Alcohol consumption and kidney function decline in the elderly: alcohol and kidney disease.
BACKGROUND
Alcohol consumption appears to be protective for cardiovascular disease; however, its relationship with kidney disease is unclear.


METHODS
This prospective cohort study included 4343 subjects from the Cardiovascular Health Study, a longitudinal, community-based cohort of persons aged ≥65 from four US communities. We used previously defined categories based on weekly alcohol consumption: none, former, <1 drink, 1-6 drinks, 7-13 drinks and ≥14 drinks. Cystatin C was measured at baseline, year 3 and year 7; eligible subjects had at least two measures. Estimated GFR(cys) was calculated from cystatin C. The primary outcome was rapid kidney function as an annual estimated GFR (eGFR(cys)) loss >3 mL/min/1.73 m(2)/year.


RESULTS
Eight percent of the cohort reported former alcohol use and 52% reported current alcohol consumption. During a mean follow-up of 5.6 years, 1075 (25%) participants had rapid kidney function decline. In adjusted logistic regression models, there was no association between alcohol use and kidney function decline (odds ratio, 95% confidence interval: none = reference; former = 1.18, 0.89-1.56; <1 drink = 1.20, 0.99-1.47; 1-6 = 1.18, 0.95-1.45; 7-13 = 1.10, 0.80-1.53; >14 = 0.89, 0.61-1.13). Results were similar with kidney function decline as a continuous outcome.


CONCLUSIONS
Our results suggest that moderate alcohol consumption has neither adverse nor beneficial effects on kidney function. Although clinicians will need to consider the potential deleterious effects associated with alcohol consumption, there does not appear to be a basis for recommending that older adults discontinue or initiate light to moderate alcohol consumption to protect against kidney disease.
Menon
Vandana
V
Division of Nephrology, Tufts Medical Center, Boston, MA, USA. vmenon@tuftsmedicalcenter.org
Katz
Ronit
R
Mukamal
Kenneth
K
Kestenbaum
Bryan
B
de Boer
Ian H
IH
Siscovick
David S
DS
Sarnak
Mark J
MJ
Shlipak
Michael G
MG
D000368:Aged; D000375:Aging / Q000502:physiology*; D000428:Alcohol Drinking; D015331:Cohort Studies; D055316:Cystatin C / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000502:physiology*; D007674:Kidney Diseases / Q000517:prevention & control*; D008297:Male; D011446:Prospective Studies
C525030:CST3 protein, human; D055316:Cystatin C
Free Radic Biol Med. 2002 Aug 1;33(3):409-22
12126763
Nephrol Dial Transplant. 2005 Aug;20(8):1610-6
15870217
Ann Intern Med. 1999 Mar 16;130(6):461-70
10075613
Arterioscler Thromb Vasc Biol. 2003 Dec;23(12):2252-9
14563651
Arch Intern Med. 2008 Nov 10;168(20):2212-8
19001197
Kidney Int. 2008 Apr;73(7):870-6
18185503
Kidney Int. 2007 Aug;72(3):247-59
17568785
Epidemiol Rev. 1993;15(2):328-51
8174661
Am J Kidney Dis. 2008 Mar;51(3):395-406
18295055
Arch Intern Med. 2005 May 9;165(9):1048-53
15883245
Arch Intern Med. 2000 Apr 10;160(7):1025-30
10761969
Am J Epidemiol. 1999 Dec 15;150(12):1275-81
10604769
Nephrol Dial Transplant. 2003 Aug;18(8):1549-54
12897093
Ann Epidemiol. 2003 Nov;13(10):712-20
14599736
J Am Geriatr Soc. 2006 Jan;54(1):30-7
16420195
Ann Epidemiol. 1991 Feb;1(3):263-76
1669507
BMC Public Health. 2006 May 03;6:118
16670030
BMJ. 1999 Dec 11;319(7224):1523-8
10591709
Addict Biol. 1996;1(1):7-17
12893483
J Chronic Dis. 1984;37(8):617-23
6746851
Am J Epidemiol. 2006 Aug 1;164(3):263-71
16775042
Ann Epidemiol. 1993 Jul;3(4):358-66
8275211
Curr Opin Nephrol Hypertens. 2001 May;10(3):385-90
11342802
Stroke. 2005 Sep;36(9):1830-4
16081863
J Am Coll Cardiol. 2006 Jul 18;48(2):305-11
16843180