Author: John Carter

Drinking Alcohol with Chronic Kidney Disease

In addition, hydrogen ion concentration (i.e., acid-base balance) influences cell structure and permeability as well as the rate of metabolic reactions. The amounts of these substances must be held within very narrow limits, regardless of the large variations possible in their intake or loss. The kidneys are the organs primarily responsible for regulating the amounts and concentrations of these substances in the extracellular fluid. Studies suggest that ethanol consumption may increase renal expression of other potential sources of free radicals involving a family of enzymes called nitric oxide synthases (Tirapelli et al. 2012).

1. Both of these factors affect hormones that regulate kidney function, just as changes in fluid volume and electrolyte balance do.
2. The investigators noted increased plasma and extracellular fluid volume 1 week after chronic alcohol ingestion, and these volume expansions persisted for the remaining 7 weeks of the study.
3. It may be that toxins released from the intestines into blood circulation because of ethanol’s effects on the digestive system activate the expression of nitric oxide synthase.
4. If you are living with diabetes and kidney disease, it is important to stay in control of your blood sugar so you can be your healthiest and avoid other…

Another study with dogs (Beard et al. 1965) disclosed that the effects of chronic alcohol consumption endured even longer. The investigators noted increased plasma and extracellular fluid volume 1 week after chronic alcohol ingestion, and these volume expansions persisted for the remaining 7 weeks of the study. Similar alterations have been found in body fluid volumes among chronic alcoholic patients. Binge drinking (usually more than four to five drinks within two hours) can raise a person’s blood alcohol to dangerous levels. This can cause a sudden drop in kidney function known as “acute kidney injury.” When this happens, dialysis is needed until a person’s kidney function returns to normal. Acute kidney injury usually goes away in time, but in some cases, it can lead to lasting kidney damage.

It’s unclear why this might occur, but experts warn that the risks of drinking alcohol don’t outweigh this potential benefit. Heavy drinking makes it more difficult for you to qualify for a kidney transplant. Over time, alcohol can damage the kidneys, according to the National Kidney Foundation. Though scientists agree that alcohol can play a role in the development of certain types of cancer, kidney cancer isn’t one of them. We used data from the National Health Interview Survey (NHIS) in 2001, 2005, and 2009; the National Health Insurance research database; and, the National Deaths Dataset. All data were composed, organized, and explored in the Health and Welfare Data Science Center of Ministry of Health and Welfare in Taiwan.

What are the first signs of kidney damage from alcohol?

As the rate of glucose breakdown increases, profound hypophosphatemia potentially can result. (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). Due to the metabolism of ethanol, significant amounts of acetate are produced and subsequently incorporated into acetyl-coenzyme-A, a molecule that participates in metabolism of proteins, lipids, and carbohydrates. Protein acetylation—adding an acetyl group to a protein—is integral to regulating processes controlled by mitochondria, including fatty acid metabolism and antioxidant defense (Choudhary et al. 2014). This could also be a significant factor contributing to ethanol-induced mitochondrial dysfunction in the kidneys (Harris et al. 2015).

Their results show not only how alcohol disrupts homeostasis but also how the body reacts to restore it. Following moderate alcohol consumption—about 24 oz—of nonalcoholic beer with 1 milliliter of alcohol per kilogram of body weight added, the investigators noted several effects. Alcohol-induced urination reduced the subjects’ plasma volume, resulting in an increased concentration of plasma sodium. In addition, the subjects’ blood pressure and plasma potassium concentration decreased. 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.

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. Each 4.5-inch-long kidney contains about 250 of the largest collecting ducts, each duct transmitting urine from approximately 4,000 nephrons. In addition to their role in regulating the body’s fluid composition, the kidneys produce hormones that influence a host of physiological processes, including blood pressure regulation, red blood cell production, and calcium metabolism. Besides producing hormones, the kidneys respond to the actions of regulatory hormones produced in the brain, the parathyroid glands in the neck, and the adrenal glands located atop the kidneys.

Potential Mechanisms of Alcoholic Kidney Injury: Lessons From Experimental Studies

The National Health Interview Survey selected participants while using a multistage stratified systematic sampling design. Participant information, including education, income, marriage status, and lifestyle behaviors, were obtained during in-person interviews. The National Health Insurance research database comprises medical information of nearly 99% of Taiwanese people, including ambulatory and inpatient care. To keep the kidneys functioning optimally and to maintain functional stability (i.e., homeostasis) in the body, a variety of regulatory mechanisms exert their influence. Alcohol can perturb these controls, however, to a degree that varies with the amount of alcohol consumed and the particular mechanism’s sensitivity. Of the 48 gallons of filtrate processed through the nephrons of the kidneys each day, only about 1 to 1.5 quarts exit as urine.

Drinking alcohol can affect many parts of your body, including your kidneys. A little alcohol—one or two drinks now and then—usually has no serious effects. A compromised diluting ability has important implications for the management of patients with advanced liver disease. Restricting the fluid intake of hyponatremic patients eventually should restore a normal fluid balance; unfortunately, this restriction may be difficult to implement. Patients frequently fail to comply with their physician’s orders to limit their fluid intake.

In turn, such expansion of body fluid volume can contribute to high blood pressure, a condition often seen among chronic alcoholic patients. 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. The kidney tubules play an important role in keeping the body’s water and electrolyte levels in equilibrium. In many cases, control mechanisms govern the rate of reabsorption or secretion in response to the body’s fluctuating needs (see table for a summary of the body processes influenced by key electrolytes).

Alcohol-Metabolism Derived Intermediaries

Each of the 2 million functional units (i.e., nephrons) in a pair of normal kidneys forms urine as it filters blood plasma of substances not needed by the body. Within each nephron, blood plasma enters a tiny ball of unusually permeable capillaries (i.e., the glomerulus), filters into a capsule that surrounds the glomerulus, then flows through a long, looping conduit called the nephron tubule. Regular heavy drinking can eventually cause CKD, which can lead to kidney failure. There’s no cure for CKD, but treatment can help relieve symptoms and keep it from getting worse. However, alcohol consumption can have negative effects on the body and should generally be avoided if you want to keep your kidneys healthy.

More than two drinks a day can increase your chance of developing high blood pressure. Drinking alcohol in these amounts is a risk factor for developing a sign of kidney disease, protein in the urine (albuminuria). The good news is that you can prevent this by not drinking too much alcohol.

Blood-Flow Changes

One such complication is impaired vitamin D metabolism (Shankar et al. 2008), which may influence the function of several other organs, creating a vicious cycle. Alcohol causes changes in the function of the kidneys and makes them less able to filter the blood. Alcohol also affects the ability to regulate fluid and electrolytes in the body.

It is not known whether chronic alcoholic patients experience a similar difference in the ADH response as they age, however. Normally the rate of blood flow, or perfusion, (i.e., hemodynamics) through the kidneys is tightly controlled, so that plasma can be filtered and substances the body needs can be reabsorbed under optimal circumstances (see sidebar). Established liver disease impairs this important balancing act, however, by either greatly augmenting or reducing the rates of plasma flow and filtration through the glomerulus.