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The Role of Alcohol and Kidney Health: What You Should Know

Nov 3, 2023

The Centers for Disease Control estimates that most adults (2 out of 3) in the U.S. consume alcohol. In the U.S., a standard drink contains 0.6 ounces of pure alcohol, with heavy drinking being defined as eight or more standard drinks per week for women and 15 or more standard drinks per week for men.

Drinking a little alcohol (one to two standard drinks) usually does not cause severe effects on a healthy adult. However, excessive drinking- more than four standard drinks per day can cause adverse health effects and damage the kidneys.

Key Points

Kidney function overview

The kidneys are two bean-shaped organs that are made up of roughly a million nephrons (filtering units). Each nephron is made up of a tubule and a glomerulus (a filter). These nephrons work to filter the blood in the body to return the nutrients back into the bloodstream and remove waste products.

The kidneys perform the following functions in the human body:

  • Filter out any waste products or harmful substances like alcohol from the blood
  • Control the production of red blood cells
  • Release hormones that regulate blood pressure levels
  • Balance the body’s fluids
  • Create an active form of vitamin D that helps promote healthy bones

Kidney disease is characterized as any damage to the kidneys that impacts their ability to filter blood the way they usually do. People with one or more of the following risk factors may be at a higher risk of developing kidney disease:

Having risk factors does not mean that you will definitely develop kidney disease. Talk to your healthcare provider about kidney testing if you have one or more risk factors for kidney disease.

The Link Between Kidney Disease and Alcohol

The prevalence of kidney disease is increasing at a significant rate, with more than 1 in 7 American adults being diagnosed with kidney disease. Kidney disease is not reversible and often only presents with symptoms until the later stages.

Alcohol does not directly cause damage to the kidneys. However, the negative impact that it has on the body may cause changes in the functioning of the kidneys. Frequent heavy or binge drinking doubles the risk of developing kidney disease.

Alcohol and liver function

Chronic drinking of alcohol can cause liver disease. This increases the strain placed on the kidneys as they have to compensate for the damaged liver. The rate of blood flow to the kidneys and glomerular filtration rate are regulated in healthy kidneys. Liver disease affects this regulation process.

While alcohol mainly impacts the liver, there have been recorded cases where alcoholic liver disease has directly caused kidney disease. This may happen in people with alcoholic hepatitis or alcoholic cirrhosis.

In the United States, it has been found that most patients who have both liver disease and linked kidney complications are dependent on alcohol.

Alcohol increases blood pressure

It has been found that alcohol has an effect on both heart rate and blood pressure. Low doses of alcohol have little to no effect on heart rate or blood pressure. In contrast, excessive amounts of alcohol may affect blood pressure levels.

Those who consume more than a moderate amount of alcohol (more than two drinks a day are at an increased risk of developing hypertension (high blood pressure). Alcohol affects the muscles in the blood vessels, which may cause them to narrow. The heart then needs to work harder to pump (move) blood around the body, thus increasing blood pressure.

High blood pressure is an important risk factor for developing kidney disease. It is the second most common cause of kidney failure. The increased force of blood flowing through the small blood vessels in the kidney causes damage to the surrounding tissue.

Managing blood pressure levels is vital in helping manage and prevent kidney disease progression.

Alcohol causes dehydration

One of the many roles the kidneys have in the body is maintaining fluid balance. Alcohol affects the kidney’s ability to regulate fluid balance. While alcohol is a liquid, it is also a diuretic, which causes the body to remove fluids at an increased rate, causing dehydration. Dehydration can affect the normal functioning of organs and cells.

Dehydration is an added challenge for people with kidney disease as it puts more strain on the already damaged kidneys.

Drinking too much fluid with kidney disease can cause a build-up of fluid and other severe health conditions. Some kidney disease patients may be required to limit their fluid intake and thus need to factor in the alcohol they consume into their daily fluid allowance.

Kidney pain after consuming alcohol

There is no research to show a direct link between kidney pain and alcohol. However, as alcohol is a diuretic, it can cause dehydration. People who are dehydrated are at an increased risk of developing kidney stones.

Binge drinking or frequent heavy drinking may cause acute kidney injury (AKI). An AKI occurs when there is a build-up of waste products or toxins at a faster rate than the kidneys can filter out. This sudden episode of kidney damage or failure may occur within a few hours or a few days.

Someone with acute kidney injury may experience:

  • Kidney pain
  • Decreased urine production
  • Swollen legs, ankles, and face
  • Chest pressure or pain
  • Confusion
  • Nausea
  • Tiredness or fatigue

Treatment for AKI generally requires hospitalization. In severe cases, dialysis may be necessary to help replace kidney function until the kidneys are able to recover—the chances of developing kidney disease increase with every AKI episode.

Precautions to Keep in Mind for Those with Kidney Disease

When consumed in a safe manner, alcohol may not cause direct harm to the kidneys. However, if you have kidney disease, you will need to take a couple of precautions to protect your kidney function.

Living with kidney disease, you will need to be mindful of medications, fluid intake, and any other health conditions that you may have. Healthcare providers will prescribe certain medications to help manage kidney disease symptoms, high blood pressure, or diabetes. These specific medications and most medications in general should not be mixed with alcohol. Ask your healthcare provider about the negative impacts and reactions that alcohol may have on the medications you have been prescribed.

If you have been placed on a fluid-restriction diet, you will need to count the alcohol. Talk to your renal dietician about understanding how to include alcohol if you choose to. If you have any questions about consuming alcohol and your kidney disease, talk to your nephrologist or renal dietician.

Panoramic Health

Panoramic Health is a value-based kidney care platform that is led by physicians with over 14 years of experience treating patients across the CKD-ESRD continuum. We provide a transformative approach to care delivery as we partner with health systems, providers, and practices.

Our ecosystem of providers is focused on providing patients with personalized and compassionate care via holistic care coordination.