Alcohol use disorder tied to development of chronic kidney disease: A nationwide database analysis

Abstract

IntroductionAlcohol use disorder (AUD) is a spectrum of high risk behaviors including alcohol abuse and dependence. Chronic kidney disease (CKD) is progressive loss of renal function for more or equal to 3 months or presence of any irreversible kidney damage. Common risk factors of CKD have been identified, but the impact of alcohol consumption on kidney function is controversial. The study aims to investigate the relationship between alcohol use disorder and CKD on a national scale.MethodsThis retrospective cohort study was conducted using Taiwan’s National Health Insurance research database. Patients aged 20 years or older, without CKD and with the diagnosis of AUD (ICD-9-CM codes 303.X; 305.0, V113) from years 2000 to 2013 were enrolled. Control cohort was selected to match the demographics of the target population. Patients were followed until the end of 2013 or earlier if they developed CKD, died, or lost follow up. Baseline characteristics and comorbidities were identified for risk stratification.ResultsWe identified 11639 patients in the AUD cohort and 46556 patients in the control cohort. Compared to patients in the control cohort, those in the AUD group were more likely to have multiple comorbidities (p < 0.001 for all comorbidities). After adjustment of age, gender, baseline comorbidities, and nonsteroidal anti-inflammatory drug use, the diagnosis of AUD was associated with an increased risk of CKD development (aHR = 1.62, 95% CI, 1.46–1.81).During the mean follow up periods of 6.47 (standard deviation (SD) = 3.80) years for the AUD cohort and 7.23 (SD = 3.75) years for the control cohort, the overall incidence density of CKD was significantly higher in patients with AUD than those in the control cohort (3.48 vs 6.51 per 1000 person-years, aHR = 1.68, 95% CI, 1.50–1.87). Kaplan-Meier analysis showed that the AUD cohort had a higher cumulative incidence of CKD than the control cohort (log-rank test, p value < 0.001). Patients with AUD had higher risks of CKD in all the stratified groups, except for the subgroup with age over 65 years old.ConclusionOur study suggested that AUD was associated with an increased incidence of newly diagnosed CKD by nearly two folds. Young age, in particular, had a higher association between AUD and CKD. Considering the preventable nature of AUD, establishing effective health policies is imperative to reduce high-risk alcohol behaviors and thereby prevent alcohol-related kidney disease. Further prospective studies are warranted to further elucidate the causation of AUD on kidney function.

Alcohol consumption and subclinical atherosclerosis among South Asians: Findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study

“…Chronic kidney disease (CKD) has shown to be associated with atherosclerosis [39,40]. Although few studies have suggested a harmful association between alcohol consumption and CKD, our study found no such association [41,42].…”

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

“…In their study, excessive alcohol consumption is associated with a higher odds ratio of CKD than in the abstainer. Other studies also found a higher association between heavy drinking and albuminuria or CKD, particular among young and middle-aged men [4,67,73,74]. However, Kimura et al found a U-shaped and J-shaped association between alcohol consumption and the incidence of proteinuria in men and women, respectively.…”

“…Age, primary diseases, initial eGFR, and individual differences can also affect the prognosis of patients with CKD and interfere with the effects of alcohol on the kidneys [7,10,67,94]. Since aging, metabolic diseases, and hypertension impair kidney function, they can also influence the effect of ethanol on the kidneys.…”

Association Between Iron Status and Risk of Chronic Kidney Disease in Chinese Adults

“…Affected by the global population aging, chronic kidney disease (CKD), the 17th leading cause of death worldwide (1), is becoming a worldwide public health and can lead to a series of adverse health outcomes including premature death, poor quality of life, and cardiovascular disease (2)(3)(4). Moreover, smoking, alcohol use disorder, and obesity are all well-known risk factors for CKD (5)(6)(7).…”