title: Levels of Hair Ethyl Glucuronide in Patients with Decreased Kidney Function: Possibility of Misclassification of Social Drinkers.
abstract: BACKGROUND
  The use of hair ethyl glucuronide (EtG) levels as a biomarker for chronic high intake of ethanol (EtOH) is increasing, and misclassification of alcohol consumption may have large implications for the patient. The aim of this study was to compare levels of hair EtG in patients with reduced kidney function to levels seen in a comparable control group and to investigate whether the hair EtG levels among kidney failure patients who are social drinkers may lead to a false-positive diagnosis of heavy drinking.
  
  
  METHODS
  A total of 41 patients with reduced kidney function and 42 healthy volunteers were included in the study. Both patients and the healthy volunteers reported moderate alcohol intake. The levels of EtG in hair (corrected for estimated daily intake of EtOH [EDI]) were compared between the 2 groups.
  
  
  RESULTS
  There was no significant difference between the groups regarding EDI. Despite this, there were significant higher levels of hair EtG (corrected for EDI) in the patient group compared to the control group (p < 0.001). Eight subjects (20%) in the patient group showed EtG levels in hair above 30 pg/mg, in contrast to no subjects among healthy volunteers (p = 0.002). In the patient group, there was significant correlation between levels of EtG in hair and both estimated glomerulus filtration rate and serum creatinine levels.
  
  
  CONCLUSIONS
  This study documents an increased risk of obtaining a false-positive diagnosis of heavy drinking among renal disease patients who are social drinkers. Interpretation of EtG levels in hair among patients with reduced kidney function must be performed with caution.
authors: Division of Forensic Sciences, Norwegian Institute of Public Health, Oslo, Norway.
authors: Jan Toralf
authors: JT
authors: Fosen
authors: Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
authors: Luca
authors: L
authors: Morini
authors: Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
authors: Cristina
authors: C
authors: Sempio
authors: Division of Internal Medicine, Department of Nephrology, Akershus University Hospital, Lørenskog, Norway.
authors: Rudiger
authors: R
authors: Ganss
authors: Division of Forensic Sciences, Norwegian Institute of Public Health, Oslo, Norway.
authors: Jørg
authors: J
authors: Mørland
authors: Division of Forensic Sciences, Norwegian Institute of Public Health, Oslo, Norway.|Center for psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway.
authors: Gudrun
authors: G
authors: Høiseth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D015415:Biomarkers / Q000032:analysis / Q000737:chemistry; D005260:Female; D005965:Glucuronates / Q000032:analysis*; D006197:Hair / Q000737:chemistry*; D006801:Humans; D007674:Kidney Diseases / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D007677:Kidney Function Tests / Q000145:classification / Q000379:methods; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D015813:Substance Abuse Detection / Q000145:classification* / Q000379:methods
chemical_list: D015415:Biomarkers; D005965:Glucuronates; C093924:ethyl glucuronide
keywords: Alcohol; Ethyl Glucuronide; Hair; Kidney Function