What is the impact of alcohol consumption for someone with CKD and high BP?

[okarol]

What is the impact of alcohol consumption for someone with kidney disease and high blood pressure?

Answer. For many adults, minimal alcohol intake usually causes no problems. Some studies have shown that one to two drinks a day may help to prevent heart disease. Excess drinking can cause many medical problems (see table on next page). It can cause heart disease, liver disease and even kidney disease. It can also cause high blood pressure (HBP). HBP may lead to stroke, heart disease and kidney disease. Medical problems from drinking happen more rapidly in women than in men. Drinking is also more dangerous for older people than for younger people. In one study, African- American men who only had one to two drinks a day were more likely to have HBP.2 Let us look at what too much drinking can do to the body and especially the kidneys.

How much alcohol can a person safely drink?

Men should not have more than two drinks a day. Women and older adults should not have more than one drink a day. One drink can be a 12-ounce bottle of beer, one glass of wine or one ounce (one shot) of whiskey. Some people should not drink at all. These are people advised by their doctor not to drink at all. Most people taking medications should not drink. Drinking can complicate how medications work. You should check with your doctor about drinking alcohol while on medication. Even if you are only using over-the-counter (OTC) medications, check with your doctor. Also, pregnant women should not drink.

Drinking Alcohol and HBP

More than two drinks a day can increase your chance of developing HBP.3 HBP is the number two cause of kidney failure. If you have HBP, alcohol can make it harder for you to keep your blood pressure controlled. People with HBP should be extra careful about drinking alcohol. It may interfere with their medications and increase their blood pressure.

Drinking Alcohol and Your Heart

People who only drink a little are less likely to have heart disease. They are less likely to die from heart disease than people who do not drink any alcohol or those who drink a lot. Small amounts of alcohol help to protect against heart disease. Heart disease can lead to kidney problems. If you do not drink, you should not start drinking just to try to help your heart. You can help your heart by exercising and following a healthy diet. If you do drink, keep it to less than two drinks a day.

Drinking Alcohol and Your Kidneys

More than 20 million Americans have kidney disease. Kidney disease is often "silent" in its early stages. This means that you may not see or feel any symptoms. For many people, kidney disease can often be treated when detected early. People who have an increased risk of developing kidney disease should have a test for protein in their urine and a blood test to check their level of kidney function. Drinking alcohol can hurt your kidneys in many ways and can increase the chance of needing dialysis.4, 5, 6 It may damage the kidney cells. It increases your chance of developing HBP, a leading cause of kidney disease. Drinking alcohol can interfere with your medicines and make it harder to control your pressure.

Drinking alcohol can cause the kidneys to increase urinary output. This can lead to dehydration. More than two drinks a day can cause a rise in blood pressure.7, 8 The carbohydrate load from drinking can cause obesity. This could increase the risk of diabetes and diabetic kidney disease. Drinking can interfere with the blood chemistries and increase the ability of the body to protect the kidneys.9 Many people who drink are more likely to smoke. Smoking also causes kidney disease.

Other Medical Problems from Drinking Alcohol

Drinking alcohol can interfere with your sleep. It also lowers the body’s immune system, which makes it easier for a person to get sick. There are other problems drinking causes for men. Drinking alcohol decreases the male hormone testosterone, which leads to decreased sexual function. Drinking also causes damage to unborn children.

Alcohol moves quickly into the brain and can impair thinking. It can increase the chance of a person mixing up or even missing medications. Alcohol also goes to the liver and can affect how the liver handles different medications. This can also affect blood levels of medications. It can cause the levels to be too high or too low and this can be dangerous. Alcohol can irritate your stomach, causing heartburn and eventually ulcers. People who drink are more likely to have cancer of the mouth, esophagus, stomach and intestines. Drinking leads to destruction of liver cells, called cirrhosis. This can lead to liver failure, which is a fatal condition.

Heavy alcohol drinking may cause some of the following medical problems.

    *

      Heart disease
    *

      High blood pressure
    *

      Stroke
    *

      Liver disease
    *

      Kidney disease
    *

      Heartburn and stomach ulcers
    *

      Lowered immune system
    *

      Sexual dysfunction
    *

      Sleep disorders
    *

      Cancer

Summary

Drinking alcohol can be dangerous for your kidneys. This is especially true if you have HBP or kidney disease. Always check with your doctor to make sure it is safe for you to drink. Even if it is safe, it is important to drink in moderation. One to two drinks a day for men and one drink a day for women and elderly. Being smart about drinking alcohol is another way to take care of your body.

Answer provided by Keith Norris, MD. Dr. Norris is a faculty member in the Department of Internal Medicine and the Associate Dean for Research at Charles R. Drew University in Los Angeles. Dr. Norris is also a member of the AAKP Medical Advisory Board.

References:

   1.

      National Kidney foundation. Alcohol and Your Health. [Web document: www.kidney.org/atoz/atozItem.cfm?id=46 - accessed 7-6-04].
   2.

      Fuchs FD, Chambless LE, Whelton PK, Nieto FJ, Heiss G. Alcohol consumption and the incidence of hypertension: The Atherosclerosis Risk in Communities Study. Hypertension. 2001; 37 (5): 1242-1250.
   3.

      Cushman WC. Alcohol consumption and hypertension. J Clin Hypertens. 2001 3 (3): 166-170.
   4.

      Cecchin E, De Marchi S. Alcohol misuse and renal damage. Addict Biol. 1996; 1 (1): 7-17.
   5.

      Heidland A, Horl WH, Schaefer RM, Teschner M, Weipert J, Heidbreder E. Role of alcohol in clinical nephrology. Klin Wochenschr. 1985; 63 (18): 948-958.
   6.

      Perneger TV, Whelton PK, Puddey IB, Klag MJ. Risk of end-stage renal disease associated with alcohol consumption. Am J Epidemiol. 1999; 150 (12): 1275-1281.
   7.

      Puddey IB, Beilin LJ, Vandongen R, et al. Evidence for a direct effect of alcohol consumption on blood pressure in normotensive men. A randomised controlled trial. Hypertension 1985; 7: 707-713.
   8.

      Smith RM, Spargo RM, King RA, et al. Risk factors for hypertension in Kimberley Aborigines. Med J Aust 1992; 156: 562-566.
   9.

      Vamvakas S, Teschner M, Bahner U, Heidland A. Alcohol abuse: potential role in electrolyte disturbances and kidney diseases. Clin Nephrol. 1998; 49 (4): 205-213.

The American Association of Kidney Patients presents Ask the Doctor, an opportunity for readers to submit kidney related health questions to healthcare professionals who specialize in an area of concern. The answers are not to be construed as a diagnosis and therefore, alterations in current healthcare should not occur until the patient’s physician is consulted.

This article originally appeared in the September/October 2004 issue of Kidney Beginnings: The Magazine, Vol. 3, No. 3.

[MooseMom]

My neph encouraged me to have the occasional glass of red wine.  I've never been much of a drinker, so limiting alcohol consumption is not a problem for me.  However, I did do something stupid several weeks ago.  We bought a bottle of red wine that we had not had before, and OMG it was soooo good.  I actually had a second glass, which is very rare for me.  I take a small dose of temazepam each night for insomnia, and that night, my mind just kept racing, so I took an extra one, something I am loathe to do but do on the occasions when I know that I'm going to have trouble sleeping.  Well, the next day was Saturday, and I was inert the whole day.  It being the weekend, I wanted to go out and about, and we did, but I could hardly move.  I finally just had to come home and take a nap, and then I woke up for a short while and then went back to sleep.  I was really worried because I thought my kidneys had finally given up the ghost resulting in an extremely sleepy MooseMom.  When I finally woke up again about 8PM, I felt much better, and I just couldn't understand what had happened.  I finally realized that TWO glasses of wine and TWO sleeping pills would OF COURSE put me right out.  That' was really dumb.

[Riki]

When I want to conserve fluid, but still want something to drink, I have a bottle of strawberry win in the fridge.  It's alcohol content is 4%, less than a bottle of beer, but I"ll sip on one glass for 2-3 hours, where I would probably drink the same sized glass of pop in a matter of a few minutes.

[Bruno]

I drink very little these days, don't seem to feel like it the way I used to. But I find my limit now is one glass of wine, I've tried two but I feel really stupid so I know one is enough. I've got some lovely gin and I'm going to try a gin and tonic (long glass) once a week this Christmas. I'll let you know what happens.
I can also tell you that a drink pre dialysis is not recommended (by my doctor) because control of high blood pressure is then very much an objective, but after dialysis when your BP comes back to normal it's a different thing altogether.
After dialysis beer seems to be a no-no because of its phosphorus content.
I hope that's a help. Cheers!

[Stoday]

When I was younger I'd go to a restaurant with my wife and we'd easily be able to consume two bottles of wine.

Not any more. Just one glass for me now. 

[Bruno]

Ah Stoday those were the days...my girl and I went out once every week without fail, I reckon it made our marriage, we enjoyed each others company and we would always drink ONE bottle of wine (not like you!) but we always had other drinkies before. I got so I suspected there was something wrong with the marriages of couples that didn't drink.
These days I think they look at us and think the same thing.