Alcohol Consumption and the Risk of Chronic Kidney Disease

Epidemiological studies have found inconsistent results on whether “moderate” consumers of alcohol are at a lower risk of developing chronic kidney disease (CKD). The present analyses are from the Atherosclerosis Risk in Communities Study, a large, prospective, population-based, multi-cultural study. It reports the relation of varying levels of alcohol consumption at baseline—compared with abstinence—to the incidence of CKD (the diagnosis required both a low  glomerular filtration rate (GFR), and a decrease in GFR from previous levels) over 24 years of follow-up. Of 12,692 participants aged 45-64 years, 3664 participants developed CKD during follow-up; 25% of participants in their analyses were lifetime abstainers, and analyses included adjustment for known risk factors for CKD.

  • In comparison with lifetime abstainers, participants reporting all levels of alcohol consumption showed a significant decrease in the risk of incident CKD.
    • For those reporting ≤1 drink in a week, the decrease was 12%, with the greatest decrease in risk (29%) for participants reporting that they consumed 8–14 drinks in a week. For those reporting ≥15 drinks in a week, the decrease in risk was 23%.

Comments: Among the strengths of the study are the very large number of participants who developed CKD during follow-up and the use of a clear definition for diagnosing the disease. However, only baseline alcohol intake was used as the exposure and type of beverage or pattern of drinking could not be assessed. The results of this study are consistent with findings of some earlier research showing a protective effect of “moderate” drinking on the risk of kidney disease. While mechanisms are not clear, effects on renal vessels that are similar to those described for coronary and cerebrovascular arteries could play a role if the findings represent causality.

R. Curtis Ellison, MD

Reference: Hu EA, Lazo M, Rosenberg SD, et al. Alcohol consumption and incident kidney disease: results from the Atherosclerosis Risk in Communities Study. J Ren Nut. 2019 [Epub ahead of print]. doi: 10.1053/j.jrn.2019.01.011.

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