Kidney Res Clin Pract.
2021 Jun;40(2):282-293. 10.23876/j.krcp.20.186.
Causal effect of alcohol use on the risk of end-stage kidney disease and related comorbidities: a Mendelian randomization study
- Park S
1,2 - Lee S3
- Kim Y4
- Lee Y3
- Kang MW5
- Kim K6
- Kim YC5
- Han SS5,8
- Lee H5,8
- Lee JP7,8,9
- Joo KW5,7,8
- Lim CS7,8,9
- Kim YS1,5,7,8
- Kim DK5,7,8
- Affiliations
-
- 1Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
- 2Department of Internal Medicine, Korean Armed Forces Capital Hospital, Seongnam, Republic of Korea
- 3Division of Nephrology, Department of Internal Medicine, Uijeongbu Eulji University Medical Center, Seongnam, Republic of Korea
- 4Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
- 5Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- 6Transdisciplinary Department of Medicine and Advanced Technology, Seoul National University Hospital, Seoul, Republic of Korea
- 7Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- 8Kidney Research Institute, Seoul National University, Seoul, Republic of Korea
- 9Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
- KMID: 2520044
- DOI: http://doi.org/10.23876/j.krcp.20.186
Abstract
- Background
An inverse observational association between alcohol use and the risk of chronic kidney disease (CKD) or end-stage kidney disease (ESKD) has been reported. The causal effect of alcohol use on the risk of ESKD warrants additional investigation.
Methods
The study was an observational cohort study investigating the UK Biobank and performed Mendelian randomization (MR) analysis. Amounts of alcohol use were collected using a touchscreen questionnaire. In the observational analysis, 212,133 participants without prevalent ESKD were studied, and the association between alcohol use and the risk of prevalent CKD or incident ESKD was investigated. The genetic analysis included 337,138 participants of white British ancestry. For one-sample MR, an analysis based on a polygenic risk score (PRS) was conducted with genetically predicted alcohol intake. The MR analysis investigated ESKD outcome and related comorbidities.
Results
Lower alcohol use was observationally associated with a higher risk of prevalent CKD or incident ESKD. However, the genetic risk of CKD was significantly associated with lower alcohol use, suggesting reverse causation. A higher PRS for alcohol use was significantly associated with a higher risk of ESKD (per units of one phenotypical alcohol drink; adjusted odds ratio of 1.16 [95% confidence interval, 1.02–1.31]) and related comorbidities, including hypertension, diabetes mellitus, obesity, and central obesity.
Conclusion
The inverse observational association between alcohol use and the risk of CKD or ESKD may have been affected by reverse causation. Our study supports a causal effect of alcohol use on a higher risk of ESKD and related predisposing comorbidities.
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