Marijuana use not associated with worse kidney disease in adolescents, unlike cigarettes

Among 441 adolescents and young adults with chronic kidney disease, cigarette smoking was associated with higher proteinuria, but marijuana, alcohol, and e-cigarette use were not associated with worsening kidney function or disease progression.

Molino, Andrea R et al.·Pediatric nephrology (Berlin·2021·Moderate EvidenceLongitudinal Cohort
RTHC-03355Longitudinal CohortModerate Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
N=441

What This Study Found

Past-year and 30-day cigarette use were significantly associated with higher proteinuria (+18.6% and +20.0% respectively). Marijuana use (reported by 15%), alcohol (39%), and e-cigarette use (17%) were not associated with proteinuria, disease progression, or elevated blood pressure in adjusted models.

Key Numbers

441 participants; 1,245 person-visits; marijuana use 15%; cigarette use associated with +18.6% higher proteinuria (P < 0.05); marijuana, alcohol, e-cigarette not associated with kidney outcomes

How They Did This

Longitudinal analysis of 441 participants aged 16+ in the CKiD study contributing 1,245 person-visits. Repeated measures regression models with contemporaneous and lagged controls assessed associations between each substance and kidney function markers.

Why This Research Matters

Adolescents with chronic kidney disease face lifelong disease management. Knowing that marijuana does not appear to accelerate kidney disease (unlike cigarettes) provides important information for clinicians and families navigating substance use conversations.

The Bigger Picture

While this provides some reassurance about occasional marijuana use in CKD patients, it does not mean marijuana is safe. The finding reinforces that cigarette smoking remains the most harmful common substance for kidney function.

What This Study Doesn't Tell Us

Relatively low prevalence of substance use limited statistical power. Self-reported use likely underestimates actual consumption. Cannot rule out effects at higher use levels. CKiD cohort may not represent all pediatric CKD patients.

Questions This Raises

  • ?Would heavier marijuana use show kidney effects?
  • ?Are there specific cannabinoids that affect kidney function?
  • ?Should clinicians prioritize tobacco cessation over marijuana cessation in CKD patients?

Trust & Context

Key Stat:
Marijuana not associated with kidney disease progression; cigarettes were
Evidence Grade:
Well-established CKD cohort with longitudinal design and repeated measures, though low substance use prevalence limits power.
Study Age:
Published in 2021.
Original Title:
The association of alcohol, cigarette, e-cigarette, and marijuana use with disease severity in adolescents and young adults with pediatric chronic kidney disease.
Published In:
Pediatric nephrology (Berlin, Germany), 36(8), 2493-2497 (2021)
Database ID:
RTHC-03355

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Does marijuana hurt kidneys?

In this study of adolescents with chronic kidney disease, occasional marijuana use was not associated with worsening kidney function, proteinuria, or blood pressure. However, this does not mean heavy use is safe.

Which substance was most harmful for kidney disease?

Cigarette smoking was the only substance significantly associated with higher proteinuria, a marker of kidney damage, in this study.

Read More on RethinkTHC

Cite This Study

RTHC-03355·https://rethinkthc.com/research/RTHC-03355

APA

Molino, Andrea R; Jerry-Fluker, Judith; Atkinson, Meredith A; Furth, Susan L; Warady, Bradley A; Ng, Derek K. (2021). The association of alcohol, cigarette, e-cigarette, and marijuana use with disease severity in adolescents and young adults with pediatric chronic kidney disease.. Pediatric nephrology (Berlin, Germany), 36(8), 2493-2497. https://doi.org/10.1007/s00467-021-05044-5

MLA

Molino, Andrea R, et al. "The association of alcohol, cigarette, e-cigarette, and marijuana use with disease severity in adolescents and young adults with pediatric chronic kidney disease.." Pediatric nephrology (Berlin, 2021. https://doi.org/10.1007/s00467-021-05044-5

RethinkTHC

RethinkTHC Research Database. "The association of alcohol, cigarette, e-cigarette, and mari..." RTHC-03355. Retrieved from https://rethinkthc.com/research/molino-2021-the-association-of-alcohol

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.