Alcohol Consumption Can be a Double-Edged Sword for Chronic Kidney Disease Patients PMC

Since aging, metabolic diseases, and hypertension impair kidney function, they can also influence the effect of ethanol on the kidneys. Thus, the risk of kidney damage from alcohol increases with age, metabolic diseases, hypertension, and initial eGFR. However, Buja et al. suggested an inverse linear relationship between moderate alcohol consumption and the risk of age-related loss of renal function [90]. Although moderate alcohol consumption contributes to increased insulin sensitivity [95,96] and delays the progression of diabetes [77,97], the prognosis of such patients differs from non-diabetic but moderate drinking patients with CKD. This indicates that moderate drinking may be beneficial for patients with CKD, but it is not enough to offset the adverse effects of metabolic disease on these patients.

Drinking patterns and associated effects

Of those diagnosed, only 42% were on treatment, with nearly half among these having their blood pressure controlled. Hence in most of the countries, there are significant gaps in diagnosis and how does alcohol affect the kidneys treatment coverage, with low-income countries facing the major brunt of illness. For those with diabetes and CKD, alcohol may be safe to drink if you have your blood sugar level under control.

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The estimates from the 2021 Sri Lanka NCD risk factor survey (STEPS), showed that every 1 in 3 adults (34.8%) had raised blood pressure, an almost 25% increase in prevalence from that of 2015 STEPS survey. Importantly, more than half (54%) with raised blood pressure were unaware of their hypertensive status. Even among those being aware, at least 20% among them were not on any medication, whereas only 40% had their blood pressure under control while on treatment.

• Abstinence is one of the characteristics of human drinking habits; many doctors will encourage patients to stop drinking, which may be good for their health [121].
• As for the kidney damage caused by alcohol, some studies discovered that the patients’ renal function recovered after abstinence [1].
• Therefore, the effect of ethanol on the kidney is beyond our original understanding.

Drinking Alcohol Affects Your Kidneys

Therefore, we need more evidence to determine whether abstinence can relieve and heal the kidney damage caused by long-term alcohol consumption and the effects of alcohol abstinence on the prognosis of patients with CKD. In addition, long-term alcohol consumption can lead to injuries of renal tubules [1,2,30,39,51]. Na+-K+-ATPase present on the proximal tubular epithelial membrane is important for tubular reabsorption. However, recent studies have demonstrated that its activity is decreased by ROS and lipid peroxidation with the consumption of ethyl alcohol [22,41,52].

Impaired Fluid Handling

In addition, rats given intragastric infusions of a commercial whiskey (1.5 ml/100 gm body weight) 3 times a week along with a nutrient-deficient diet develop a more severe form of IgA nephropathy (Amore et al. 1994). Even without binge drinking, regularly drinking too much too often can also damage the kidneys. Regular heavy drinking has been found to double the risk chronic kidney disease, which does not go away over time. Even higher risk of kidney problems has been found for heavy drinkers who also smoke. Smokers who are heavy drinkers have about five times the chance of developing CKD than people who don’t smoke or drink alcohol to excess. A few studies have linked rhabdomyolysis and myoglobin toxicity with acute kidney injury, supporting a possible association among alcohol use, alcohol-related acute myopathy, and kidney damage.

• There are several possible protective mechanisms of alcohol on kidney function.
• 100% of your donation will go directly to kidney patients in Houston affected by the flooding.
• This subsequently promotes the conversion of H2O2 to the more reactive hydroxyl radicals, which cause damage in antioxidant capacities and mitochondria in renal cells [34,42,43].
• Drinking alcohol can generally be done safely in moderation, even if you have CKD, polycystic kidney disease, end stage renal disease (ESRD) or diabetes.
• The kidneys continuously perform their tasks of purifying and balancing the constituents of the body’s fluids.

This indicates that long-term ethyl alcohol consumption can activate both intrinsic and extrinsic pathways of apoptosis in the kidneys (Figure 1). However, other studies found that long-term alcohol consumption aggravates renal fibrosis, which may be related to epithelial mesenchymal transdifferentiation and fibrosis induced by ethanol [33,47,56]. NO is a free gaseous signal molecule produced by the NOS family, including neuronal NO synthase (nNOS), inducible NO synthase (iNOS), and endothelial NO synthase (eNOS), and it plays an important role in hemodynamics regulation. In general, NO is generated by mesangial cells and renal tubular epithelial cells, and it plays an important role in the regulation of glomerular and medullar hemodynamics and renin release. Although different studies have shown opposite results for the effects of NO and NOS activity with alcohol consumption [19,39,46,47], they came to a similar conclusion that NO and NOS play important roles in glomerular endothelial cell injury.

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Although increased serum electrolyte concentration normally activates secretion of ADH so that fluid balance can be restored, a rising blood alcohol level disrupts this regulatory response by suppressing ADH secretion into the blood. Similarly, clinicians long have noted significant kidney enlargement (i.e., nephromegaly) in direct proportion to liver enlargement among chronic alcoholic2 patients afflicted with liver cirrhosis. Laube and colleagues (1967) suggested that both cellular enlargement and cell proliferation contribute to such nephromegaly. In alcoholic patients with cirrhosis, these investigators reported a 33-percent increase in kidney weight, whereas they observed no appreciable kidney enlargement in alcoholic patients without cirrhosis compared with control subjects (Laube et al. 1967). The kidney tubules play an important role in keeping the body’s water and electrolyte levels in equilibrium.

This transfer of phosphate out of muscle cells and into the bloodstream results in an increased amount of phosphate passing through the kidneys’ filtering system. In response, reabsorption of phosphate diminishes and excretion in urine increases in an effort to return blood levels of this ion to normal. Low blood levels of phosphate commonly occur acutely in hospitalized alcoholic patients, appearing in more than one-half of severe alcoholism cases. As the plasma filtrate passes along this channel, the substances the body needs to conserve are reabsorbed into an extensive network of capillaries that wrap the nephron tubule. Small amounts of unwanted substances also are secreted directly into the nephron tubules. Together, the filtered and secreted substances form urine (see figure) and eventually trickle into a series of progressively larger collecting ducts.