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Renal biopsy specimens taken from cigarette smokers showed a range of long-term changes with varying degrees of glomerulosclerosis, ischemic glomeruli, interstitial fibrosis and tubular atrophy, and arteriolar hyalinosis [16], This broad spectrum of histologic findings combined with initial renal hyperfiltration suggested that cigarette smoking induced renal damage was primarily the result of alterations of renal hemodynamics and its sequelae on glomerular and tubular function /structure [17,18,19]

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Further details regarding the NHIS database and health examinations are described elsewhere [19, 20]