Alcohol consumption is inversely associated with the risk of developing chronic kidney disease

Sarah H Koning,Ron T Gansevoort,Kenneth J Mukamal,Eric B Rimm,Stephan J.L Bakker,Michel M Joosten

doi:10.1038/ki.2014.414

Abstract

There are few reports of associations between alcohol consumption and risk of chronic kidney disease (CKD). To investigate this further, we studied 5476 participants aged 28-75 years in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study, a prospective population-based cohort, who were free of CKD at baseline (1997/1998). Alcohol consumption was self-reported on a questionnaire validated against serum high-density lipoprotein cholesterol. The primary outcome was de novo CKD defined as a combination of a creatinine-cystatin C-based estimated glomerular filtration rate (eGFR) under 60 ml/min per 1.73 m(2) and/or the mean of two consecutive 24-h urinary albumin excretions over 30 mg. During four serial follow-up examinations (median 10.2 years until February 2012), 903 participants developed CKD. Compared with those abstaining from alcohol, the multivariable-adjusted hazard ratios (95% confidence interval) for CKD risk were 0.85 (0.69-1.04) for occasional (under 10 g/week), 0.82 (0.69-0.98) for light (10-69.9 g/week), 0.71 (0.58-0.88) for moderate (70-210 g/week), and 0.60 (0.42-0.86) for heavier (over 210 g/week) alcohol consumers (significant trend). Similar inverse associations for alcohol consumption were found when CKD was defined as eGFR <60 ml/min per 1.73 m(2) or as 24-h urinary albumin excretion over 30 mg. Thus, in this population-based cohort, alcohol consumption was inversely associated with the risk of developing CKD.

Highlights

Alcohol consumption, in moderation, has consistently been linked to a lower risk of cardiovascular disease[1] and type 2 diabetes,[2] its association with the risk of chronic kidney disease (CKD) has received considerably less attention
Most previous studies on alcohol and CKD risk relied on serum creatinine–based equations to assess glomerular filtration rate (GFR), such as the Cockgroft–Gault[7] or the Modification of Diet in Renal Disease (MDRD),[8] with uncertain validity in general population cohorts with higher GFR.[9,10]
We evaluated the association between alcohol consumption and the risk of CKD among participants in a population-based cohort study free of CKD at baseline and with serial measurements of serum creatinine, serum cystatin C, and urinary albumin excretion (UAE) for a more optimal and integral definition of CKD

Summary

Introduction

In moderation, has consistently been linked to a lower risk of cardiovascular disease[1] and type 2 diabetes,[2] its association with the risk of chronic kidney disease (CKD) has received considerably less attention. The inverse associations between alcohol consumption and the risk of CKD were generally similar in analyses stratified by selected characteristics (Table 4), with no significant interactions by age, sex, smoking, hypertension, or hypercholesterolemia (all P-interactions 40.30).

Results

Conclusion