title: Alcohol consumption, new onset of diabetes after transplantation, and all-cause mortality in renal transplant recipients.
abstract: BACKGROUND
  Renal transplant recipients (RTR) are often advised to refrain from alcohol because of possible interaction with their immunosuppressive medication. Although moderate alcohol consumption is associated with reduced risk of diabetes and mortality in the general population, this is unknown for RTR. Therefore, we investigated the association of alcohol consumption with new onset of diabetes after transplantation (NODAT), mortality, and graft failure in RTR.
  
  
  METHODS
  RTR were investigated between 2001 and 2003. Alcohol consumption was assessed by self-report. Mortality and graft failure was recorded until May 2009.
  
  
  RESULTS
  Six hundred RTR were studied (age 51 ± 12 years, 55% men). Of these RTR, 48% were abstainers, 38% had light alcohol intake, 13% had moderate intake, and 1% were heavy consumers. Moderate alcohol consumption was associated with a lower risk of developing NODAT over the follow-up period than was abstention (OR = 0.36 [0.2-0.6], P = <0.001). During follow-up for 7.0 years [6.2-7.5 years], 133 recipients died. In Cox regression analyses, moderate alcohol consumption was associated with lower mortality period than was abstention (hazard ratio = 0.40 [0.2-0.8], P = 0.009). Adjustment for confounders, including age and smoking, did not materially change this association. No association was found between alcohol consumption and graft failure.
  
  
  CONCLUSIONS
  Moderate alcohol consumption is associated with low prevalence of NODAT and reduced risk for mortality in RTR, in line with findings in the general population. These findings refute the common advice to refrain from alcohol in RTR.
authors.affiliation: Department of Nephrology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Dorien M
authors.initials: DM
authors.lastname: Zelle
authors.forename: Pramod K
authors.initials: PK
authors.lastname: Agarwal
authors.forename: Jessica L Pinto
authors.initials: JL
authors.lastname: Ramirez
authors.forename: Jaap J Homan
authors.initials: JJ
authors.lastname: van der Heide
authors.forename: Eva
authors.initials: E
authors.lastname: Corpeleijn
authors.forename: Reinold O B
authors.initials: RO
authors.lastname: Gans
authors.forename: Gerjan
authors.initials: G
authors.lastname: Navis
authors.forename: Stephan J L
authors.initials: SJ
authors.lastname: Bakker
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012189:Retrospective Studies; D014180:Transplantation / Q000401:mortality*