NDT Advance Access published online on March 22, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp114
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Alcohol consumption and 5-year onset of chronic kidney disease: the AusDiab study
1 The George Institute for International Health, Sydney 2 Central Clinical School, Faculty of Medicine, University of Sydney 3 Department of Medicine, Monash Medical Centre, Melbourne 4 Baker IDI Heart and Diabetes Institute, Caulfield, Victoria 5 Department of Transplantation, Royal Prince Alfred Hospital, Sydney, Australia
Correspondence and offprint requests to: Sarah White; E-mail: swhite{at}george.org.au
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Abstract |
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Background. Excessive alcohol consumption is a risk factor for hypertension and stroke; however, evidence for an association with chronic kidney disease is conflicting.
Methods. A total of 6259 adults 
25 years of age, without a history of alcohol dependence, participating in baseline (1999–2000) and follow-up (2004–2005) phases of an Australian population-representative study (AusDiab) were the subject of this analysis. Alcohol consumption status and volume/frequency were collected by standardized interviewer administered questionnaires and self-administered food frequency questionnaires. The outcomes were as follows: (i) 5-year decline in estimated glomerular filtration rate (eGFR) 10%, with baseline eGFR 60 and final eGFR <60 mL/min/1.73 m2, and (ii) 5-year doubling of albumin to creatinine ratio (ACR) with final ACR 2.5 (males)/ 3.5 (females) mg/mmol, in the absence of albuminuria at baseline.
Results. Self-identification as a moderate or heavy, versus light, drinker was associated with elevated risk of albuminuria in males and females <65 years of age (OR, 95% CI: males 1.87, 0.99–3.52; females 2.38, 1.37–4.14). Odds of de novo eGFR <60 mL/min/1.73 m2 were 0.34 (95% CI 0.22–0.59) and 0.68 (95% CI 0.36–1.27) in males and females, respectively, who were moderate–heavy drinkers. Alcohol intake of 30 g/day was associated with an increased risk of albuminuria after adjustment for age, sex and baseline kidney function (OR = 1.59, 95% CI 1.07–2.36), but a reduced risk of eGFR <60 mL/min/1.73 m2 (OR = 0.59, 95% CI 0.37–0.95), compared with consumption of <10 g/day.
Conclusions. Moderate–heavy alcohol consumption may be an important modifiable risk factor for albuminuria in the general population. The natural history of alcohol-induced kidney damage and how this relates to markers of kidney function in the general population warrant further research.
Keywords: albuminuria; alcohol; chronic kidney disease; epidemiology; estimated glomerular filtration rate
Received for publication: 14.12.08
Accepted in revised form: 24. 2.09