Alcohol and Kidneys: What it Means for Your Renal Diet

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To drink or not to drink? A common question among those with kidney issues. Research shows the combination of alcohol and kidneys could be harmful in excess. This article discusses the effects of drinking on kidney function in both the short and long term. It also discusses the question is alcohol bad for your kidneys when you have kidney disease.

How Much is a Drink?

When it comes to knowing how much alcohol is dangerous for kidney health you first need to know how much is a drink.

Experts define one drink as any (1) of the following:

• 12-ounce bottle of beer
• 5 ounce glass of wine
• 1.5 ounces of liquor

Depending on how many drinks you have will determine the type of drinking you do. The various levels of drinking include

• Light drinking
• Moderate drinking
• Heavy drinking
• Abusive drinking

Light drinking is having 1.2 drinks per day. Moderate drinking consists of 2.2 drinks per day. 

Heavy drinking is having 3 or more drinks a day (more than 7 drinks per week) for women. For men, heavy drinking is having more than 4 drinks a day (more than 14 per week). Heavy drinking requires more work from the kidneys. It also doubles the risk for kidney disease.

Binge drinking is typically having more than 4 to 5 drinks within 2 hours. This can raise the blood alcohol to dangerous levels. Abusive drinking is considered having 5.4 drinks a day. 

What Does Alcohol Do To Your Body

Research tells us that too much alcohol even on a single occasion can affect health.

When digested alcohol produces free radicals, acetaldehyde, and acetate. These compounds are toxic to the body. 

Alcohol effects on the body include damage to the following organs:

• Brain
• Heart
• Liver
• Pancreas

Alcohol prevents communication between brain cells. As a result, the brain cannot function properly. It also causes problems with cognition, mood, and behavior.

Excessive drinking can change how blood flows to and from the heart. It can cause irregular heartbeat, high blood pressure, and stretch out the heart muscles. 

The liver is responsible for the majority of alcohol digestion. So alcohol can damage this organ.  Heavy drinking can result in liver disease.

Pancreatitis is inflammation of the pancreas. This condition is caused by excess alcohol intake. It can damage the body.

Regular heavy drinking also increases the risk of certain cancers. They include

• Cancer of the upper respiratory tract
• Liver cancer
• Colon or rectum cancer
• Breast cancer
• Stomach cancer
• Mouth cancer
• Throat cancer

Why Do My Kidneys Hurt When I Drink Alcohol?

Do your kidneys hurt after drinking alcohol? Kidney pain after drinking could be one of the following:

• An obstruction in the kidney and pelvis
• A swollen kidney
• An inflamed stomach lining

Alternatively, kidney pain could be the first sign of kidney damage from alcohol.

How Can Alcohol Damage Your Kidneys

Alcohol and kidneys can be an unhealthy combination over time and in excess. The use of alcohol can lead to both short- and long-term kidney damage.

How Does Alcohol Affect kidneys In the Short-Term

After digestion, the kidneys will detect toxic substances. The kidneys will work to get rid of them. This has both short and long-term effects on the health of the kidneys.

Short-term effects of alcohol on the kidneys include

• Dehydration
• Fluid imbalances
• Changes in electrolyte levels
• Increases in blood pressure

Dehydration and Kidneys

Drinking can lead to alcoholic dehydration even with just a few drinks. Kidney cells need water to function. Consuming alcohol dries out the body. This can lead to kidney dysfunction.

Fluid Imbalance

The kidneys control fluid balance. They determine how much fluid goes into the urine. When levels are low, the brain releases antidiuretic hormone (ADH). ADH tells the kidneys to conserve water. As a result, urine becomes concentrated. Alternatively, high body water prevents ADH production. So urine becomes diluted.

Alcohol affects this function of the kidneys within 20 minutes of consumption. Alcohol inhibits the release of ADH. This causes the kidneys to produce diluted urine. It will also lose water it normally would keep. The loss of ADH causes parts of the kidney unable to move water back into the body. 

ADH suppression varies by age. People under 50 years old are more likely to suffer from this condition. Older individuals do not have the same problem and ADH levels will increase after drinking alcohol. 

Changes in Electrolyte Levels

The changes in fluid balance also affect electrolyte levels. Diluted urine causes an increase in electrolytes in the blood. High electrolytes normally produce ADH. However, the increase in blood alcohol level stops this from happening. So again alcohol suppresses ADH.

Changes in Sodium Levels 

Alcohol can both increase and decrease sodium levels.

Beer has little to no sodium. Too much of this drink prevents the kidneys from retaining any water. So fluid overload and extremely low sodium levels develop.

Alcohol also stops sodium kidney removal. This can elevate sodium levels and possibly cause hypernatremia. People who consistently drank 4 ounces of 100-proof bourbon whiskey had higher concentrations of sodium. 

Changes in Potassium Levels

Potassium and kidneys regulation is altered by alcohol use. Like sodium, potassium affects fluid levels. Alcohol can either increase or reduce how much potassium is excreted by the kidneys. Hydration status may play a role in potassium levels. Potassium levels drop when the body is high in fluids.

Beer reduced potassium levels while bourbon whiskey increased them. Wine is a higher potassium drink. However, there is no specific research on how wine affects potassium levels when consuming alcohol.

Potassium levels also affect sodium levels. Low potassium can cause low sodium levels and the risk of hyponatremia. Another way potassium affects sodium is by triggering the ADH hormone.

When potassium is low, ADH is produced. This increases the amount of fluid reabsorbed by the kidneys and lowers sodium levels.

Changes in Phosphorus Levels

Alcohol can impact levels of phosphorus bringing them up too high as well as dropping them too low. Hyperphosphatemia or high levels of phosphorus usually occurs before phosphorus becomes depleted and hypophosphatemia sets in. 

Drinking alcohol can trigger muscle cells to break down and release phosphorus into the bloodstream. The body sees high levels of phosphorus. They will be moved to the kidneys where they will be excreted in the urine.  

Beer does not contain a lot of phosphorus. This affects how the kidneys balance fluids. It is similar to how alcohol affects sodium and potassium levels.

Acute pancreatitis related to alcohol intake changes the level of phosphorus in the blood. This sudden condition causes the pancreas to become inflamed. It can occur from even short-term heavy drinking. Experts say that having 4 to 7 drinks a day is the cause of this disorder.

Changes in Magnesium Levels

Alcohol intake acts as a magnesium diuretic. It may affect magnesium balance in the kidneys. Consequently, it causes an increase in the removal of magnesium from the kidneys. Excess alcohol intake could lead to large depletions of magnesium in the urine.

Research in animals suggests that alcohol use also disrupts magnesium absorption in the gut. This can lead to the need for more magnesium in the diet.

Changes in Calcium Levels

Alcohol intake causes urinary calcium losses. Low calcium may be due to muscle depletion or magnesium losses. 

How Does Alcohol Increase Blood Pressure

If you are wondering, “does drinking alcohol raise your blood pressure?” The answer varies depending on how much you drink.

There is a direct relationship between blood pressure and kidneys’ function. The kidneys maintain blood pressure. When fluids and sodium levels get low, ADH will tell the body to increase blood flow. This constricts blood vessels and raises blood pressure. The same thing may happen when alcohol is consumed.

One study found that light drinking did not elevate blood pressure. Alternatively, moderate and heavy drinking had a 79 and 91% increase in blood pressure. The more alcohol consumed the higher the risk of elevated blood pressure.

Other research found that drinking an alcoholic beverage causes a sudden spike in blood pressure for up to two hours. If you drink a lot in one sitting you may experience changes in blood pressure.

Having more than one drink a day could also increase the risk for high blood pressure in diabetics.

How Does Drinking Affect Your Kidneys  in the Long-Term

Alcohol’s effect on the kidneys in the long-term include the following: 

• Physical changes to the kidneys
• Problems with acid-base balance
• Hypertension
• Liver disease
• Pancreas problems

Physical Changes to the Kidneys

Alcohol can also physically alter the kidneys and causes dysfunction. Chronic alcohol use in animals caused enlarged cells, a thickened glomerulus and swollen kidneys. Kidney cells also contained large amounts of protein, fat, and water when compared with cells with no alcohol use. 

Problems with Acid-Base Balance

The kidneys are needed to maintain the body’s acid-base balance. Chronic alcohol abuse interferes with this regulation. It can result in both acidic and basic conditions that threaten health.

Acidic conditions include:

• Respiratory acidosis
• Alcoholic ketoacidosis

Respiratory acidosis is when the lungs fill up with carbon dioxide. Alcoholic ketoacidosis is when there is a high amount of ketones in the blood. When blood sugar drops the body does not have enough glucose to make energy. So it will use fat instead. Broken down fats will become ketones. This condition is common among diabetics.

Basic or alkaline conditions include:

• Respiratory Alkalosis
• Metabolic alkalosis

Respiratory alkalosis is another name for hyperventilation. It is when there is too little carbon dioxide in the blood. Metabolic alkalosis is when there is too much base in the body.

Most of the acid-base problems that occur with alcohol consumption are ones involving too little acid. People with liver disease are more likely to get these as well.

The kidneys will work to stabilize acid-base balance. In the process, they will form acidic or basic urine.

Hypertension and High Blood Pressure

Hypertension and high blood pressure are common among people who drink more than two drinks a day. High blood pressure also increases your risk of kidney disease.

Heavy drinking had a 91% increased risk of elevated blood pressure. It also increased the risk of hypertension by 149% for stage 1 and 204% for stage 2. As alcohol intake goes up so does the risk of hypertension.

People with high blood pressure and on blood pressure medication are also affected by alcohol. Levels can be reduced by limiting alcohol intake.

Kidney Problems Due to Liver Disease

The liver and kidneys have a symbiotic relationship. They depend on each other to work properly. So damage in one organ can cause problems for the other.

Chronic alcohol intake causes liver disease. A damaged liver will not be able to regulate blood flow into the kidneys. This causes kidney damage.

Having liver disease further weakens the kidneys by impairing sodium and fluid regulation and reducing urine flow. It can also lead to acute kidney failure.

Most patients in the United States who have both liver disease and kidney issues are dependent on alcohol.

Kidney Problems from Pancreas Damage

Like the liver, excessive alcohol consumption can damage the pancreas. These problems can lead to issues with the kidneys. Regular alcohol consumption leads to acute pancreatitis. This can become chronic for some individuals with heavy alcohol use. Pancreatitis can also cause kidney failure.

Kidney Conditions from Short and Long-Term Drinking 

Both short and long-term drinking can lead to various kidney issues including:

• Urinary tract infections (UTI)
• Kidney Stones
• Acute Kidney Failure (Acute Renal Failure/Acute Kidney Infection)
• Chronic Kidney Disease

Alcohol and Urinary Tract Infections (UTI)

The use of alcohol may increase the risk of getting a urinary tract infection (UTI). UTIs that move to the bladder will affect the kidneys. Changes in hydration and electrolytes from alcohol intake can increase the risk for a UTI.  

Symptoms of a UTI include:

• A persistent urge to go to the bathroom
• A burning sensation when urinating
• Cloudy urine
• Red, bright pink, or cola-colored urine
• Passing frequent, small amounts of urine

Alcohol and Kidney Stones

When it comes to kidney stones and alcohol there is some conflicting information.  Some research shows an association between kidney stones and drinking alcohol.

Alcohol causes dehydration. This results in concentrated urine which is a common cause of kidney stones.  

On the other hand, a 2015 article showed moderate drinking somewhat reduced the risk of kidney stones forming. Alcohol increases the need to urinate. This helps move fluids through the system and lowered the risk of getting calcium oxalate stone. 

The key here is that alcohol can otherwise be dehydrated if you do not drink enough water to replenish what you lose from alcohol- and the article does emphasize the need for overall fluid intake to be at least 2.5 liters per day. (Keep in mind everyone’s fluid needs are not the same.)

Wine and beer have been shown to be the most beneficial when it comes to reducing kidney stone risk.

Alcohol and Acute Kidney Failure (Acute Renal Failure/Acute Kidney Infection)

Acute kidney failure is a sudden infection and temporary failure of the kidneys. It occurs when wastes build up on the blood faster than the kidneys can filter them out.

It often results from excessive alcohol intake or binge drinking. Symptoms of this condition include the following:

• Kidney pain
• Less urine 
• Exhaustion
• Swollen legs, ankles, and/or face
• Problems breathing or shortness of breath
• Nausea or vomiting
• Confusion
• Chest pressure or pain 

The decline in kidney function can go away but it can sometimes leave lasting damage. 

Having acute pancreatitis and alcoholic ketoacidosis also increases the risk for acute kidney failure.

Alcohol and Chronic Kidney Disease

According to the National Kidney Foundation, regular heavy drinking can double the risk of getting chronic kidney disease (CKD). The combination of heavy drinking and smoking also puts people at five times greater risk of getting CKD.

On the other hand, there is evidence showing alcohol may lower the risk of CKD

A study published in 2015 tested the risk of developing chronic kidney disease based on their self-reported alcohol intake. It found an inverse correlation between alcohol consumption and CKD. 

While this is by means no recommendation to drink more alcohol or to start drinking, they do suggest that light to moderate drinking has not been shown to increase the risk of developing CKD.

Additionally, individual health needs to be considered since even small amounts of alcohol can increase the risk of health conditions and death.

Can You Reverse Kidney Damage from Alcohol? 

Even in the short-term too much alcohol causes changes to the kidneys. So despite whether you have kidney stones, CKD or just a temporary infection there is damage done to your kidneys.

Unfortunately, this cannot be erased. However, you can work towards preserving what function you have left. That starts with finding a healthcare team with a kidney doctor and renal dietitian.

Treatment for Alcohol Related Kidney Damage

There are both medical and nutritional treatments for alcohol-related kidney damage. Your medical team will provide you with medications if necessary and your renal dietitian can give you a diet plan to help improve symptoms. These treatments will vary by condition. 

Nutrition for kidney stones varies depending on the type of stone that has formed. Learn more about kidney stone nutrition in this post.

Dialysis is often a treatment for acute kidney failure. It will run until the function returns. Your renal dietitian will also help to get your calories, protein, and other nutrient levels in check.

If there is enough damage to cause kidney disease your nutrition interventions will vary depending on what stage of CKD you have.

For information on nutrition for kidney disease check out our guides on stage 3, stage 4, and stage 5 of kidney disease.

Recommendations for For People with Kidney Dysfunction 

Are you wondering, “how much alcohol can I drink with kidney dysfunction?” How much alcohol is too much varies from person to person. Even just one drink a day could be harmful depending on their kidney health and other underlying conditions.

To get the answers right for you, be sure to talk to your healthcare team. They will tell you exactly how much drinking is too much and whether or not it is safe for you to drink alcohol at all.

If you are on any medications be sure to ask your doctor and renal dietitian about possible alcohol interactions before drinking.

Even if it is safe, moderation is the key. Stick to just one or two drinks a day depending on if you are a woman or man. If you are over 65, have just one drink or less a day. 

Are There Any Kidney Benefits from Drinking in Moderation?

Some research indicates alcohol intake may have positive effects on a healthy population, specifically men. 

Men who consumed moderate alcohol had a lower risk of renal dysfunction. This could be due to the antioxidant effects of alcohol being more prevalent among men.

This is no reason to start drinking. Especially when there are many other factors to focus on when it comes to keeping your kidneys healthy and happy before looking to add in alcohol. 

Quality of the foods and supplements you consume, amount of water and other beverages, and stress management are some other very important factors I focus on with clients before we discuss alcohol as part of a balanced diet.

Summary

Drinking too much even on just one occasion can have negative effects on overall health. Alcohol digestion produces toxic compounds that damage many essential organs including the kidneys. Both short- and long-term drinking can cause many kidney-related problems like structural changes, dehydration, high blood pressure, along with imbalances of fluids, electrolytes, and acid-base balance.

Additionally, chronic alcohol use causes problems with liver and pancreas function. Damage to these organs makes the kidneys work harder creating more dysfunction. 

Irreversible damage related to alcohol intake increases the risk for urinary tract infections (UTIs), kidney stones, acute kidney failure, and chronic kidney disease. These are serious conditions th medical and nutritional interventions. Be sure to enlist the health of a kidney doctor and renal dietitian for help on how to improve these conditions.

If you currently have kidney dysfunction it is best to talk to your healthcare team about how much if any alcohol you should be drinking.