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Table 4 Potential pathomechanisms of smoking-induced renal injury

From: Cigarette smoking: an important renal risk factor – far beyond carcinogenesis

• Increased sympathetic nerve activity
• Increase of blood pressure and heart rate
• Decreased fall of night-time blood pressure
• Increase of renal vascular resistance leading to a decrease in glomerular filtration rate and renal plasma flow
• Increase of intraglomerular capillary pressure
• Aggravation of hyperfiltration in patients with diabetic nephropathy
• Atherosclerosis of renal arteries and myointimal hyperplasia of the intrarenal arteries and arterioles
• Endothelin-1- and/or angiotensin II-mediated proliferation and matrix accumulation of vascular smooth muscle cells, endothelial cells and mesangial cells
• Tubulotoxic effects with alteration of tubular function
• Toxic effects on endothelial cells
• Oxidative stress
• Increased clotting of platelets
• Impaired lipoprotein and glycosaminoglycan metabolism
• Modulation of the immune response
• Vasopressin-mediated antidiuresis
• Insulin resistance