A Dose-Dependent Association between Alcohol Consumption and Incidence of Proteinuria and Low Glomerular Filtration Rate: A Systematic Review and Meta-Analysis of Cohort Studies

In recent years, significant progress has been achieved in comprehending the impact of alcohol consumption on adverse health outcomes. However, the quality of evidence remains limited. Our objective was to conduct a prospective study examining the relationship between different types of alcoholic beverages and the risk of all-cause mortality, cardiovascular disease (CVD), and chronic kidney disease (CKD), and identifying the thresholds of safe dose stratified by sex using data from the UK Biobank. 502,490 participants were enrolled. These participants were initially registered between 2006 and 2010, and underwent reassessment between 2012 and 2013. All participants completed a detailed questionnaire on their alcohol consumption, including total alcohol consumption yesterday, weekly consumption of red wine, champagne plus white wine, beer, spirits, and fortified wine. All-cause mortality and the incidence of CVD and CKD were considered as the primary outcomes. 2852 participants reported CKD during a median follow-up period of 11.94 years, while 79,958 participants reported CVD over a median follow-up period of 11.35 years. Additionally, 18,923 participants died over a median follow-up period of 11.89 years. After adjusting for variables such as age, sex, education level, smoking status, diet score, and exercise score, total alcohol consumption showed a U-shaped relationship with the risk of CVD and all-cause mortality, but showed an inverse association with the risk of CKD. Upon further classification of alcoholic beverages, our analysis revealed that red wine, champagne plus white wine, beer, spirits, and fortified wine presented a U-shaped relationship with the risk of all-cause mortality and CKD. However, spirits were positively associated with the risk of CVD, only red wine, champagne plus white wine, beer, and fortified wine showed a U-shaped relationship with the risk of CVD. The safe doses of total alcohol consumption should be < 11 g/d for males and < 10 for females, red wine consumption should be < 7 glasses/week for males and < 6 for females, champagne plus white wine consumption should be < 5 glasses/week, and fortified wine consumption should be < 4 glasses/week. Red wine, champagne plus white wine, beer, and fortified wine below the corresponding thresholds of safe dose in our analysis were significantly associated with a lower risk of all-cause mortality, CVD, and CKD. And these alcoholic beverages under safe doses exhibited a protective effect against conditions like diabetes, depression, dementia, epilepsy, liver cirrhosis, and other digestive diseases, while didn’t increase the risk of cancer.

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Association between alcohol consumption and the risk of incident chronic kidney disease in community-dwelling older adults: a Korean nationwide population-based senior cohort study

SUN,

Lee,

Lim

et al. 2024

Preprint

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Background The relationship between alcohol consumption and kidney function decline is not well established, especially in older adults. This study aimed to investigate the effects of alcohol consumption on the risk of incident chronic kidney disease (CKD) in community-dwelling older adults. Methods Adults aged ≥ 65 years with an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 and without proteinuria between 2009 and 2010 were recruited and followed through December 2018 from a Korean national population-based cohort. Alcohol consumption was categorised into non-, mild, moderate, and heavy drinking groups based on self-administered questionnaires. New-onset CKD was defined as an eGFR < 60 mL/min/1.73 m2. Results Of the total 122,319 subjects, the non-, mild, moderate, and heavy drinking groups were 99,091 (81.0%), 14,842 (12.1%), 4,257 (3.5%), and 4,139 (3.4%), respectively. During follow-up, 19,796 (20.0%), 4,636 (31.2%), 1,696 (39.8%), and 1,695 (41.0%) developed CKD in the non-, mild, moderate, and heavy drinking groups. Univariate Cox regression analyses showed a significantly increased risk of incident CKD in older adults in all drinking groups compared to non-drinkers (all P < 0.001). However, hazard ratios (HR) for developing CKD were 0.90 (95% confidence interval [CI] 0.87–0.94, P < 0.001) for mild, 0.89 (95% CI 0.84–0.95, P < 0.001) for moderate, and 0.93 (95% CI 0.88–0.99, P = 0.027) for heavy drinkers after fully adjusting for confounding variables. This inverse relationship between alcohol consumption and CKD risk was observed in males in all drinking groups, whereas in females it was found only in mild drinkers. Conclusion In the subgroup analysis, the beneficial effect of alcohol consumption on incident CKD was prominent among moderate drinkers aged 65–75 years, male mild drinkers aged ≥ 75 years, and female mild drinkers aged < 85 years. This study shows that alcohol consumption is inversely associated with the risk of incident CKD in older adults. Further studies are required to elucidate the effects of alcohol on kidney damage in older adults.

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A Dose-Dependent Association between Alcohol Consumption and Incidence of Proteinuria and Low Glomerular Filtration Rate: A Systematic Review and Meta-Analysis of Cohort Studies

Cited by 4 publications

References 78 publications

Ambient ozone pollution impairs glucose homeostasis and contributes to renal function decline: Population-based evidence

Ambient ozone pollution impairs glucose homeostasis and contributes to renal function decline: Population-based evidence

Association between alcohol consumption and all-cause mortality, cardiovascular disease, and chronic kidney disease: A prospective cohort study

Association between alcohol consumption and the risk of incident chronic kidney disease in community-dwelling older adults: a Korean nationwide population-based senior cohort study

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