The Truth About Alcohol
By Kelly Morrow, Registered Dietician
Many people with PKD have questions about alcohol. Is it OK to have an occasional drink when you have PKD? Are there any benefits to drinking alcohol? What are the risks?
Here are some factors to consider before you pour yourself a drink. In general, when speaking about an otherwise healthy population, moderate alcohol intake may help reduce the risk of heart disease, Alzheimer's and dementia. Red wine is known to have phytochemicals that are protective to the heart and blood vessels. Microbrew beers are a source of B-vitamins. This being said, nutritional benefits of whole, natural foods outweigh the benefits of alcohol, so there is no reason to start drinking if you never have before. The real question lies in the consideration of risk to the kidneys when they are affected by PKD.
What Does Research Say?
To date, there have not been any studies looking at alcohol's effects on the progression of PKD. When looking at the effects on other kidney diseases, moderate drinking does not seem to have a dramatic impact. Several studies looking at lifestyle factors and the development of chronic kidney diseases have shown that obesity, smoking, and physical inactivity have associations, while moderate drinking does not seem to have a negative effect.
How Can Alcohol Affect My Kidneys?
Alcohol can increase your chance of developing high blood pressure, which is known to accelerate the decline in kidney function in PKD, as well as other kidney diseases. Recent studies from Japan demonstrate an elevation in blood pressure in healthy adult men even with small amounts of alcohol (20 grams per day or roughly equivalent to 1 glass of wine). The effects were magnified in people older than 48, so it is becoming apparent that even light drinking may increase blood pressure, especially if done on a regular basis.
If you already have high blood pressure, alcohol can interfere with your medications and make it harder to control your blood pressure. Uncontrolled or poorly controlled high blood pressure is more likely to damage your kidneys. Regular alcohol consumption can damage kidney function, particularly if liver disease is also present. Researchers have observed alcohol-related changes in the kidneys that impairs their ability to regulate fluid and electrolytes in the body. This is especially a problem when liver disease is present, so those with liver cysts may want to be especially cautious. Chronic high intake of alcohol can cause both liver and kidney failure.
How Much Is OK?
This should ultimately be determined by your doctor; however most people with PKD who are otherwise healthy can enjoy the occasional social drink. According to the Dietary Guidelines for Americans, "Moderate Intake of Alcohol" means:
- No more than two drinks a day for men
- No more than one drink a day for women and older adults (older than 65)
One drink equals:
- one 12-ounce bottle of beer or wine cooler
- one 5-ounce glass of wine
- one ounce of 100-proof whiskey
These intakes are recommendations for otherwise healthy people. Those with PKD should drink less.
How Can Alcohol Interact With My Medications?
Alcohol is known to interfere with the function of many prescription drugs, making them toxic or lessening their effects. It is estimated that nearly half of the 100 most commonly prescribed medications have negative interactions with alcohol. If you are taking prescription medications, it is important that you know how they interact with alcohol before having a drink. Ask your doctor or pharmacist for more information.
What If I'm On Dialysis?
Your doctor will need to evaluate your medications, overall health and nutritional status before making a recommendation about alcohol. Remember that all alcohol should be counted toward your daily fluid intake. If you are pre-dialysis, do not have high blood pressure and are not on any medications that interact with alcohol, an occasional drink of alcohol will probably not adversely affect your kidneys. Its always best, however, to consult with your doctor to find out your specific recommendations regarding alcohol and PKD.
Patient Story: Eileen Litchfield
Eileen Litchfield learned about healthy eating habits at a young age.
"Our mother always pushed the food pyramid on us," Eileen said. "Fresh fruits and vegetables. No soda pop. Of course, we also had a lot of meat, which turned out to be expensive urine, I later learned."
Her father practiced good nutrition, as well, and she saw that he was able to push off dialysis longer than most people. She has tried to do the same since learning she had PKD.
"When I initially learned I had PKD, my nephrologist said that I should have no caffeine and limit my protein and salt intake," she said. "And, of course, no smoking. I'm still following those guidelines, and the good nutrition and exercise have helped me keep my weight and blood pressure down."
Those habits, as well as frequent exercise, have contributed to healthier kidneys for Eileen. She notes that having better overall health is great, but it specifically makes it easier on her kidneys.
"I'm motivated by wanting quality years from my life," she said. "I exercise every day, even if it means waking up at 5:30 a.m. You get addicted to it, and it's a good addiction."
Eileen suggests starting off small when trying to make a big change.
"Start with trying one vegetarian meal a week. Try fresh herbs instead of salt," she said. "Walk a short distance with someone. You'll be less likely to make excuses. Switch to fresh fruit for dessert.
"If you were raised to clean your plate, get a dog. Let him clean your plate."
While having a dog isn't a necessary component for every diet, having realistic expectations and following just a few simple steps can make it easy for anyone to get started on the path to better nutrition and healthier kidneys.
Solving the Protein Puzzle for early-stage PKD
by Kelly Morrow, MS, RD
Protein is an essential nutrient that is a chief component of cells in the body. It is essential for building and repairing body tissues, supporting the immune system, and providing the proper balance of neurotransmitters (the brain's communications molecules). For people with PKD, protein needs vary according to kidney function.
What foods have protein?
Meats, fish, eggs, dairy products (milk, cheese, yogurt), legumes (beans), grains and a small amount in vegetables.
How much should I eat?
If you have PKD and are not on dialysis, you may have heard the recommendation to eat less
protein. The average American diet contains up to two times the recommended amount of protein! If you have PKD, it is not recommended that you follow a low-carbohydrate, high-protein diet. Research in humans and animals has shown that consuming less protein may slow the progression of kidney disease, including PKD. One precaution about lowering protein intake is to make sure that calorie intake is adequate. If protein intake is severely restricted or if calorie intake is too low, weight loss and malnutrition are potential problems. Meeting with a dietician can be helpful in preventing these problems.
Here's an equation to help you determine how much protein you should eat if you are not on dialysis and have not been told you have compromised kidney function: 0.6–0.8 grams per kilogram ideal body weight*
Take your ideal body weight and divide that number by 2.2; then multiply by 0.6 and 0.8 to get
your recommended range of protein intake. The equation is the same for men and women. For example, a 180-pound man (at ideal weight) would need 49-65 grams of protein per day.
- 180 pounds / 2.2 = 81.8 kilograms
- 81.8 kilograms / 0.6 = 49 grams of protein
- 81.8 kilograms / 0.8 = 65 grams of protein