Association between alcohol intake and measures of incident CKD 

A paper published in PLOS One, analysed health screening data in Korean to investigate the association between alcohol consumption and chronic kidney disease.
The researchers comment that chronic kidney disease (CKD), of which current international definition is decreased kidney function shown by glomerular filtration rate (GFR) of less than 60 mL/min per 1.73 m2 or markers of kidney damage frequently shown by albuminuria or proteinuria, is one of the most important global health issues because of its heavy socio-economic burden, and the cost-effectiveness of CKD prevention programmes in high-risk subjects has been proven. Therefore, the influences of various lifestyles on the development of CKD should be investigated to develop effective strategies to prevent CKD. Considering the high percentage of the population who drink, the relationship between alcohol intake and CKD risk deserves much more attention.
In order to evaluate the association between alcohol intake, the risk of incident proteinuria, and change in estimated GFR (eGFR) as well as the possible sex differences in this association, the study analysed health screening data of more than 14 million Korean adults, who underwent health screening ≥3 times between 2009 and 2016 and who had a negative urine dipstick test for proteinuria and an eGFR ≥60 mL/min per 1.73 m2 at baseline.
eGFR was calculated with the Chronic Kidney Disease Epidemiology Collaboration equation. Proteinuria was defined as ≥1+ dipstick proteinuria and low eGFR as <60 mL/min/1.73 m2. The risk of incident proteinuria and low eGFR was analysed with an extended Cox model with alcohol intake level as a time-varying determinant and the annual change of eGFR with generalised linear model.
A J-shape association of alcohol intake with the incident proteinuria was observed in men (adjusted hazard ratio [aHR], 0.961 in men drinking alcohol <10 g/day; aHR 1.139 in men drinking alcohol ≥40 g/day, compared with non-drinking men), and a positive association was seen in women (aHR, 1.034, in women drinking alcohol
<10 g/day; aHR, 1.094 in women drinking alcohol
≥40 g/day, compared with non-drinking women). In both sexes, an inverse association of alcohol intake with the annual eGFR decline and incident low eGFR was observed.
This study observed a beneficial effect of moderate alcohol intake on incident proteinuria in men and a protective effect of alcohol intake of any amount on the annual eGFR decline and incident low eGFR in both sexes. The long-term implications of these observations need to be clarified with future studies, the authors comment.
Source: Association between alcohol intake and measures of incident CKD: An analysis of nationwide health screening data. Park M, Lee SM, Yoon HJ. PLoS One. 2019 Sep 20;14(9):e0222123.