september 2025

Alcohol consumption and incidence of decline in glomerular filtration rate and of proteinuria: the Osaka Kenko Innovation (TOKI) study

BACKGROUND: Although excessive alcohol consumption is a critical factor for non-communicable diseases, its clinical relevance to chronic kidney disease is controversial.

METHODS: This retrospective cohort study, including 80,765 men and 88,507 women aged 40-74 years who underwent annual health checkups in Japan between April 2012 and March 2017, assessed a dose-dependent association between alcohol consumption (rare, occasional, and daily drinkers with </= 19, 20-39, 40-59, and >/= 60 g/day) and incidence of >/= 30% decline in estimated glomerular filtration rate (eGFR), eGFR < 60 ml/min/1.73 m(2) and presence of proteinuria (dipstick urinary protein >/= 1 +), using Cox proportional hazards models adjusted for clinically relevant factors.

RESULTS: The incidence of >/= 30% eGFR decline was observed in 1231 (1.5%) men and 1291 (1.5%) women during the median observation period of 2.8 and 2.9 years, respectively. In men, daily drinkers consuming >/= 40 g/day of ethanol were at significantly high risk for >/= 30% eGFR decline (adjusted hazard ratio [95% confidence interval] of rare, occasional, and daily drinkers with </= 19, 20-39, 40-59, and >/= 60 g/day: 1.00 [reference], 1.05 [0.87, 1.27], 0.99 [0.80, 1.21], 1.05 [0.88, 1.26], 1.23 [1.01, 1.51], 1.61 [1.22, 2.11], respectively). Similar dose-dependent associations with incidence of eGFR < 60 ml/min/1.73 m(2) and proteinuria were observed in men. Contrary to men, alcohol consumption was not associated with eGFR decline and proteinuria in women.

CONCLUSION: Men with alcohol consumption >/= 40 g/day were at a high risk of eGFR decline and development of proteinuria.

Additional Info

  • Authors

    Nakamura Y.; Otsuki N.; Li Q.; Shinzawa M.; Matsui I.; Yamakawa M.; Oyama A.; Toki H.; Yamamoto R.
  • Issue

    Periodical: J Nephrol - Volume: 38 - Number: 7 - Edition: 20250713
  • Published Date

    september 2025