Alcohol and kidney damage
Alcohol abuse can damage many organs in our body. This can also happen with our kidneys. The occasional use of alcohol does not pose problems, but alcohol abuse certainly does.
What is the direct effect of alcohol abuse on the kidney function?
If someone consumes more than 60g of alcohol a day for 6 months, there will be an increase in kidney size by 30% and morphological changes in kidney cells as well.
The effect of alcohol on the kidney is direct as well as indirect. There is evidence to suggest that alcohol exerts a direct harmful effect on the kidney, its functions, and the process of 'filtering' by reducing its function. Furthermore, it disturbs balance, and more specifically fluid balance. Alcohol has a diuretic action suppressing hormones that aim to regulate the metabolism of water in the body. This disrupts the ability of the kidney to maintain a constant amount of water in our body, thereby dehydrating it. Dehydration is the cause of renal dysfunction in an acute phase but also a cause of exacerbation of pre-existing renal failure. In general, people who suffer from alcohol abuse are more likely to develop albuminuria, an indicator but also a risk factor for CKD.
Does alcohol abuse affect renal function and indirectly as well?
Yes. Mainly with two mechanisms. Alcohol abuse is responsible for increasing blood pressure, which is a very strong risk factor for CKD. This is done by various mechanisms such as fluid retention in addition to chronic abuse, it also affects the autonomic nervous system, and increases the hormones that rise the pressure (adrenaline, cortisone). Alcohol is known to be responsible for liver dysfunction initially and cirrhosis of the liver at a later stage. Both situations severely affect renal function and are often associated with severe renal failure.
Is it true that alcohol abuse disrupts the balance of basic electrolytes?
Yes. It can result in hyponatremia (low sodium in the blood), low phosphorus, low magnesium and low calcium in the blood. All these electrolytes are necessary for the balance of the proper body function.
How much is the alcohol consumption limit?
You should consult your nephrologist. A good rule of thumb is to consume no more than 1-2 drinks/ day for men and a drink/ day for women or for people aged over 65.
Mesogeios Dialysis Centers Group Scientific Team
1: Arroyo V, Moreau R, Jalan R, Ginès P; EASL-CLIF Consortium CANONIC Study.Acute-on-chronic liver failure: A new syndrome that will re-classify cirrhosis. JHepatol. 2015 Apr;62(1 Suppl):S131-43. doi: 10.1016/j.jhep.2014.11.045. Review.
2: Cheungpasitporn W, Thongprayoon C, Kittanamongkolchai W, Brabec BA,O'Corragain OA, Edmonds PJ, Erickson SB. High alcohol consumption and the risk of renal damage: a systematic review and meta-analysis. QJM. 2015 Jul;108(7):539-48.doi: 10.1093/qjmed/hcu247. Epub 2014 Dec 16. Review.
3: Steele MR, Belostotsky V, Lau KK. The dangers of substance abuse in adolescents with chronic kidney disease: a review of the literature. CANNT J.2012 Jan-Mar;22(1):15-22; quiz 23-4. Review. PubMed PMID: 22558679.
4: Rodrigo R, Rivera G. Renal damage mediated by oxidative stress: a hypothesis of protective effects of red wine. Free Radic Biol Med. 2002 Aug 1;33(3):409-22. Review. PubMed PMID: 12126763.
5: Vupputuri, S. and Sandler, D.P. Lifestyle risk factors and chronic kidney disease. Ann Epidemiol. 2003;13: 712–720
6: White, S.L., Polkinghorne, K.R., Cass, A. et al. Alcohol consumption and 5-year onset of chronic kidney disease: the AusDiab study. Nephrol Dial Transplant. 2009; 24: 2464–2472
7: Reynolds, K., Gu, D., Chen, J. et al. Alcohol consumption and the risk of end-stage renal disease among Chinese men. Kidney Int. 2008; 73: 870–876.