Alcohol consumption and incidence of decline in glomerular filtration rate and of proteinuria: the Osaka Kenko Innovation (TOKI) study.

BACKGROUND

Although excessive alcohol consumption is a critical factor for non-communicable diseases, its clinical relevance to chronic kidney disease is controversial.

METHODS

This retrospective cohort study, including 80,765 men and 88,507 women aged 40-74 years who underwent annual health checkups in Japan between April 2012 and March 2017, assessed a dose-dependent association between alcohol consumption (rare, occasional, and daily drinkers with ≤ 19, 20-39, 40-59, and ≥ 60 g/day) and incidence of ≥ 30% decline in estimated glomerular filtration rate (eGFR), eGFR < 60 ml/min/1.73 m2 and presence of proteinuria (dipstick urinary protein ≥ 1 +), using Cox proportional hazards models adjusted for clinically relevant factors.

RESULTS

The incidence of ≥ 30% eGFR decline was observed in 1231 (1.5%) men and 1291 (1.5%) women during the median observation period of 2.8 and 2.9 years, respectively. In men, daily drinkers consuming ≥ 40 g/day of ethanol were at significantly high risk for ≥ 30% eGFR decline (adjusted hazard ratio [95% confidence interval] of rare, occasional, and daily drinkers with ≤ 19, 20-39, 40-59, and ≥ 60 g/day: 1.00 [reference], 1.05 [0.87, 1.27], 0.99 [0.80, 1.21], 1.05 [0.88, 1.26], 1.23 [1.01, 1.51], 1.61 [1.22, 2.11], respectively). Similar dose-dependent associations with incidence of eGFR < 60 ml/min/1.73 m2 and proteinuria were observed in men. Contrary to men, alcohol consumption was not associated with eGFR decline and proteinuria in women.

CONCLUSION

Men with alcohol consumption ≥ 40 g/day were at a high risk of eGFR decline and development of proteinuria.