical staff in Qingdao, China: a retrospective cross-sectional study. BMC Nephrol. 2024 Jul 1;25(1):213. doi: 10.1186/s12882-024-03651-6.
Khalili P, Jamali Z, Sadeghi T, Esmaeili-Nadimi A, Mohamadi M, Moghadam-Ahmadi A, et al. Risk factors of kidney stone disease: a cross-sectional study in the southeast of Iran. BMC Urol. 2021 Oct 8;21(1):141. doi: 10.1186/s12894-021-00905-5.
Chen CH, Lee JI, Jhan JH, Lee YC, Geng JH, Chen SC, et al. Secondhand smoke increases the risk of developing kidney stone disease. Sci Rep. 2021 Sep 6;11(1):17694. doi: 10.1038/s41598-021-97254-y.
Chen YH, Lee JI, Shen JT, Wu YH, Tsao YH, Jhan JH, et al. The impact of secondhand smoke on the development of kidney stone disease is not inferior to that of smoking: a longitudinal cohort study. BMC Public Health. 2023 Jun 20;23(1):1189. doi: 10.1186/s12889-023-16116-6.
Fu YC, Xu ZL, Zhao MY, Xu K. The Association between smoking and renal function in people over 20 years old. Front Med (Lausanne). 2022 Jun 3;9:870278. doi: 10.3389/fmed.2022.870278.
Rapp JL, Alpert N, Flores RM, Taioli E. Serum cotinine levels and nicotine addiction potential of e-cigarettes: an NHANES analysis. Carcinogenesis. 2020 Oct 15;41(10):1454-9. doi: 10.1093/carcin/bgaa015.
Yang J, Hashemi S, Han W, Song Y, Lim Y. Exposure and Risk Assessment of Second- and Third-Hand Tobacco Smoke Using Urinary Cotinine Levels in South Korea. Int J Environ Res Public Health. 2022 Mar 21;19(6):3746. doi: 10.3390/ijerph19063746.
Robert M, Roux JO, Bourelly F, Boularan AM, Guiter J, Monnier L. Circadian variations in the risk of urinary calcium oxalate stone formation. Br J Urol. 1994;74(3):294-7. doi: 10.1111/j.1464-410x.1994.tb16613.x.
Mooser V, Burnier M, Nussberger J, Juillerat L, Waeber B, Brunner HR. Effects of smoking and physical exercise on platelet free cystosolic calcium in healthy normotensive volunteers. J Hypertens. 1989;7(3):211-6.
Kim S, Chang Y, Yun KE, Jung HS, Kim I, Hyun YY, et al. Metabolically healthy and unhealthy obesity phenotypes and risk of renal stone: a cohort study. Int J Obes (Lond). 2019 Apr;43(4):852-861. doi: 10.1038/s41366-018-0140-z.
Khan SR. Renal tubular damage/dysfunction: key to the formation of kidney stones. Urol Res. 2006;34(2):86-91. doi: 10.1007/s00240-005-0016-2.
Khan SR. Hyperoxaluria-induced oxidative stress and antioxidants for renal protection. Urol Res. 2005;33(5):349-57. doi: 10.1007/s00240-005-0492-4.
Tang J, Sammartino C, Chonchol M. Dietary sodium and potassium intakes and kidney stone prevalence: The National Health and Nutrition Examination Survey 2011-2018. Nutrients. 2024 Jul 10;16(14):2198. doi: 10.3390/nu16142198.
López M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol. 2010 Jan;25(1):49-59. doi: 10.1007/s00467-008-0960-5.
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