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 bodyís 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.
High blood pressure
Heartburn and stomach ulcers
Lowered immune system
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.
National Kidney foundation. Alcohol and Your Health. [Web document: www.kidney.org/atoz/atozItem.cfm?id=46
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Smith RM, Spargo RM, King RA, et al. Risk factors for hypertension in Kimberley Aborigines. Med J Aust 1992; 156: 562-566.
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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 patientís physician is consulted.
This article originally appeared in the September/October 2004 issue of Kidney Beginnings: The Magazine, Vol. 3, No. 3.