Risk of end-stage renal disease associated with alcohol consumption

Alcohol consumption has been linked to kidney disorders in selected patient groups, but whether it contributes to the burden of end-stage renal diseas e (ESRD) in the general population is unknown. The authors conducted a popu lation-based case-control study to assess the relation between alcohol cons umption and risk of ESRD, The study took place in Maryland, Virginia, West Virginia, and Washington, DC, in 1991. Participants were 716 patients who h ad started treatment for ESRD and 361 control subjects of similar age (20-6 4 years) selected by random digit dialing. The main risk factor of interest was self-reported consumption of alcoholic beverages (frequency of drinkin g days and number of drinks consumed per drinking day). In univariate analy sis, consumption of alcohol exhibited a J-shaped association with risk of E SRD. The J shape disappeared after exclusion of persons who had ever consum ed home-distilled whiskey ("moonshine") and adjustment for age, race, sex, income, history of hypertension, history of diabetes mellitus, use of aceta minophen, use of opiates, and cigarette smoking; however, the odds ratio fo r ESRD remained significantly increased (odds ratio = 4.0; 95% confidence i nterval: 1.2, 13.0) among persons who consumed an average of >2 alcoholic d rinks per day. The corresponding population attributable risk was 9 percent . Thus, consumption of more than two alcoholic drinks per day, on average, was associated with an increased risk of kidney failure in the general popu lation. A lower intake of alcohol did not appear to be harmful. Because the se results are based on self-reports in a case-control study, they should b e seen as preliminary.