OBJECTIVE To assess the association of alcohol consumption with chronic kidney disease (CKD) progression in patients with CKD. PATIENTS AND METHODS The KoreaN cohort study for Outcome in patients with CKD (KNOW-CKD) is a prospective observational study that included detailed questionnaires regarding alcohol consumption. The 1883 individuals with CKD were enrolled from April 1, 2011, through February 28, 2016, and followed until May 31, 2017. Using a questionnaire, alcohol consumption pattern was classified according to the amount of alcohol per occasion (none, moderate, or binge) or drinking frequency (none, occasional, or regular). The primary endpoint was a composite of 50% or greater decline in estimated glomerular filtration rate (eGFR) from the baseline level or end-stage renal disease. RESULTS During a follow-up of 5555 person-years (median, 2.95 years), the primary outcome occurred in 419 patients. Unadjusted cause-specific hazards model showed that the risk of the primary outcome was lower in drinkers than in non-drinkers. However, a fully adjusted model including eGFR and proteinuria yielded a reverse association. Compared with non-drinking, regular and occasional binge drinking were associated with a 2.2-fold (95% CI, 1.38-3.46) and a 2.0-fold (95% CI, 1.33-2.98) higher risk of CKD progression, respectively. This association was particularly evident in patients who had decreased kidney function and proteinuria. There was a significant interaction between alcohol consumption and eGFR for CKD progression. The slopes of eGFR decline were steeper in binge drinkers among patients with eGFR less than 60 mL/min/1.73 m2. CONCLUSIONS Heavy alcohol consumption was associated with faster progression of CKD.

中文翻译：

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慢性肾脏病的饮酒量和病情进展：慢性肾脏病患者结局的韩国队列研究结果。

目的评估饮酒与慢性肾病（CKD）患者的慢性肾脏病（CKD）进展之间的关系。患者与方法韩国针对CKD患者的结局队列研究（KNOW-CKD）是一项前瞻性观察性研究，其中包括有关饮酒的详细调查表。从2011年4月1日至2016年2月28日，入选1883名CKD患者，随后随访至2017年5月31日。使用问卷调查，根据每次使用的酒精量（无，中度或暴饮暴食）或饮酒频率（无，偶尔或有规律）。主要终点是估计的肾小球滤过率（eGFR）从基线水平或终末期肾脏疾病下降50％或更高的复合结果。结果在5555人年（中位数，2.95年）的随访中，主要结果发生在419例患者中。未经调整的特定病因危害模型显示，饮酒者的主要结局风险低于不饮酒者。但是，包括eGFR和蛋白尿的完全调整模型产生了反向关联。与不饮酒相比，经常和不定期的暴饮暴食分别使CKD病发风险增加2.2倍（95％CI，1.38-3.46）和2.0倍（95％CI，1.33-2.98）。这种联系在肾功能和蛋白尿减少的患者中尤为明显。CKD进程中，饮酒与eGFR之间存在显着的相互作用。在eGFR低于60 mL / min / 1.73 m2的患者中，暴饮暴食者的eGFR下降斜率更陡。