School of Public Health, Medical College of Soochow University, Suzhou, China.
Department of Radiotherapy, The First Affiliated Hospital of Soochow University, Suzhou, China.
Alcohol Clin Exp Res. 2019 Jul;43(7):1360-1372. doi: 10.1111/acer.14112. Epub 2019 Jun 5.
The relationship between alcohol drinking and chronic kidney damage, mainly including declined glomerular filtration rate (GFR), proteinuria, and end-stage renal disease, was conflicting. Thus, a meta-analysis was conducted to investigate their potential associations. PubMed and Web of Science were searched to identify prospective studies assessing the associations between alcohol drinking and chronic kidney damage published up to March 2019. Random-effects model was employed to pool the relative risks (RR) with 95% confidence intervals (CIs). Subgroup meta-analyses stratified by the basic characteristics of subjects were performed. A total of 15 cohort studies were included in the present study, with 268,723 participants and 31,766 incident cases. Participants with low (<13 g/d), moderate (13 to 26 g/d), and high (26 to 60 g/d) dose of alcohol drinking had 12% (RR: 0.88, 95% CI: 0.83 to 0.93), 24% (RR: 0.76, 95% CI: 0.70 to 0.83), and 21% (RR: 0.79, 95% CI: 0.71 to 0.88) lower risk of chronic kidney damage compared with the reference group (non- or occasional drinkers), respectively. The lower risk for chronic kidney damage remained significant for the declined GFR, or in men, or for participants aged less than 55 yrs, or studies with longer than 8 yrs of follow-up, while severe alcohol drinking (≥60 g/d) insignificantly increased 7% risk of chronic kidney damage (RR: 1.07, 95% CI: 0.53 to 2.15). No obvious heterogeneity and no publication bias were observed. Based on our meta-analysis, participants with alcohol drinking less than 60 g/d were at lower risk of declined GFR, especially in men or participants aged less than 55 yrs. Much more prospective cohort studies are required to confirm our present findings.
饮酒与慢性肾脏损害的关系,主要包括肾小球滤过率(GFR)下降、蛋白尿和终末期肾病,存在争议。因此,进行了一项荟萃分析以研究它们之间的潜在关联。检索了 PubMed 和 Web of Science,以确定截至 2019 年 3 月评估饮酒与慢性肾脏损害之间关联的前瞻性研究。采用随机效应模型计算相对风险(RR)及其 95%置信区间(CI)。根据研究对象的基本特征进行了亚组荟萃分析。本研究共纳入了 15 项队列研究,共 268723 名参与者和 31766 例病例。低(<13g/d)、中(13 至 26g/d)和高(26 至 60g/d)剂量饮酒的参与者发生慢性肾脏损害的风险分别降低了 12%(RR:0.88,95%CI:0.83 至 0.93)、24%(RR:0.76,95%CI:0.70 至 0.83)和 21%(RR:0.79,95%CI:0.71 至 0.88)。与对照组(非或偶尔饮酒者)相比,这种较低的慢性肾脏损害风险仍然显著,而且对于 GFR 下降、男性、年龄小于 55 岁的参与者、或随访时间超过 8 年的研究也是如此,而大量饮酒(≥60g/d)则显著增加了 7%的慢性肾脏损害风险(RR:1.07,95%CI:0.53 至 2.15)。未观察到明显的异质性和发表偏倚。基于我们的荟萃分析,饮酒量小于 60g/d 的参与者发生 GFR 下降的风险较低,尤其是男性或年龄小于 55 岁的参与者。需要更多的前瞻性队列研究来证实我们目前的发现。