how alcoholism affects kidneys

How Does Alcohol Affect the Kidneys?

Alcohol consumption, whether heavy or in moderation, affects several organs in the body. While its effects on the liver and the heart have always been highlighted, another organ that is often left out is the kidney. They can be affected by alcohol directly – or indirectly through alcohol-related liver disease.

As such, chronic alcoholism can lead to kidney disease – which is an irreversible condition. Should this progress further, the only options would have to be dialysis – or a kidney transplant. 

Indeed, bean-shaped kidneys are truly essential. Without them, we wouldn’t be able to remove much of the toxic wastes in the body. As such, alcohol users need to know how their drinking binges affect their kidneys. 

Kidneys: An Overview

Located below each side of the rib cage, kidneys are excretory organs that are usually the size of a fist. They can filter half a cup of blood every minute – for a total of 150 quarts every day. 

How Kidneys Work

Your kidneys keep you healthy by doing the following feats:

  • Remove extra fluids and waste materials from the body
  • Excrete acids produced by different cells
  • Maintain the balance of water, salts, and electrolytes such as potassium, sodium, phosphorous, and calcium
  • Create red blood cells
  • Regulate blood pressure
  • Ensure bone health 

The kidneys’ activities, as mentioned above, are made possible by its important structures. Its basic filtering unit is the Nephron, which is comprised of the glomerulus and the tubule.

The glomerulus is in charge of sifting your blood for wastes, while the tubule is responsible for removing these byproducts – while returning the important substances to the blood circulation. 

Kidneys' basic filtering unit is the Nephron, which is comprised of the glomerulus and the tubule.

How Does Alcohol Affect the Kidneys?

As it has been mentioned, alcohol can harm your kidneys directly and indirectly. Whether you drink in moderation – or a whole lot – you can expect your kidneys to suffer from the following problems:

Abnormal Changes in Kidney Structures 

According to a study by Chaikoff et al, chronic alcoholism can bring about changes in some kidney structures. For one, it can lead to the thickening of the glomerular membrane.

It can also cause the enlargement and the thickening of the cells in the kidney tubules. Changes in these kidney structures can lead to a decreased ability to filter out the wastes in the body. In the long run, it might render the kidney incapable of filtering blood – for good. 

Kidney Enlargement

Also known as nephromegaly, kidney enlargement is brought about by a bevy of diseases. However, it can also occur due to alcohol-related liver disease. 

Remember that the liver’s main function is to filter the blood coming from the digestive tract before it is circulated to other parts of the body. When the liver is compromised, it is not able to filter the blood well. This leaves the bulk of the job to the kidney. Since the kidneys need to work doubly hard due to liver disease, its functionality can be compromised as well.  

Changes in Blood Flow to the Kidney

Alcohol-related liver disease is again, the culprit behind this change. A compromised liver can either increase or decrease the flow of plasma through the glomerulus, which can then lead to lower or higher rates of blood filtration. 

To make matters worse, a study in dogs has shown that such blood flow changes remain in place up to 7 weeks after alcohol ingestion. With these flow changes, your kidneys are at risk of developing imminent failure. 

Fluid and Electrolyte Imbalance

As has been mentioned, the kidney maintains the balance of fluid and electrolytes in the body. This can be disturbed by alcohol, which has a diuretic effect, meaning it can bring about excessive urination. When this happens, a person may end up dehydrated, with low levels of essential electrolytes in the body. 

Such was proven in the study of Martin et al, where the majority of the participants demonstrated low magnesium, potassium, and calcium levels. A third of the subjects, on the other hand, fit the clinical picture of hyponatremia (low sodium) and hypochloremia (low chloride levels). 

Low electrolyte levels may prove disastrous to the body. Low concentrations of potassium may bring about cardiac arrest, while decreased levels of sodium may lead to coma. 

Increase in Body Fluid Volume and Blood Pressure

Alcoholism leads to the accumulation of fluid and other substances in the body, which in turn increases total body fluid volume. This results in high blood pressure, which can be harmful to the kidney in the long run. 

According to the American Heart Association, high blood pressure is the second leading cause of kidney failure. Over time, hypertension can weaken, widen, or constrict the vessels that deliver blood, oxygen, and nutrients to the nephrons. When this happens, the nephron is no longer able to filter blood effectively. The result: kidney damage. 

To make matters worse, impaired kidneys are no longer able to produce aldosterone, a hormone that regulates blood pressure. This results in a lethal cycle. After hypertension damages the kidney, it’s the kidneys’ turn to further increase blood pressure. 

Changes in Acid-Base Balance

As has been mentioned earlier, one of the kidneys’ functions is to remove acids from the body. The normal process, however, can be disrupted with chronic alcohol use. 

Alcoholism can lead to acidosis, where there are high levels of acid in the body. To maintain acid balance in the body, the kidney will get rid of these acids by excreting them in the urine. Unfortunately, chronic alcoholism leaves the kidney damaged – with its functioning impaired. Because of these, the body is unable to properly regulate the acid-base balance in the body. 

This may prove detrimental to people who develop alcoholic ketoacidosis, which stems from alcoholism and starvation. Such a condition can be fatal, especially in people whose kidneys were impaired by alcohol use. 

Excessive alcohol use can harm the kidney – which in turn can lead to a variety of illnesses. Although kidney disease is irreversible, it is possible to stop the condition from progressing. With that being said, the best way to save your kidney is to stop (or limit) your alcohol intake starting today

Latest posts by Raychel Ria Agramon, BSN, RN, MPM (see all)

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