What is Nephrology - Why is smoking history significant in renal disease patients?

What is Nephrology - Why is smoking history significant in renal disease patients?
​Chronic renal disease has been linked to cardiovascular disease as well as smoking. The idea of smoking being a "independent" progression factor in renal disease has attracted researchers' interest in a number of studies. Several publications of clinical and experimental evidence on the harmful consequences of smoking on the kidneys have piqued attention since 2003, including large, prospective, population-based observational studies. These studies clearly show that smoking is a significant risk factor for renal dysfunction (i.e., an increase in serum creatinine), regardless of the underlying cause of kidney disease. It's been proposed that urine cotinine, a nicotine byproduct, could be utilized as an objective indicator of smoking exposure. Its effectiveness in people with chronic renal disease has not been studied.