Alcohols Impact on Kidney Function PMC

The combination of low phosphate excretion and low blood levels indicates that phosphate is simply being shifted from the bloodstream into body cells, implying that kidney dysfunction is not a likely cause of phosphate wasting in this case. Drinking alcohol heavily can have several long-term health consequences including type 2 diabetes and high blood pressure. Excessive drinking is considered to be more than four drinks per day. This doubles your risk of developing chronic kidney disease or long-term kidney damage.

Judgments based on such relatively modest BUN and serum creatinine increases often underestimate kidney dysfunction in patients with hepatorenal syndrome, however, because malnourished cirrhotic patients tend to have low levels of urea and creatinine. Chronic alcohol consumption is a well-known risk factor for tissue injury. The link between alcohol use disorder (AUD) and kidney injury is intriguing but controversial, and the molecular mechanisms by which alcohol may damage the kidneys are poorly understood.

Alcohol can produce urine flow within 20 minutes of consumption; as a result of urinary fluid losses, the concentration of electrolytes in blood serum increases. These changes can be profound in chronic alcoholic patients, who may demonstrate clinical evidence of dehydration. One of the main functions of the kidneys is to regulate both the volume and the composition of body fluid, including electrically charged particles (i.e., ions), such as sodium, potassium, and chloride ions (i.e., electrolytes).

Alcohol and Your Kidneys

The answer to this version of the “chicken-and-egg” question remains to be elucidated. Chronic alcohol consumption may cause both fluid and solutes to accumulate, thereby increasing the overall volume of body fluids. In turn, such expansion addiction and termination of body fluid volume can contribute to high blood pressure, a condition often seen among chronic alcoholic patients. Alcohol can induce abnormally high phosphate levels (i.e., hyperphosphatemia) as well as abnormally low levels.

For example, in an early study on dogs (Chaikoff et al. 1948), investigators observed several striking alterations after chronic alcohol administration. The basement membrane of the glomerulus (see sidebar figure) became abnormally thickened and was characterized by cell proliferation. Further changes included enlarged and altered cells in the kidney tubules. In another study, Van Thiel and colleagues (1977) compared kidney structure and function in alcohol-fed and control rats. A cell’s function depends not only on receiving a continuous supply of nutrients and eliminating metabolic waste products but also on the existence of stable physical and chemical conditions in the extracellular fluid1 bathing it. Among the most important substances contributing to these conditions are water, sodium, potassium, calcium, and phosphate.

Alcohol’s Impact on Kidney Function

Uncoupling eventually leads to generation of damaging ROS like superoxide anion, instead of the vasorelaxant nitric oxide that maintains normal blood flow in the kidney. Excessive alcohol consumption can have profound negative effects on the kidneys and their function in maintaining the body’s fluid, electrolyte, and acid-base balance, leaving alcoholic people vulnerable to a host of kidney-related health problems. Despite the clinical importance of alcohol’s effects on the kidney, however, relatively few recent studies have been conducted to characterize them or elucidate their pathophysiology.

Clinical studies of hypertensive patients have demonstrated that reducing alcohol intake lowers blood pressure and resuming consumption raises it. Although the mechanisms responsible for these effects have not been established, an experimental study by Chan and Sutter (1983) offers some insight. In this study, male rats given 20-percent alcohol in their drinking water for 4 weeks experienced decreased urinary volume and sodium excretion as well as increased blood concentrations of hormones that raise blood pressure by constricting blood vessels. The results of this study suggest that alcohol’s influence on blood pressure may be attributable, at least in part, to its effects on the production of hormones that act on the kidneys to regulate fluid balance or that act on blood vessels to constrict them. In fact, IgA glomerulonephritis—acute inflammation of the kidney caused by an IgA immune response—is one of the most common types of primary glomerulonephritis worldwide (D’Amico 1987).

When you have liver disease, your body doesn’t balance the flow and filtering of blood as well as it should. This has a harmful effect on your overall health and can increase the chance of complications. Kidneys that have been overworked due to excess alcohol consumption don’t function properly. This makes them less able to filter blood and maintain the correct water balance in the body. The hormones that control kidney function can also be adversely affected. Alcohol consumption also is known to induce a state of low blood sugar (i.e., hypoglycemia) and activate the portion of the nervous system that coordinates the body’s response to stress (i.e., the sympathetic nervous system).

1. The overactivation of RAAS further aggravates oxidative stress in chronic alcoholism (Ungvari et al. 2004).
2. For example, in an early study on dogs (Chaikoff et al. 1948), investigators observed several striking alterations after chronic alcohol administration.
3. A cell’s function depends not only on receiving a continuous supply of nutrients and eliminating metabolic waste products but also on the existence of stable physical and chemical conditions in the extracellular fluid1 bathing it.
4. These changes in fluid volume, electrolyte balance, and blood pressure may have stimulated the activity of hormones to return body fluid volume and composition back to normal, which occurred soon after consumption.
5. Too often, some of these regular drinkers have more than five drinks at one time.

Evidence also exists that alcohol-related damage to the liver, in particular advanced liver cirrhosis, leads to hepatorenal syndrome (HRS)—a deterioration in renal function related to impaired circulation. The underlying mechanisms involved in the development and progression of HRS are incompletely understood, although it is plausible that the altered balance between vasoconstrictor and vasodilator factors plays a significant role (Lenz 2005). Alcohol-induced intestinal damage and increased mucosal translocation of bacterial endotoxin are crucial in the initiation and cyclobenzaprine: muscle relaxer uses side effects and dosage progression of alcoholic liver injury and in the pathogenesis of other alcohol-related diseases (Bala et al. 2014; Purohit et al. 2008). (For an in-depth discussion of alcohol and the digestive tract, see the article by Keshavarzian in this issue.) The direct role of alcohol-related endotoxin release in alcoholic kidney injury has not yet been studied. However, it is possible that activation of the innate immune system due to endotoxins released by a leaky gut plays a central role in the development of renal damage, as it does for liver damage (Zhang et al. 2008).

Treat gastritis by avoiding alcohol, pain medications, and recreational drugs. Your doctor may prescribe proton pump inhibitors or H2 antagonists to reduce the production of stomach acid. Severe or recurring kidney infections may require hospitalization or surgery.

In some cases, vast amounts of abdominal fluid may collect, occasionally more than 7 gallons (Epstein 1996). The few studies focusing on alcohol’s direct effects on perfusion in human kidneys suggest that regulatory mechanisms retain control over this component of kidney function despite alcohol consumption. Even at high blood amazon best sellers alcohol levels, only minor fluctuations were found in the rates of plasma flow and filtration through the kidneys (Rubini et al. 1955). Additional studies are needed to confirm these observations, however. Similarly, there’s minimal evidence to suggest that alcohol increases the risk of kidney stones or kidney infections.

How Much Alcohol is Too Much?

The overactivation of RAAS further aggravates oxidative stress in chronic alcoholism (Ungvari et al. 2004). As a consequence, oxidative stress not only propagates kidney failure, but it also contributes to the progression of chronic heart failure (Pacher et al. 2005) and leads to a vicious cycle in alcohol-induced cardiovascular complications. That said, epidemiological data have yet to confirm a relationship between alcohol consumption and chronic kidney disease. A recent meta-analysis (Cheungpasitporn et al. 2015) found little support for such a relationship. Their analysis included 20 studies representing a total of 292,431 patients. Even without binge drinking, regularly drinking too much too often can also damage the kidneys.

Unfortunately, alcohol has the potential to interfere with each of these functions. Check with your doctor, especially if you take medications that might be affected by using alcohol. Try swapping out alcoholic drinks for alternative beverages such as juices and teas. Coconut water, apple cider vinegar drinks, and hot chocolate are great options. You can make mocktails in a fancy glass if you want to drink something special, especially in social situations.

You may have kidney pain after drinking alcohol due to dehydration or inflammation of your stomach lining. But it can also happen if you have other health conditions, including a kidney infection. A compromised diluting ability has important implications for the management of patients with advanced liver disease.

Don’t miss your chance to TRIPLE your impact for children and adults living with kidney disease. You might wonder if you can continue to enjoy a glass of wine with dinner or your favorite craft IPA. The answer will depend on a few things, including your current health. See a doctor or therapist if you feel you’re dependent on alcohol or if it’s interfering with your life in some way. Your doctor may prescribe kidney medication or recommend programs in your area to help you.

Both of these factors affect hormones that regulate kidney function, just as changes in fluid volume and electrolyte balance do. Despite the multiple possible causes of acidosis, disturbances in acid-base balance are more frequently manifested as low acidity (i.e., alkalosis). Alkalosis was present in 71 percent of patients with established liver disease in 11 studies, and respiratory alkalosis was the most common disturbance in 7 of the studies (Oster and Perez 1996).