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Alcohol and Chronic Kidney Disease

When it comes to drinking alcohol, for anyone who can drink it safely, moderation is the key. Drinking too much alcohol—even for a completely healthy person—can cause heart disease, liver disease, high blood pressure and kidney disease, in addition to many other medical problems. Drinking too much alcohol can also impair judgment—and this could interfere with decision making related to remembering to take medicines and following fluid and diet guidelines.

For someone with healthy kidneys, doctors, scientists and recent studies suggest alcohol has benefits and risks.

Some of the benefits of drinking alcohol include:

  • a decrease in the risk of cardiovascular disease
  • a decrease in the risk of diabetes
  • warding off Alzheimer’s disease and other dementia
  • reducing stress, anxiety and tension
  • creating a more pleasant, carefree attitude

On the downside, drinking alcohol can:

  • increase the chance of developing high blood pressure, which is the second leading cause of kidney disease
  • interfere with medicines making it harder to control high blood pressure. Uncontrolled high blood pressure is more likely to damage kidneys.
  • cause more frequent urination, which can lead to dehydration
  • prevent the kidneys from maintaining a proper balance of body fluids and minerals
  • damage kidney cells changing the structure and function of the kidneys

Renal diets and alcohol

Moderate alcohol drinking may be okay for people with chronic kidney disease who are not on dialysis. However, it is best to first check with your nephrologist or renal dietitian to find out if alcohol is safe for you. If you are able to drink alcohol safely, your health care team will advise you on the types and amounts that are right for you.

If you are on dialysis, drinking alcohol may be allowable, but it must be counted within your normal fluid allowance and diet, and medicines must be taken into consideration. Talk to your doctor or renal dietitian before you drink to find out if alcohol will have a negative impact on your health.

For those with diabetes and chronic kidney disease alcohol may be safe to drink if you have your blood sugar level under control. After checking with your doctor or dietitian and getting the okay to drink, it is recommended that you drink with food or at mealtime. Alcohol on an empty stomach can cause blood sugar levels to drop in those with diabetes. Additional ingredients in mixed drinks may add carbohydrate that must be considered. You will also have to fit alcohol into your meal plan.

Alcohol has no nutritional benefit, but it does have calories. And calories from alcoholic beverages add up quickly. Make sure you take this into consideration when planning your daily menus. 

Some medicines, both prescription and over-the-counter, may interact with alcohol. This interaction may cause the medicines not to work properly. There are other medicines that may cause your blood alcohol level to rise. Check drug labels and ask your pharmacist or doctor to review your medications to make sure alcohol will not be harmful with your medication.

Composition of alcohol drinks

In addition to alcohol, calories and fluid, drinks containing alcohol must be evaluated for sodium, potassium and phosphorus content. Often the added ingredients in mixed drinks add undesirable amounts of these minerals.  The chart below provides nutrient information on some common alcohol containing beverages.

Beverage

Portion

Calories

Protein (g)

Carbs (g)

Sodium (mg)

Potassium (mg)

Phosphorus (mg)

Beer

12 ounce

146

1.0

13

18

89

43

Light Beer

12 ounce

99

0.7

5

11

64

43

Red wine

5 ounces

106

0.3

3

7

165

21

White wine

5 ounces

100

0.2

1

7

118

21

Champagne

5 ounces

100

0.1

1

7

118

21

Bloody Mary

8 ounces

137

2.0

8

1120

311

22

Daiquiri, strawberry

1 cocktail

200

0

35

0

22

9

Irish Coffee

6 ounces

151

0.4

7

7

60

12

Margarita with salt

1 cocktail

213

0.1

25

1069

40

9

Martini

1 cocktail

133

0

0

2

12

2

Pina Colada

1 cocktail

252

0.6

15

9

100

11

Screwdriver

1 cocktail

175

1.0

18

2

326

30

Tequila Sunrise

1 cocktail

189

0.5

15

7

179

17

Whisky Sour

1 cocktail

110

0.2

5

9

46

6

Bourbon, scotch, whiskey

1 jigger 1.5 ounces

97

0

0

0

1

0

Gin, vodka

1 jigger 1.5 ounces

97

0

0

0

1

2

Rum

1 jigger 1.5 ounces

97

0

0

0

1

2

MIXERS

Cola

6 ounces

76

0

21

3

0

26

7Up®

6 ounces

75

0

18

32

0

0

Cranberry Juice

6 ounces

105

0

25

25

22

4

Safe levels of drinking

The federal government’s Dietary Guidelines for Americans defines moderate drinking as:

  • one drink per day for women and older people
  • two drinks per day for men

The limits are different for men and women, because men usually weigh more and alcohol is processed differently by the sexes. Women tend to have a stronger reaction to alcohol. One reason is that women have less water in their bodies, so the alcohol becomes more concentrated. The risk for alcohol-related diseases (such as liver disease) is also higher in women than in men.

The following count as one drink and each contains the same amount of alcohol:

  • 12 ounces of beer or a wine cooler
  • 5 ounces of wine
  • 1.5 ounces of 80-proof distilled spirits (whiskey, bourbon, scotch, vodka, gin, tequila, rum). Mixed drinks vary in size. Most include 1.5 ounces of distilled spirits.

To drink or not to drink

Drinking alcohol can generally be done safely in moderation, even if you have chronic kidney disease, polycystic kidney disease, end stage renal disease or diabetes. Take caution, however, if you have high blood pressure. Also, be aware of ingredients and nutrient content of the beverage you choose to drink. Always check with your doctor or renal dietitian to make sure it is safe for you to drink alcohol. They will also let you know the right amount for you, so that you can enjoy an occasional alcoholic beverage and stay safe and healthy.


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