Assessment of Cotinine Reveals a Dose-Dependent Effect of Smoking Exposure on Long-term Outcomes After Renal Transplantation
| Autor: | Stephan J. L. Bakker, Douwe Postmus, Willem J. van Son, Merel E. Hellemons, Gerjan Navis, Anneke C. Muller Kobold, Rijk O. B. Gans, Marc A. Seelen, Jan-Stephan F. Sanders |
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| Přispěvatelé: | Groningen Kidney Center (GKC), Groningen Institute for Organ Transplantation (GIOT), Lifestyle Medicine (LM), Methods in Medicines evaluation & Outcomes research (M2O), Value, Affordability and Sustainability (VALUE), Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment PROTEIN Smoking Prevention Kaplan-Meier Estimate Urine NONSMOKERS chemistry.chemical_compound Postoperative Complications Predictive Value of Tests Risk Factors Internal medicine Humans Medicine Prospective Studies Risk factor Cotinine Prospective cohort study Kidney transplantation Aged Proportional Hazards Models RISK Transplantation business.industry Proportional hazards model CURRENT SMOKERS Smoking Reproducibility of Results Middle Aged medicine.disease Kidney Transplantation Surgery RECIPIENTS Treatment Outcome chemistry Smoking cessation Female Smoking Cessation Self Report CIGARETTE-SMOKING business Biomarkers |
| Zdroj: | Transplantation, 99(9), 1926-1932. LIPPINCOTT WILLIAMS & WILKINS |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/tp.0000000000000636 |
| Popis: | BACKGROUND: Smoking is a risk factor for poor late outcomes in renal transplant recipients (RTR). Smoking exposure can be assessed by self-report and cotinine measurements. We investigated whether use of cotinine as a biomarker for smoking exposure can serve as an alternative for self-report and to compare associations of smoking exposure by self-report and cotinine with outcomes in RTR and assess dose dependency.METHODS: Renal transplant recipients were classified as never, former, light (≤10 cigarettes/day), and heavy smokers (>10 cigarettes/day) according to self-report and analogous categories for urine and plasma cotinine. First, we assessed agreement of self-reported smoking exposure with smoking exposure according urine and plasma cotinine. Second, we compared the associations with graft failure and mortality.RESULTS: Of 603 RTR (age 51.5 ± 12.1 years, 55% men), 36.0% RTR were never, 42.3% former, 10.6% light, and 11.1% heavy smokers according to self-report. The majority (98.6%) of never smokers had nondetectable cotinine. However, 14 and 13 RTR reporting no active smoking had respective urine or plasma cotinine consistent with active smoking. Cotinine-based measurements were dose-dependently associated with mortality and graft failure.CONCLUSIONS: Plasma and urine cotinine can serve as an alternative to self-report and were dose-dependently associated with poor late outcomes in RTR. |
| Databáze: | OpenAIRE |
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