Bundy JD, et al. - In a prospective, longitudinal cohort study, researchers studied the associations of substance use with CKD progression and all-cause mortality among patients with CKD. In this Chronic Renal Insufficiency Cohort Study, conducted in the United States, participants were assessed for self-reported tobacco smoking, alcohol drinking, marijuana use, and hard illicit drug (cocaine, heroin, or methamphetamine) use both at baseline and at annual follow-up visits. The definition for CKD progression included incident ESKD or halving of eGFR. Findings revealed an association of hard illicit drug use with higher risk of CKD progression and all-cause mortality. Higher risk of all-cause mortality and lower risk of all-cause mortality were reported in association with tobacco smoking and alcohol drinking, respectively.