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Meta-Analysis
. 2023 Mar 25;15(7):1592.
doi: 10.3390/nu15071592.

A Dose-Dependent Association between Alcohol Consumption and Incidence of Proteinuria and Low Glomerular Filtration Rate: A Systematic Review and Meta-Analysis of Cohort Studies

Ryohei Yamamoto  1   2 , Qinyan Li  1   2 , Naoko Otsuki  1 , Maki Shinzawa  2 , Makoto Yamaguchi  3 , Minako Wakasugi  4 , Yasuyuki Nagasawa  5 , Yoshitaka Isaka  2
Affiliations
Meta-Analysis

A Dose-Dependent Association between Alcohol Consumption and Incidence of Proteinuria and Low Glomerular Filtration Rate: A Systematic Review and Meta-Analysis of Cohort Studies

Ryohei Yamamoto et al. Nutrients. .

Abstract

Previous cohort studies have reported conflicting associations between alcohol consumption and chronic kidney disease, characterized by proteinuria and low glomerular filtration rate (GFR). This systematic review, which included 14,634,940 participants from 11 cohort studies, assessed a dose-dependent association of alcohol consumption and incidence of proteinuria and low estimated GFR (eGFR) of <60 mL/min/1.73 m2. Compared with non-drinkers, the incidence of proteinuria was lower in drinkers with alcohol consumption of ≤12.0 g/day (relative risk 0.87 [95% confidence interval 0.83, 0.92]), but higher in drinkers with alcohol consumption of 36.1-60.0 g/day (1.09 [1.03, 1.15]), suggesting a J-shaped association between alcohol consumption and the incidence of proteinuria. Incidence of low eGFR was lower in drinkers with alcohol consumption of ≤12.0 and 12.1-36.0 than in non-drinkers (≤12.0, 12.1-36.0, and 36.1-60.0 g/day: 0.93 [0.90, 0.95], 0.82 [0.78, 0.86], and 0.89 [0.77, 1.03], respectively), suggesting that drinkers were at lower risk of low eGFR. In conclusion, compared with non-drinkers, mild drinkers were at lower risk of proteinuria and low eGFR, whereas heavy drinkers had a higher risk of proteinuria but a lower risk of low eGFR. The clinical impact of high alcohol consumption should be assessed in well-designed studies.

Keywords: alcohol consumption; chronic kidney disease; cohort study; dose-dependent association; glomerular filtration rate; meta-analysis; proteinuria; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the study design; collection, analyses, or interpretation of data; writing of the manuscript; or decision to publish the results.

Figures

Figure 1
Figure 1
Alcohol consumption and incidence of proteinuria. CI, confidence interval; RR, relative risk [19,20,21,35,37,38,40].
Figure 2
Figure 2
Dose-dependent association between alcohol consumption and incidence of proteinuria (a) and low eGFR <60 mL/min/1.73 m2 (b). RR, relative risk. Solid and dashed curves represent RR and 95% confidence interval, respectively. Circles represent the number of participants of each category of alcohol consumption.
Figure 3
Figure 3
Alcohol consumption and incidence of low eGFR <60 mL/min/1.73 m2. CI, confidence interval; eGFR, estimated glomerular filtration rate; RR, relative risk [19,21,32,33,34,36,37,39,40].
See this image and copyright information in PMC

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