21 June 2009

How does alcohol affect kidney function?

What effects do you think alcohol consumption could have on renal function tests?

You’ve heard before that alcohol in moderation (in moderation!) may be good for your heart, but what can it do to your kidneys? Acute and chronic alcohol consumption does alter renal function and other physiological processes such as blood flow and fluid and electrolyte balances, which can directly affect results of renal function tests (1;2). Effects include higher level of creatine clearance and glomerular filtration rate (3). The alterations are especially noticeable in cases of liver disease (1;2).

Heavy drinking—which would be four or more alcoholic drinks a day—has a strong correlation with chronic kidney disease, especially in patients who smoke, have diabetes or hypertension or who are obese (4). When under condition of liver cirrhosis, chronic alcohol intake has been shown in rats and humans to possibly play a role in causing kidney enlargement and alterations in tubules (1). This all suggests renal detriment from consumption of alcohol.

However, prospective cohorts on moderate consumption in men and women tell a different story. A 2005 study on 11,023 healthy men over 14 years found that while there was association between alcohol consumption and glomerular filtration rates, moderate alcohol consumption actually caused a lower risk of renal dysfunction over time (5). A 2005 study on 1,658 female nurses for 11 years showed similar data in that while glomerular filtration rate was affected, moederate alcohol consumption had no adverse effect on renal dysfunction over time (2).

Good news for moderate drinkers!

Reference List

1. Epstein M. Alcohol's impact on kidney function. Alcohol Health Res World 1997;21:84-92.
2. Knight EL, Stampfer MJ, Rimm EB, Hankinson SE, Curhan GC. Moderate alcohol intake and renal function decline in women: a prospective study. Nephrol Dial Transplant 2003;18:1549-54.
3. Chung FM, Yang YH, Shieh TY, Shin SJ, Tsai JC, Lee YJ. Effect of alcohol consumption on estimated glomerular filtration rate and creatinine clearance rate. Nephrol Dial Transplant 2005;20:1610-6.
4. Shankar A, Klein R, Klein BE. The association among smoking, heavy drinking, and chronic kidney disease. Am J Epidemiol 2006;164:263-71.
5. Schaeffner ES, Kurth T, de Jong PE, Glynn RJ, Buring JE, Gaziano JM. Alcohol consumption and the risk of renal dysfunction in apparently healthy men. Arch Intern Med 2005;165:1048-53.

No comments: