The kidneys are responsible for filtering blood to remove waste products, cellular debris, metabolic byproducts and extra water, which becomes urine. Kidneys play a crucial role in controlling blood pressure, maintaining red blood cell populations, and hormone production.
How Does Alcohol Affect Your Kidneys?
Despite its popularity as a recreational drug, alcohol is a potent toxin. The liver will spend about an hour breaking the alcohol from one drink into less toxic byproducts at the expense of normal metabolic function. Importantly, because the rate of metabolism doesn’t change, additional drinks accumulate in your bloodstream where they remain until the liver can metabolize them.
Chronic alcohol use disorder (AUD) forces the liver to constantly detoxify alcohol in the blood and, over time, cells in the liver become damaged and die, leading to scarring in the liver (fibrosis). A consequence of liver damage is the production of chemicals that cause vasoconstriction (constriction of blood vessels), which raises blood pressure. Chronically elevated blood pressure is linked to kidney disease.
While data conclusively shows that chronic AUD is extremely damaging to the liver, data evaluating the effects of alcohol on the kidneys is far less clear cut. Even within the same study, the data is seemingly at odds. For example, one study evaluated two measures of kidney failure in men who had consumed three or more drinks per day for more than five years. The men were found to have high levels of a protein called albuminuria in their urine, which is indicative of kidney failure, but were simultaneously found to have improved kidney function compared to non-drinkers as measured by the “estimated glomerular filtration rate” (eGFR) a standard test used to determine kidney function.
Is Alcohol Causing My Kidney Pain?
Although alcohol use has yet to be conclusively linked to kidney pain, there are a few potential mechanisms that may explain kidney pain after a night of drinking:
- When you are dehydrated, a hormone called vasopressin is produced that tells the kidneys to stop producing urine in order to retain water. Alcohol inhibits vasopressin production, so even if you are severely dehydrated, your kidneys work hard to continue producing urine.
- The kidneys regulate pH in the body, and heavy alcohol use can change pH (especially if you vomit). Consequently, the kidneys have to work hard to restore the pH balance.
- Heavy alcohol use increases blood pressure, which forces the kidneys to work harder to filter the blood.
Kidney Problems and Alcohol
Evidence is clear that AUD causes severe liver damage and convincing data exists that links AUD to cardiovascular diseases. However, data linking any amount of alcohol use to kidney damage has major discrepancies. Although the data on a direct link is unclear, it is likely that chronic AUD’s negative effects on the liver function through indirect means.
Alcohol and Kidney Stones
The most often cited reason that alcohol could cause kidney stones is the fact that alcohol consumption leads to dehydration, but empirical data that supports this claim is scarce. Similarly, alcohol-induced pH changes could potentially affect kidney stone development, but again, data is lacking. Moderate alcohol consumption has been shown to be protective against kidney stones.
Alcohol and Kidney Disease
Whether alcohol directly contributes to kidney disease is controversial. However, the link between AUD and liver and cardiovascular diseases is well established, as are links between the liver, cardiovascular diseases and reduced kidney function.
In addition, chronic AUD causes substantial injury to several other organ systems that affect kidney function, including the gastrointestinal tract and even muscle tissue. When organs are injured, they release molecules that promote inflammation and damaging oxidation (which is why antioxidants became such a hit as a diet supplement). The net result is that input to the kidneys from injured organ systems delivers damaging molecules and proteins that accumulate in the kidneys. Over time, the aggregation of harmful products can lead to kidney disease.
It should be noted that a number of well-designed studies have found that alcohol may be protective against kidney disease and that more alcohol offered more protection. However, the mechanism of this protection remains unclear and in light of substantial literature documenting the negative effects of chronic AUD on kidney function, the most appropriate route of action is to drink only in moderation.
Alcohol and Kidney Failure
Whether there is a conclusive link between alcohol and kidney failure remains to be determined. Much of the data that has been published is in disagreement, even within the same study. For example, a 2009 study determined that three or more drinks per day was significantly linked to increased urinary levels of a protein called albuminuria, which is indicative of kidney failure. However, the same study found that moderate to heavy alcohol consumption was protective against liver failure as measured by eGFR.
A 2013 study also found that kidney function as measured by eGFR was worse in non-drinkers compared to drinkers. The authors of the papers urge caution in interpreting the results as an indication that alcohol use can protect against kidney failure, especially considering that other reports indicate that alcohol use is associated with kidney failure. For example, a 1999 study found that consumption of more than two drinks per day was associated with end-stage renal disease (the last stage of chronic kidney disease).
Alcohol and Kidney Infection
Very little data exists on the role of alcohol in kidney infections. A 1994 study evaluated whether chronic AUD was associated with a kidney infection called acute postinfectious glomerulonephritis (APIGN) and found that AUD was a risk factor. However, their conclusion was complicated by the fact that 47% of the people they evaluated had cirrhosis, which is a sign of late-stage liver failure and indicates overall poor health. A 2008 study evaluated 86 patients with APIGN and found a history of AUD in only 2%, although the study cites statistics from research conducted in Germany and France between 1976 and 1993 that reported a history of AUD in 57% and 30% of patients, respectively. Taken together, the data does not provide a convincing link between alcohol use and kidney infection.
Preventing Kidney Damage from Alcohol
In spite of a great deal of conflicting evidence on whether alcohol leads to kidney injury, the fact that alcohol causes substantial damage to the liver and other organs that input into the kidney suggests that the most prudent course of action is to consume alcohol in moderation.
If you struggle with alcohol use, contact The Recovery Village Palm Beach today to speak to a representative about how professional addiction treatment can help you achieve a healthier future.
National Institute of Diabetes and Digestive and Kidney Diseases. “Your Kidneys & How They Work.” June 2018. Accessed August 19, 2019.
National Institute of Diabetes and Digestive and Kidney Diseases. “High Blood Pressure & Kidney Disease.” September 2014. Accessed August 19, 2019.
White, Sarah; et al. “Alcohol consumption and 5-year onset of chronic kidney disease: the AusDiab study.” Nephrology Dialysis Transplantation, March 2009. Accessed August 19, 2019.
AffiliatedUrologists.com. “Effects of Alcohol on the Kidneys.” Accessed August 19, 2019.
Curhan, Gary C; Willett, Walter C; Speizer, Frank E; Stampfer, Meir J. “Beverage use and risk for kidney stones in women.” Annals of Internal Medicine, April 1998. Accessed August 19, 2019.
Varga, Zoltan V; Matyas, Csaba; Paloczi, Janos; Pacher, Pal. “Alcohol Misuse and Kidney Injury: Epidemiological Evidence and Potential Mechanisms.” Alcohol Research, 2017. Accessed August 19, 2019.
Schaeffner, Elke; et al. “Alcohol Consumption and the Risk of Renal Dysfunction in Apparently Healthy Men.” JAMA Internal Medicine, May 2009. Accessed August 19, 2019.
Hsu, Yueh-Han; Pai, Hsiang-Chu; Chang, Yao-Mao; Liu, Wen-Hsin & Hsu; Chih-Cheng. “Alcohol consumption is inversely associated with stage 3 chronic kidney disease in middle-aged Taiwanese men.” BMC Nephrology, November 2013. Accessed August 19, 2019.
Perneger, Thomas V; Whelton, Paul K; Puddey, Ian B; Klag, Michael J. “Risk of End-stage Renal Disease Associated with Alcohol Consumption.” American Journal of Epidemiology, 1999. Accessed August 19, 2019.
Keller, Christine K; Andrassy, K; Waldherr, R; Ritz, Eberhard. “Postinfectious glomerulonephritis–is there a link to alcoholism?” Quarterly Journal of Medicine, February 1994. Accessed August 19, 2019.
Nasr, Samih; et al. “Acute Postinfectious Glomerulonephritis in the Modern Era: Experience With 86 Adults and Review of the Literature.” Medicine, January 2008. Accessed August 19, 2019.