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논문분류	춘계학술대회 초록집
제목	The association between alcohol consumption and renal outcome is modified by chronic kidney disease stages
저자	Heebyung KOH1, Youn kyung KEE1, Shinchan KANG1, Jaeyeol KWON1, Joohwan KIM1, Cheol ho PARK1, Sangmi LEE1, Changhyun LEE1, Tae ik CHANG4, Jung tak PARK1, Tae-hyun YOO1, Shin-wook KANG1,3, Kyu hun CHOI1, *Seung hyeok HAN1
출판정보	2017; 2017(1):
키워드	Alcohol consumption, chronic kidney disease, renal outcome
초록	Objectives : Several studies have suggested that moderate alcohol drinking exhibits beneficial effects on the development of chronic kidney disease (CKD). However, these studies included mostly healthy individuals or those having glomerular rate (eGFR) of ≥ 60 ml/min/1.73 m2. To date, studies that examined the association between alcohol consumption and progression of CKD in patients with CKD are scarce. Methods : We analyzed drinking pattern according to CKD stages and examined the association between alcohol consumption and CKD progression using the database from the prospective KoreaN cohort study for Outcome in patients With CKD (KNOW-CKD). After excluding 641 patients who did not respond to dietary survey or have missing data, a total 1597 patients were included. Alcohol consumption within last 1 year was categorized into none, ≤ 1 drinks per month, 2-4 drinks per month, 2-3 drinks per week, and ≥ 4 drinks per week. Primary outcome was a composite of halving of eGFR or the onset of end stage renal disease. Results : The mean age was 53.5 years and 61.6% were male. Patients with decreased baseline renal function were less likely to consume alcohol (P for trend < 0.001). Multivariable Cox analysis showed that there was a significant interaction between alcohol consumption and eGFR (p < 0.001). In addition, Charlson comorbidity index (CCI) score was higher in patients with less alcohol consumption, suggesting abstinence from alcohol in patients with high comorbid condition. During a median follow-up of 38.1 months, primary outcome occurred in 263 (16.5%) patients. In a multivariate Cox regression after adjustment of age, sex, body mass index, systolic blood pressure, Creactive protein, total cholesterol, smoking and CCI score, more alcohol consumption was significantly associated with a lower risk for adverse outcome. Compared to non-drinkers, hazard ratios (HRs) for developing primary renal outcome in patients who consumed 2-4 drinks per month, 2-3 drinks per week, ≥ 4 drinks per week were 0.67 (95% confidence interval [CI], 0.47-0.97; p=0.034), 0.59 (95% CI, 0.37-0.95; p=0.031) and 0.29 (95% CI, 0.11-0.79; p=0.015), respectively. However, beneficial effect of alcohol was lost after CKD-related parameters such as eGFR, urine protein-creatinine ratio, hemoglobin, and phosphate were added to the model. Similar association was observed between the amount of alcohol and adverse renal outcomes. Conclusions : We demonstrated no association between alcohol consumption and renal adverse outcomes after adjustment of CKD-related factors. Thus, beneficial effects of alcohol on CKD development or progression should be interpreted cautiously with CKD severity taken into account.
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