Evaluation of the effect on urine metal levels and glomerular filtration rate (GFR) in smoking adolescents

Aim Smoking affects a significant part of society and is spreading with increasing frequency among young people (9). For this reason, smoking is a priority problem within the scope of health education targeting children and youth. Smoking usually starts at a young age and continues as a habit. About 80% of smokers begin smoking under the age of 18. Those who smoke for the first time in childhood have a high risk of smoking (10). Metals are found in air, water, soil and biological materials. They are emitted from automobile exhausts, industrial activities, pesticides and waste. Although some metals such as chromium, cobalt, manganese, zinc are essential elements, high exposure can lead to toxic effects. In contrast, other metals widely distributed in the environment, such as arsenic, cadmium, lead, mercury, vanadium, are toxic to humans even at low levels (52). We aim to investigate the impact of urinary heavy metal levels on kidney function in smoking adolescents, and to contribute to the treatment and follow-up of those patients with the results we find. Material and Methods In this study, the anamnesis of adolescents aged 13-19 years who admitted to the Dicle University Faculty of Medicine Pediatric Adolescent Health Polyclinic between 15.10.2021 and 15.05.2022 was recorded and their physical examination was performed, then their urinary cadmium levels was measured and finally their glomerüler filtration rate (GFR) was calculated according to the Schwartz formula. In this study, the effect of smoking-induced cadmium on the GFRs of children in the adolescent age group, 30 adolescents who smoked at least once a day (regular smokers) in the last year and 30 adolescents who have never smoked before was investigated in the study as a control group. Results The study groups were consisted of the patient and control group. The number of patients in the groups was kept equal. A total of 30 patients were included in the patient group. Of these, 33.3% (n=10) patients were identified as female. The number of men in the patient group was 66.6% (n=20). The youngest patient was a 13-year-old, and the oldest was 19 years old. The mean age was found to be 16.97±1.377 years. A total of 30 patients were included in the control group, while the patients were included, information was given about the study, and patient consent form was obtained. The gender distribution of the control group was 40% (n=12) female and 60% (n=18) male. In the group, the youngest age was 13 and the oldest was 19. The mean age was 14.30±1.643 years. Conclusion Our study examined the effects of heavy metals in the urine of smokers on kidney function compared to non-smokers. According to our study, smokers' kidney function is negatively impacted more than non-smokers'. GFR levels are higher in the non-smoker group. Kidney dysfunction has many causes. Keeping adolescents away from smoking, organizing educational programs for them, and ensuring their participation in these programs will reduce smoking, as well as improve kidney functions and have healthier organs. Cadmium and similar heavy metals should not be ignored when evaluating kidney functions, especially in adolescents. Keywords: Adolescent, heavy metal, cigarette, cadmium