Nicotine.It’s the chemical in tobacco responsible for addiction and the reason it’s the key ingredient in those smoking-cessation gums and patches. But it may also play a key role in accelerating kidney disease.

“We are finding that nicotine may have other effects in other places, including in the vasculature and also in the kidney,” says Edgar A. Jaimes, M.D., associate professor of medicine in the Division of Nephrology. “Smokers have a more rapid progression of kidney disease, so if you have kidney disease because of diabetes or high blood pressure, you progress to dialysis a lot faster if you are a smoker.”

Jaimes, who is also a staff physician and investigator at the Miami Veterans Affairs Medical Center, led a study that found nicotine receptors on the surface of some kidney cells. These mesangial cells suffered scarring when exposed to nicotine, dramatically reducing their ability to filter urine from the blood.

Even before this study, physicians knew that people with diabetes or high blood pressure who smoked lost their kidney function much more quickly than nonsmokers. And Jaimes and his colleagues in the UM Vascular Biology Institute knew that nicotine contributed to hardening of the arteries and the growth of new blood vessels to tumors. So he decided to look for a nicotine effect in kidney cells.

“We are basically establishing a mechanism by which smoking promotes kidney disease, so it’s clearly very novel,” says Jaimes, who published the findings in the American Journal of Physiology and presented them to the High Blood Pressure Council of the American Heart Association last fall. “The receptors that we looked at were found in human cells, and so it’s clearly relevant to human disease.”

Jaimes says this research clears the air on a clinical link between smoking and kidney disease. “Smoking cessation should be part of the treatment for any patient with kidney disease.”