Clinical and Experimental Nephrology

, Volume 22, Issue 5, pp 1133–1142 | Cite as

Alcohol consumption and incidence of proteinuria: a retrospective cohort study

  • Yoshiki Kimura
  • Ryohei YamamotoEmail author
  • Maki Shinzawa
  • Yoshitaka Isaka
  • Kunitoshi Iseki
  • Kunihiro Yamagata
  • Kazuhiko Tsuruya
  • Hideaki Yoshida
  • Shouichi Fujimoto
  • Koichi Asahi
  • Toshiki Moriyama
  • Tsuyoshi Watanabe
Original article



Previous studies report conflicting results of a dose-dependent association between alcohol consumption and incidence of chronic kidney disease. Only a few studies have assessed the clinical impact of > 45–65 g/day of critically high alcohol consumption.


This retrospective cohort study included 88,647 males and 88,925 females with dipstick urinary protein ≤ ± and estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2 at their first annual health examinations between April 2008 and March 2010 in Japan. The exposure was the self-reported alcohol consumption. The outcome was proteinuria defined as dipstick urinary protein ≥ 1 + or ≥ 2 +.


During median 1.8 years (interquartile range 1.0–2.1) of the observational period, 5416 (6.1%) males and 3262 (3.7%) females developed proteinuria defined as dipstick urinary protein ≥ 1 +. In males, a U-shape association between alcohol consumption and proteinuria was observed in a multivariable-adjusted Poisson regression model [incidence rate ratio (95% confidence interval) of rare, occasional, and daily drinkers with ≤ 19, 20–39, 40–59, and ≥ 60 g/day: 1.00 (reference), 0.86 (0.79–0.94), 0.70 (0.64–0.78), 0.82 (0.75–0.90), 1.00 (0.90–1.11), and 1.00 (0.85–1.17), respectively], whereas a J-shape association was observed in females [1.00 (reference), 0.81 (0.75–0.87), 0.74 (0.64–0.85), 0.93 (0.78–1.11), 1.09 (0.83–1.44), and 1.45 (1.02–2.08), respectively]. Similar associations with dipstick urinary protein ≥ 2 + were shown in males and females.


Moderate alcohol consumption was associated with lower risk of proteinuria in both males and females. Females with ≥ 60 g/day of high alcohol consumption were at higher risk of proteinuria, whereas males were not. Females were more vulnerable to high alcohol consumption, than males.


Alcohol consumption Heavy drinkers Proteinuria Gender difference Epidemiology 



The present study was supported by Health and Labor Sciences Research grants for ‘‘Research on the positioning of CKD in Specific Health Check and Guidance in Japan’’ (20230601), the Ministry of Health, Labor and Welfare of Japan.

Compliance with ethical standards

Conflict of interest

All the authors have declared no competing interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (IRB approval number 1485 and 13085-3 at Fukushima Medical University and Osaka University Hospital, respectively) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was not obtained from participants, because all data were anonymized, according to Japanese Ethical Guidelines for Medical and Health Research Involving Human Subjects.

Supplementary material

10157_2018_1568_MOESM1_ESM.pdf (108 kb)
Supplementary material 1 (PDF 109 KB)


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Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  • Yoshiki Kimura
    • 1
  • Ryohei Yamamoto
    • 1
    • 2
    Email author
  • Maki Shinzawa
    • 1
  • Yoshitaka Isaka
    • 1
  • Kunitoshi Iseki
    • 3
  • Kunihiro Yamagata
    • 3
  • Kazuhiko Tsuruya
    • 3
  • Hideaki Yoshida
    • 3
  • Shouichi Fujimoto
    • 3
  • Koichi Asahi
    • 3
  • Toshiki Moriyama
    • 1
    • 2
    • 3
  • Tsuyoshi Watanabe
    • 3
  1. 1.Department of NephrologyOsaka University Graduate School of MedicineSuitaJapan
  2. 2.Health Care Division, Health and Counseling CenterOsaka UniversityToyonakaJapan
  3. 3.Steering Committee for the “Research on the Positioning of Chronic Kidney Disease (CKD) in Specific Health Check and Guidance in Japan”TokyoJapan

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