Evidence map›Paper›PMID 42498857›Full record

ArticlePediatric nephrology (Berlin, Germany)2026

Impact of childhood and parental smoking and substance use on nephrotic syndrome outcomes: a prospective cohort study.

Tanay Joshi, Cal H Robinson, Nowrin Aman, Tonny H M Banh, Josefina Brooke, Valentina Bruno, Rahul Chanchlani, Vaneet Dhillon, Mackenzie Garner, Sophia Gorgiev and 10 more

Abstract read
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In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

20 authors.

Tanay JoshiChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.ORCID http://orcid.org/0009-0005-0579-772X
Cal H RobinsonChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.
Nowrin AmanChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.
Tonny H M BanhChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.
Josefina BrookeChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.
Valentina BrunoDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Rahul ChanchlaniDivision of Nephrology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, ON, Canada.
Vaneet DhillonChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.
Mackenzie GarnerChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.
Sophia GorgievChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.
Leo LevinDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Christoph LichtDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Ashlene M McKayDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Rachel PearlDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Seetha RadhakrishnanDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Nithiakishna SelvathesanDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Chia Wei TeohDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Jovanka Vasilevska-RistovskaDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Hubert WongDivision of Nephrology, The Hospital for Sick Children, Toronto, ON, Canada.
Rulan S ParekhChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada. rulan.parekh@wchospital.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe impact of environmental exposures such as household and adolescent smoking, alcohol use, and drug use on childhood nephrotic syndrome outcomes is unknown. Our objective was to characterize tobacco, alcohol, and recreational drug use and longitudinal associations.

methodsAnalyzing data from Insight into Nephrotic Syndrome: Investigating Genes, Health, and Therapeutics, a prospective cohort, we included children (1-18 years) diagnosed with nephrotic syndrome from 1996 to 2023. Tobacco, alcohol, and recreational drug use were self-reported at annual study visits, treated as time-varying exposures. We evaluated prevalence and quantity of exposure to each substance and associations with relapse rate, steroid-sparing medication initiation, and hospitalizations using generalized linear mixed models.

resultsWe included 732 children with nephrotic syndrome (total of 2065 study visits). Median age at diagnosis was 3.8-years (IQR 2.7-6.3), 461 (73%) were male, and 692 (96%) were steroid-sensitive at diagnosis. Exposure to a household tobacco smoker was reported in 114 (16%) participants. Eight adolescents (1%) reported personal tobacco smoking, 33 (5%) used alcohol, and 10 (1%) used recreational drugs at any time. Personal or household tobacco smoking was not associated with relapse rate (adjusted rate ratio 1.22, 95% CI 0.96-1.54), steroid-sparing medication initiation (adjusted odds ratio 0.97, 95% CI 0.66-1.42), or hospitalization (adjusted odds ratio 0.66, 95% CI 0.31-1.37). Youth alcohol use was also not associated with nephrotic syndrome outcomes.

conclusionsUp to 5% of youth with nephrotic syndrome use tobacco, alcohol, or recreational drugs, and 16% are exposed to a household smoker. While this study was underpowered to evaluate the independent impact of personal tobacco and recreational drug use, no clear association between substance exposure and longitudinal outcomes was identified.

Indexed as

AlcoholCaregiverNephrotic syndromePediatricSmokingSubstance use

Identifiers

PMID42498857

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.