Alcohol consumption is inversely associated with stage 3 chronic kidney disease in middle-aged Taiwanese men

BMC Nephrology

Chih-Cheng Hsu¹  Wen-Hsin Liu⁴  Yao-Mao Chang²  Hsiang-Chu Pai³  Yueh-Han Hsu³ 

[1] Department of Health Services Administration, China Medical University and Hospital, Taichung City 404, Taiwan;Center for Liberal Arts, Taipei Medical University, Taipei 110, Taiwan;Department of Nursing, Min-Hwei Junior College of Health Care Management, Tainan City 736, Taiwan;Division of Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City 600, Taiwan

关键词: Taiwan;    Proteinuria;    Gender;    Chronic kidney disease;    Alcohol consumption;   

Others  :  1082785
DOI  :  10.1186/1471-2369-14-254

 received in 2013-05-10, accepted in 2013-11-12,  发布年份 2013

【 摘 要 】

Background

Chronic kidney disease (CKD) is a major global public health burden, but there is limited understanding of the relationship of alcohol consumption with CKD.

Methods

In this cross-sectional multivariable study, all participants of a health check-up program in Ditmanson Medical Foundation Chia-Yi Christian Hospital in Taiwan from 2003 to 2009 (15 353 women and 11 900 men) were included for analysis. Estimated glomerular filtration rate was used to define CKD stage and history of alcohol consumption was obtained by self-reporting. Multivariable logistic regression analyses of gender-specific association of alcohol drinking with stage 3 CKD were conducted. A trend tests was conducted to check the dose–response relationship of alcohol consumption with renal disease. A sensitivity test was conducted to rule out the likelihood of reverse causality.

Results

The prevalence of stage 3 CKD was lower in drinkers than non-drinkers (p < 0.001) and the percentage of drinkers with stage 3 CKD was less than that of non-drinkers. Multivariable analysis indicated that alcohol consumption was negatively associated with the presence of stage 3 CKD in men (adjusted odds ratio [aOR] for occasional drinking: 0.68, 95% CI: 0.59 ~ 0.78, p < 0.001; aOR for frequent drinking: 0.47, 95% CI: 0.35 ~ 0.63, p < 0.001). Advanced age, hypertension, anemia, BMI of at least 24, hyperuricemia, and proteinuria were also associated with stage 3 CKD in men. Trend tests indicated lower odds of having stage 3 CKD with increased alcohol consumption in both genders. Subgroup analyses and sensitivity tests also indicated the reverse association between alcohol consumption and stage 3 CKD in men regardless of age, diabetes status, and other risky behaviors.

Conclusions

Alcohol consumption was inversely associated with stage 3 CKD in Taiwanese men. However, considering the potential of other health damage with alcohol consumption, the current results should be interpreted cautiously.

【 授权许可】

   
2013 Hsu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van Lente F, Levey AS: Prevalence of chronic kidney disease in the United States. JAMA 2007, 298:2038-2047.
• [2]Chadban SJ, Briganti EM, Kerr PG, Dunstan DW, Welborn TA, Zimmet PZ, Atkins RC: Prevalence of kidney damage in Australian adults: the AusDiab kidney study. J Am Soc Nephrol 2003, 14:S131-S138.
• [3]Hsu CC, Hwang SJ, Wen CP, Chang HY, Chen T, Shiu RS, Horng SS, Chang YK, Yang WC: High prevalence and low awareness of CKD in Taiwan: a study on the relationship between serum creatinine and awareness from a nationally representative survey. Am J Kidney Dis 2006, 48:727-738.
• [4]United States Renal Data System (USRDS) 2012 Annual Data Report. [http://www.usrds.org/2012/pdf/v2_ch12_12.pdf webcite]
• [5]Wu MJ, Shu KH, Liu PH, Chiang PH, Cheng CH, Chen CH, Yu DM, Chuang YW: High risk of renal failure in stage 3B chronic kidney disease is under-recognized in standard medical screening. J Chin Med Assoc 2010, 73:515-522.
• [6]Tanaka K, Hara S, Kushiyama A, Ubara Y, Yoshida Y, Mizuiri S, Aikawa A, Kawatzu S: Risk of macrovascular disease stratified by stage of chronic kidney disease in type 2 diabetic patients: critical level of the estimated glomerular filtration rate and the significance of hyperuricemia. Clin Exp Nephrol 2011, 15:391-397.
• [7]Ito S, Naritomi H, Ogihara T, Shimada K, Shimamoto K, Tanaka H, Yoshiike N: Impact of serum uric acid on renal function and cardiovascular events in hypertensive patients treated with losartan. Hypertens Res 2012, 35:867-873.
• [8]Keith DS, Nichols GA, Gullion CM, Brown JB, Smith DH: Longitudinal follow-up and outcomes among a population with chronic kidney disease in a large managed care organization. Arch Intern Med 2004, 164:659-663.
• [9]Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY: Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004, 351:1296-1305.
• [10]WHO: Global status report on alcohol and health 2011. Geneva: World Health Organization; 2011:37-41.
• [11]Perneger TV, Whelton PK, Puddey IB, Klag MJ: Risk of end-stage renal disease associated with alcohol consumption. Am J Epidemiol 1999, 150:1275-1281.
• [12]Shankar A, Klein R, Klein BE: The association among smoking, heavy drinking, and chronic kidney disease. Am J Epidemiol 2006, 164:263-271.
• [13]White SL, Polkinghorne KR, Cass A, Shaw JE, Atkins RC, Chadban SJ: Alcohol consumption and 5-year onset of chronic kidney disease: the AusDiab study. Nephrol Dial Transplant 2009, 24:2464-2472.
• [14]Savdie E, Grosslight GM, Adena MA: Relation of alcohol and cigarette consumption to blood pressure and serum creatinine levels. J Chronic Dis 1984, 37:617-623.
• [15]Cueto-Manzano AM, Martinez-Ramirez HR, Cortes-Sanabria L: Management of chronic kidney disease: primary health-care setting, self-care and multidisciplinary approach. Clin Nephrol 2010, 74:99-104.
• [16]Schaeffner ES, Kurth T, de Jong PE, Glynn RJ, Buring JE, Gaziano JM: Alcohol consumption and the risk of renal dysfunction in apparently healthy men. Arch Intern Med 2005, 165:1048-1053.
• [17]Reynolds K, Gu D, Chen J, Tang X, Yau CL, Yu L, Chen CS, Wu X, Hamm LL, He J: Alcohol consumption and the risk of end-stage renal disease among Chinese men. Kidney Int 2008, 73:870-876.
• [18]Gupta PC, Ray CS: Epidemiology of betel quid usage. Ann Acad Med Singapore 2004, 33:31-36.
• [19]Chen JW, Shaw JH: A study on betel quid chewing behavior among Kaohsiung residents aged 15 years and above. J Oral Pathol Med: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology 1996, 25:140-143.
• [20]Hsu YH, Liu WH, Chen W, Kuo YC, Hsiao CY, Hung PH, Jong IC, Chiang PC, Hsu CC: Association of betel nut chewing with chronic kidney disease: a retrospective 7-year study in Taiwan. Nephrology (Carlton) 2011, 16:751-757.
• [21]Liu WH, Hsu CC, Hsu YH: Chewing areca nut as an independent risk factor for proteinuria in middle-aged men. Kaohsiung J Med Sci 2013, 29:214-220.
• [22]National Kidney Foundation: K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002, 39:S1-S266.
• [23]Wortmann RL, Kelley WN: Gout and hyperuricemia. In Textbook of Rheumatology. 7th edition. Edited by Kelley WN, Harris ED, Ruddy S, Sledge CB. Philadelphia: W.B. Saunders; 2005:1402-1448.
• [24]Yamagata K, Ishida K, Sairenchi T, Takahashi H, Ohba S, Shiigai T, Narita M, Koyama A: Risk factors for chronic kidney disease in a community-based population: a 10-year follow-up study. Kidney Int 2007, 71:159-166.
• [25]Rodrigo R, Rivera G, Orellana M, Araya J, Bosco C: Rat kidney antioxidant response to long-term exposure to flavonol rich red wine. Life Sci 2002, 71:2881-2895.
• [26]Orellana M, Valdes E, Fernandez J, Rodrigo R: Effects of chronic ethanol consumption on extramitochondrial fatty acid oxidation and ethanol metabolism by rat kidney. Gen Pharmacol 1998, 30:719-723.
• [27]Dreosti IE, Manuel SJ, Buckley RA: Superoxide dismutase (EC 1.15.1.1), manganese and the effect of ethanol in adult and foetal rats. Br J Nutr 1982, 48:205-210.
• [28]Giovannini L, Migliori M, Longoni BM, Das DK, Bertelli AA, Panichi V, Filippi C, Bertelli A: Resveratrol, a polyphenol found in wine, reduces ischemia reperfusion injury in rat kidneys. J Cardiovasc Pharmacol 2001, 37:262-270.
• [29]Kahraman A, Erkasap N, Serteser M, Koken T: Protective effect of quercetin on renal ischemia/reperfusion injury in rats. J Nephrol 2003, 16:219-224.
• [30]Burchfiel CM, Tracy RE, Chyou PH, Strong JP: Cardiovascular risk factors and hyalinization of renal arterioles at autopsy. The Honolulu heart program. Arterioscler Thromb Vasc Biol 1997, 17:760-768.
• [31]Shigematsu S, Ishida S, Hara M, Takahashi N, Yoshimatsu H, Sakata T, Korthuis RJ: Resveratrol, a red wine constituent polyphenol, prevents superoxide-dependent inflammatory responses induced by ischemia/reperfusion, platelet-activating factor, or oxidants. Free Radic Biol Med 2003, 34:810-817.
• [32]Gaziano JM, Buring JE, Breslow JL, Goldhaber SZ, Rosner B, VanDenburgh M, Willett W, Hennekens CH: Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 1993, 329:1829-1834.
• [33]Ridker PM, Vaughan DE, Stampfer MJ, Glynn RJ, Hennekens CH: Association of moderate alcohol consumption and plasma concentration of endogenous tissue-type plasminogen activator. JAMA 1994, 272:929-933.
• [34]Wakabayashi I, Kobaba-Wakabayashi R, Masuda H: Relation of drinking alcohol to atherosclerotic risk in type 2 diabetes. Diabetes Care 2002, 25:1223-1228.
• [35]Northcote J, Livingston M: Accuracy of self-reported drinking: observational verification of ‘last occasion’ drink estimates of young adults. Alcohol Alcohol 2011, 46:709-713.
• [36]Giovannucci E, Colditz G, Stampfer MJ, Rimm EB, Litin L, Sampson L, Willett WC: The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol 1991, 133:810-817.
• [37]Parekh RS, Klag MJ: Alcohol: role in the development of hypertension and end-stage renal disease. Curr Opin Nephrol Hypertens 2001, 10:385-390.
• [38]Keane WF, Zhang Z, Lyle PA, Cooper ME, de Zeeuw D, Grunfeld JP, Lash JP, McGill JB, Mitch WE, Remuzzi G, et al.: Risk scores for predicting outcomes in patients with type 2 diabetes and nephropathy: the RENAAL study. Clin J Am Soc Nephrol 2006, 1:761-767.
• [39]Mohanram A, Zhang Z, Shahinfar S, Keane WF, Brenner BM, Toto RD: Anemia and end-stage renal disease in patients with type 2 diabetes and nephropathy. Kidney Int 2004, 66:1131-1138.
• [40]See LC, Kuo CF, Chuang FH, Shen YM, Ko YS, Chen YM, Yu KH: Hyperuricemia and metabolic syndrome: associations with chronic kidney disease. Clinical rheumatology 2011, 30:323-330.
• [41]Hackam DG, Khan NA, Hemmelgarn BR, Rabkin SW, Touyz RM, Campbell NR, Padwal R, Campbell TS, Lindsay MP, Hill MD, et al.: The 2010 Canadian hypertension education program recommendations for the management of hypertension: part 2 - therapy. Can J Cardiol 2010, 26:249-258.