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논문분류	춘계학술대회 초록집
제목	Smoking Cessation Duration and Risk of Acute Kidney Injury: A Nationwide Cohort Study in Korea
저자	Soo-Young Yoon
출판정보	2026; 2026(1):
키워드	acute kidney injury, kidney replacement therapy, incidence, smoking cessation
초록	Objectives: Smoking is a modifiable risk factor for kidney disease, but the degree to which smoking cessation reduces acute kidney injury (AKI) and AKI requiring kidney replacement therapy (AKI-KRT) remains unclear. This study evaluated whether the duration of smoking cessation is associated with AKI and AKI-KRT outcomes. Methods: Using the Korean National Health Insurance Service database (2002–2023), we included 1,151,722 adults with at least four national health examinations: 885,299 never smokers, 55,391 quitters, and 211,032 current smokers. Smoking status was time-updated, and cessation duration was grouped in 2-year intervals. Incident AKI (ICD-10 N17) and AKI-KRT were identified through claims data. Multivariable Cox models estimated adjusted hazard ratios (HRs) across cessation-duration groups, using current and never smokers as reference categories. Sex-stratified subgroup analyses were performed to examine differential effects in men and women. Results: Among 11,972 AKI events and 637 AKI-KRT events, quitters with <2 years of cessation had the highest AKI incidence, declining progressively with longer cessation duration. Using current smokers as reference, adjusted HRs decreased progressively with longer cessation duration. For AKI-KRT, only never smokers showed significantly reduced risk, although quitters exhibited a similar downward trend. Patterns were consistent in men; estimates for women were imprecise due to few events. Approximately 6–7 years of sustained abstinence was needed to approach the risk of never smokers. Conclusion: Sustained smoking cessation was associated with a progressive decline in AKI risk, with 6–7 years of abstinence needed to approach the risk comparable to those of never smokers. Findings support long-term cessation as an important kidney-protective strategy.
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