Background: This study was conducted to determine the prevalence of smoking among patients receiving hemodialysis in a state hospital, to compare the sociodemographic characteristics of smokers and non-smokers, and to evaluate the effects of smoking on selected biochemical parameters.

Methods: This descriptive cross-sectional study was carried out in a hemodialysis unit between April 15 and June 30, 2025, including a total of 80 voluntary patients. Data were collected through a structured questionnaire and hospital records, and analyzed using SPSS version 25.0.

Results: The mean age of participants was 56.96±15.17 years, and the mean duration of dialysis was 1212.40 months. Among the participants, 21.3% were current smokers, 23.8% were former smokers, and 55.0% had never smoked. Among smokers, the mean duration of smoking was 27.66±14.52 years, with an average daily consumption of 23.69±21.15 cigarettes and a mean Fagerström Test score of 7.00±1.87. The average time since quitting among former smokers was 16.26±13.22 years. While 58.8% believed that smoking negatively affected their disease course, only 6 individuals were considering quitting. Alcohol and substance use were reported by 8.8% and 2.2% of participants, respectively. The most common dialysis-related complications were hypertension (11.3%), hypotension (6.3%), and bleeding (2.5%). The comorbidity rate was 87.5%. Smoking was significantly more common among males (p=0.006), individuals with freelance occupations and those unemployed (p=0.011). Hospitalization within the past year (p=0.039), particularly due to infections (p=0.022), was also more frequent among smokers. In terms of biochemical parameters, serum phosphorus levels were significantly higher in smokers (5.24±1.54 mg/dL) compared to non-smokers (4.49±1.40 mg/dL) (p=0.037). Conversely, bicarbonate levels were significantly lower in the smoking group (p=0.003).

Conclusion: Smoking may increase the risk of complications in hemodialysis patients, potentially by suppressing the immune system and increasing susceptibility to infections. Despite acknowledging its negative effects, only a small proportion of smokers expressed willingness to quit, highlighting that behavioral change requires not just knowledge but also motivation and supportive interventions. Smoking in hemodialysis patients represents a significant health concern with serious clinical and biochemical consequences. Integrating structured smoking cessation counseling and intervention programs into dialysis care is crucial for improving patient survival and quality of life.

Keywords: biochemical markers, hemodialysis, smoking