Impact of Cigarette Smoking on Serum Cystatin C and Creatinine Levels and MAU: A Case-Control Study

Nizar M. Farah, Anass M. Abbas, Ayman Ali Mohammed Alameen, Manar G. Shalabi, Abozer Y. Elderdery, Lienda Basheir Eltayeb, Asaad Ma. Babker, Hatem Mohamed, Abdullah I Aedh

International Journal of Biomedicine. 2023;13(1):58-61.
DOI: 10.21103/Article13(1)_OA6
Originally published March 3, 2023


Background: Smoking-related hemodynamic events may adversely influence renal function. The aim of this study was to evaluate renal impairment biomarkers among healthy people influenced by cigarette smoke.
Methods and Results: In this case-control study, 90 subjects were enrolled: 60 were smokers, and 30 were non-smokers (apparently healthy control). Serum CysC was measured using a semi-automated, specific protein analyzer Mispa-i2 (Germany). Serum creatinine and MAU were assayed in the fully automated biochemistry analyzer (Mindray BS380). The mean concentration of CysC was significantly higher in cigarette smokers than in non-smokers (0.793±0.125 vs. 0.619±0.103, P=0.000). Also, the mean of MAU and serum creatinine levels were significantly higher in cigarette smokers than in non-smokers (18.33±3.41 vs. 12.70±0.517, 1.06±0.161 vs. 0.810±0.058, respectively, P=0.000 in both cases). The mean concentration of CysC and MAU was significantly greater in heavy smokers than in light smokers (P=0.000 and P=0.001, respectively). Serum CysC and MAU levels were positively correlated with the age of cigarette smokers (r=0.734 and r=0.730, respectively; P=0.000 in both cases) and the duration of smoking (r=0.773 and r=0.790, respectively; P=0.000 in both cases).
Conclusion: cigarette smoking increases the specific renal biomarkers considered risk factors for renal impairment. Using such inflammatory biomarkers as diagnostic tools can be a necessary precaution in the development of chronic kidney disease caused by smoking and in the avoidance of acute renal consequences linked to cigarette smoking.

cigarette smoking • inflammatory biomarkers • chronic kidney disease
  1. Halmai R. Role of Cigarette Smoke in Chronic Kidney Disease. University of Pécs, Faculty of Medicine, 2nd Department of Internal Medicine, Pécs, Hungary, 2013. Available from:
  2. Jha P, Chaloupka FJ, Moore J, Gajalakshmi V, Gupta PC, Peck R, et al., editors. In: Disease Control Priorities in Developing Countries. 2nd edition. Washington (DC): The International Bank for Reconstruction and Development. The World Bank; 2006. Chapter 46.
  3. Gambaro G, Verlato F, Budakovic A, Casara D, Saladini G, Del Prete D, Bertaglia G, Masiero M, Checchetto S, Baggio B. Renal impairment in chronic cigarette smokers. J Am Soc Nephrol. 1998 Apr;9(4):562-7. doi: 10.1681/ASN.V94562.
  4. Yacoub R, Habib H, Lahdo A, Al Ali R, Varjabedian L, Atalla G, Kassis Akl N, Aldakheel S, Alahdab S, Albitar S. Association between smoking and chronic kidney disease: a case control study. BMC Public Health. 2010 Nov 25;10:731. doi: 10.1186/1471-2458-10-731.
  5. Orth SR, Hallan SI. Smoking: a risk factor for progression of chronic kidney disease and for cardiovascular morbidity and mortality in renal patients--absence of evidence or evidence of absence? Clin J Am Soc Nephrol. 2008 Jan;3(1):226-36. doi: 10.2215/CJN.03740907.
  6. Hammer Y, Cohen E, Levi A, Krause I. The Relationship between Cigarette Smoking and Renal Function: A Large Cohort Study. Isr Med Assoc J. 2016 Sep;18(9):553-556. 
  7. Koroshi A. Microalbuminuria, is it so important? Hippokratia. 2007 Jul;11(3):105-7. 
  8. Lassus J, Harjola VP. Cystatin C: a step forward in assessing kidney function and cardiovascular risk. Heart Fail Rev. 2012 Mar;17(2):251-61. doi: 10.1007/s10741-011-9242-6. 
  9. Andersen TB, Jødal L, Erlandsen EJ, Morsing A, Frøkiær J, Brøchner-Mortensen J. Detecting reduced renal function in children: comparison of GFR-models and serum markers. Pediatr Nephrol. 2013 Jan;28(1):83-92. doi: 10.1007/s00467-012-2268-8. 
  10. Knight EL, Verhave JC, Spiegelman D, Hillege HL, de Zeeuw D, Curhan GC, de Jong PE. Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Kidney Int. 2004 Apr;65(4):1416-21. doi: 10.1111/j.1523-1755.2004.00517.x.
  11. Ahmed MME, Sabah AO, Aziz Jawad A.  The effect of smoking cigarette on kidney functions among Sudanese peoples. International Journal of Development Research. 2015;5(5):4473-4475.
  12. Ishizaka N, Ishizaka Y, Toda E, Shimomura H, Koike K, Seki G, Nagai R, Yamakado M. Association between cigarette smoking and chronic kidney disease in Japanese men. Hypertens Res. 2008 Mar;31(3):485-92. doi: 10.1291/hypres.31.485. 
  13. Halimi JM, Giraudeau B, Vol S, Cacès E, Nivet H, Lebranchu Y, Tichet J. Effects of current smoking and smoking discontinuation on renal function and proteinuria in the general population. Kidney Int. 2000 Sep;58(3):1285-92. doi: 10.1046/j.1523-1755.2000.00284.x. 
  14. Pinto-Sietsma SJ, Mulder J, Janssen WM, Hillege HL, de Zeeuw D, de Jong PE. Smoking is related to albuminuria and abnormal renal function in nondiabetic persons. Ann Intern Med. 2000 Oct 17;133(8):585-91. doi: 10.7326/0003-4819-133-8-200010170-00008. 
  15. Yoon HJ, Park M, Yoon H, Son KY, Cho B, Kim S. The differential effect of cigarette smoking on glomerular filtration rate and proteinuria in an apparently healthy population. Hypertens Res. 2009 Mar;32(3):214-9. doi: 10.1038/hr.2008.37.
  16. Gupta RK, Gupta R, Maheshwari VD, Mawliya M. Impact of smoking on microalbuminuria and urinary albumin creatinine ratio in non-diabetic normotensive smokers. Indian J Nephrol. 2014 Mar;24(2):92-6. doi: 10.4103/0971-4065.127893.
  17. Abdallah EM, Modawe GA, Shrief NM. Assessment of Creatinine and Microalbuminuria in Sudanese Smoker. Sch Bull. 2016;2(3):153-156
  18. Yamada Y, Noborisaka Y, Ishizaki M, Yamazaki M, Honda R, Yokoyama H, Kakuma T. Different association of cigarette smoking with GFR estimated from serum creatinine and that from serum cystatin C in the general population. Clin Exp Nephrol. 2015 Aug;19(4):669-77. doi: 10.1007/s10157-014-1058-y. 

Download Article
Received January 12, 2023.
Accepted February 17, 2023.
©2023 International Medical Research and Development Corporation.