The Link between Alcohol Consumption and Kidney Injury

Alcohol use disorder contributes to systemic organ dysfunction, but its direct effect on kidney health is unclear. Epidemiologic studies have shown inconsistent findings due to a reliance on conventional markers, such as serum creatinine and blood urea nitrogen, which are insensitive to early chronic kidney disease and influenced by factors such as muscle mass, diet, and hydration status. Experimental studies have indicated that alcohol may directly exacerbate renal damage through mitochondrial dysfunction, oxidative stress, and inflammation. Furthermore, indirect effects from alcohol-induced altered intestinal permeability and microbiome, liver injury, microcirculatory/cardiac dysfunction and muscle damage may also facilitate kidney damage. Notably, alcohol-related liver disease can lead to hepatorenal syndrome, a severe type of kidney dysfunction driven by circulatory disturbances and systemic inflammation. This overview explores the adverse effects of alcohol misuse on kidney health and disease, emphasizing the need for comprehensive epidemiologic studies with more sensitive kidney injury biomarkers. It also highlights the importance of using clinically relevant preclinical models to clarify the underlying mechanisms of alcohol-related kidney injury and to enhance the understanding of its long-term clinical consequences.