Young Su Joo1, Heebyung Koh1, Ki Heon Nam2, Sangmi Lee1, Joohwan Kim1, Changhyun Lee1, Hae-Ryong Yun1, Jung Tak Park1, Ea Wha Kang3, Tae Ik Chang3, Tae-Hyun Yoo1, Kook-Hwan Oh4, Dong Wan Chae5, Kyu-Beck Lee6, Soo Wan Kim7, Joongyub Lee8, Shin-Wook Kang9, Kyu Hun Choi1, Curie Ahn4, Seung Hyeok Han10. 1. Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea. 2. Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea; Division of Integrated Medicine, Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea. 3. Department of Internal Medicine, National Health Insurance Service Medical Center, Ilsan Hospital, Goyang, Gyeonggi-do, Republic of Korea. 4. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Republic of Korea. 5. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do. 6. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 7. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea. 8. Department of Prevention and Management, Inha University School of Medicine, Incheon, Republic of Korea. 9. Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea; Department of Internal Medicine, College of Medicine, Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University, Seoul, Republic of Korea. 10. Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea. Electronic address: hansh@yuhs.ac.
Abstract
OBJECTIVE: To assess the association of alcohol consumption with chronic kidney disease (CKD) progression in patients with CKD. PATIENTS AND METHODS: The KoreaN cohort study for Outcome in patients with CKD (KNOW-CKD) is a prospective observational study that included detailed questionnaires regarding alcohol consumption. The 1883 individuals with CKD were enrolled from April 1, 2011, through February 28, 2016, and followed until May 31, 2017. Using a questionnaire, alcohol consumption pattern was classified according to the amount of alcohol per occasion (none, moderate, or binge) or drinking frequency (none, occasional, or regular). The primary endpoint was a composite of 50% or greater decline in estimated glomerular filtration rate (eGFR) from the baseline level or end-stage renal disease. RESULTS: During a follow-up of 5555 person-years (median, 2.95 years), the primary outcome occurred in 419 patients. Unadjusted cause-specific hazards model showed that the risk of the primary outcome was lower in drinkers than in non-drinkers. However, a fully adjusted model including eGFR and proteinuria yielded a reverse association. Compared with non-drinking, regular and occasional binge drinking were associated with a 2.2-fold (95% CI, 1.38-3.46) and a 2.0-fold (95% CI, 1.33-2.98) higher risk of CKD progression, respectively. This association was particularly evident in patients who had decreased kidney function and proteinuria. There was a significant interaction between alcohol consumption and eGFR for CKD progression. The slopes of eGFR decline were steeper in binge drinkers among patients with eGFR less than 60 mL/min/1.73 m2. CONCLUSIONS: Heavy alcohol consumption was associated with faster progression of CKD.
OBJECTIVE: To assess the association of alcohol consumption with chronic kidney disease (CKD) progression in patients with CKD. PATIENTS AND METHODS: The KoreaN cohort study for Outcome in patients with CKD (KNOW-CKD) is a prospective observational study that included detailed questionnaires regarding alcohol consumption. The 1883 individuals with CKD were enrolled from April 1, 2011, through February 28, 2016, and followed until May 31, 2017. Using a questionnaire, alcohol consumption pattern was classified according to the amount of alcohol per occasion (none, moderate, or binge) or drinking frequency (none, occasional, or regular). The primary endpoint was a composite of 50% or greater decline in estimated glomerular filtration rate (eGFR) from the baseline level or end-stage renal disease. RESULTS: During a follow-up of 5555 person-years (median, 2.95 years), the primary outcome occurred in 419 patients. Unadjusted cause-specific hazards model showed that the risk of the primary outcome was lower in drinkers than in non-drinkers. However, a fully adjusted model including eGFR and proteinuria yielded a reverse association. Compared with non-drinking, regular and occasional binge drinking were associated with a 2.2-fold (95% CI, 1.38-3.46) and a 2.0-fold (95% CI, 1.33-2.98) higher risk of CKD progression, respectively. This association was particularly evident in patients who had decreased kidney function and proteinuria. There was a significant interaction between alcohol consumption and eGFR for CKD progression. The slopes of eGFR decline were steeper in binge drinkers among patients with eGFR less than 60 mL/min/1.73 m2. CONCLUSIONS: Heavy alcohol consumption was associated with faster progression of CKD.