ALCOHOL-ABUSE - POTENTIAL ROLE IN ELECTROLYTE DISTURBANCES AND KIDNEY-DISEASES

The present review summarizes the current knowledge on the multiple ef fects of alcohol overconsumption on the kidney function as well as on water, electrolyte and acid-base homeostasis. In contrast to the well known transitory diuretic effect, the overall long-term effect of chro nic alcohol overconsumption is water and salt retention with expansion of extracellular volume. Furthermore, depletion of magnesium, phospha te and calcium is also frequently found in alcohol-dependent patients. These electrolyte disturbances may be associated with the alcohol-ind uced hypoparathyroidism and parathyroid hormone resistance of the skel etal muscle as well as with the decrease of serum osteocalcin. Metabol ic acidosis with lower arterial blood pH and plasma bicarbonate concen trations was revealed in alcoholic patients upon admission and a signi ficant correlation between chronic alcohol overconsumption and increas ed incidence of hyperuricemia and gout attacks was also reported. Alco hol seems to have dual effects on the blood pressure. Increased blood pressure was demonstrated in men above 80 g and in women above 40 g et hanol consumption daily. In contrast, young adults consuming only 10 t o 20 g per day had lower blood pressure than the abstinent group indic ating a J-curve relationship. This is in line with the lowered risk fo r coronary heart disease associated with regular consumption of small alcohol amounts. The mechanisms responsible for the association betwee n alcohol overconsumption and postinfectious glomerulonephritis have n ot been elucidated yet. Finally severe alcohol abuse predisposes to ac ute renal failure and seems to be associated with the general cataboli c effects.