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Transplant centers, including our own, commonly require that patients http://www.selleck.cn/products/mi-773-sar405838.html have stopped smoking for at least 6 months before being enlisted for LTx (15,16). In this study, we analyzed the potential association between smoking history before LTx and development of CKD after LTx in a large single center cohort of LTx recipients. In addition, we analyzed the impact of past smoking on mortality and causes of death after LTx. A total of 370 lung transplantations, of which 22 heart�Clung transplantations were performed at the University Medical Center of Groningen (UMCG), the Netherlands between 1990 and 2008. Pediatric transplantations (n = 17) and retransplantations (n = 13) were excluded. Quantitative data on smoking history were obtained from patient records. We excluded, 14 patients of the remaining 340 patients from further analyses because of lack of data on smoking history, leaving a total of 326 patients eligible for evaluation. Further clinical information of all individuals was gathered at baseline and during follow-up. Consent for the use of patient data was obtained from all patients before transplantation. Smoking cessation for at least 6 months is a requirement for LTx enlistment. Returning to active smoking after LTx is very strongly disapproved and occurs, to the best of our knowledge, only exceptionally. Smoking history before transplantation was quantified by number of pack years. One pack year is defined as 20 cigarettes (one pack) smoked per day for 1 year. Patients were categorized into never and http://www.selleckchem.com/products/VX-770.html former smokers and the latter were further categorized according to number of pack years: 1�C10, 11�C25 and >25 pack years. Glomerular filtration rate (GFR) measurements were performed by constant infusion of radiolabeled tracers 125I-iothalamate and 131I-hippuran as described before (17�C19). This method is considered a gold standard method for GFR measurement, has a day-to-day coefficient of variation of 2.5% (19) and is used for the development and validation of novel renal function equations (20). Height and weight were measured in every patient before every GFR measurement. Body surface area (BSA) was calculated as 0.007184 �� http://www.selleckchem.com/products/Imatinib-Mesylate.html weight0.425�� length0.725 (21), and GFR was expressed per 1.73 m2 of BSA. GFR measurements were performed routinely at outpatient basis, before transplantation and at regular time intervals after transplantation. Primary endpoints of the study were CKD-III and CKD-IV. CKD-III and CKD-IV were defined as GFR