Nodular glomerulosclerosis in a kidney transplant recipient who smokes

Cigarette smoking may have harmful effects on both native and 'transplant kidneys. Although a causal relationship was not shown, nodular glomerulosclerosis was reported in association with long-term cigarette smoking. We report a 48-year-old woman with a long-term history of smoking who underwent cadaveric renal transplantation. A renal biopsy to assess a progressive increase in serum creatinine levels 11 years posttransplantation showed features of nodular glomerulosclerosis. Other causes of nodular glomerulosclerosis were excluded. We speculate that long exposure to smoking may be the etiologic factor for nodular glomerulosclerosis in the kidney graft of our patient. Further confirmation of this risk relationship is important because cessation of smoking may help improve renal survival.