Can drinking alcohol cause kidney failure?

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The kidneys are two fist-sized, bean-shaped organs located on either side of the spine, just below the ribcage. Their primary function is to remove excess waste and fluid from the blood. Other functions they perform include:

• balancing levels of water and minerals in the blood
• producing hormones that help control blood pressure
• producing hormones that make red blood cells

Alcohol is a toxic substance that can cause dependence alongside a range of other negative health effects.

According to the World Health Organization (WHO), there is no so-called “safe” level of alcohol consumption, and the more alcohol a person drinks, the greater their risk of health issues.

In terms of alcohol’s effects on the kidneys, the National Kidney Foundation (NKF) states that drinking too much alcohol can harm kidney function and worsen existing kidney disease.

According to a 2017 review, the question of whether alcohol consumption affects kidney function remains controversial.

Scientists are not sure whether an association exists, and they are unsure as to the underlying mechanisms.

Nonetheless, the reviewers note that alcohol metabolism produces free radicals and other harmful by-products that are known to damage the body’s organs and tissues.

A 2018 study found that having alcohol use disorder increased the likelihood of having a new diagnosis of CKD. However, the study authors also mentioned that more studies are needed to explore the connection between AUD and kidney function.

As the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) explains, the kidneys contain tiny, finger-like structures called nephrons. These filter waste products from the blood and maintain the balance of water and minerals in the bloodstream.

According to the NKF, excessive alcohol consumption can damage the nephrons, impairing their ability to balance water and minerals in the body. Excessive alcohol use can lead to dehydration, which may further affect the kidneys.

Regular and excessive alcohol use can also cause high blood pressure (hypertension) for a combination of reasons, such as disrupting hormones and affecting the muscles in blood vessels.

As the American Heart Association (AHA) explains, chronic hypertension can damage the blood vessels that supply the nephrons, further impairing kidney function.

According to the NKF, regular heavy drinking can double a person’s risk of developing kidney disease. The NKF defines “heavy drinking” as follows:

• For women: consuming more than three drinks in a day or more than seven drinks in 1 week
• For men: consuming more than four drinks in a day or more than 14 drinks in 1 week

The NKF also notes that excessive drinking can cause acute kidney injury (AKI) — a sudden decrease in kidney function that usually resolves with time but may be lasting in some cases.

The Centers for Disease Control and Prevention (CDC) define excessive drinking as follows:

• For women: consuming four or more drinks on a single occasion
• For men: consuming five or more drinks on a single occasion

According to the American Kidney Fund (AKF), there are five stages of chronic kidney disease (CKD), with stage 1 representing the earliest and mildest stage and stage 5 representing the most advanced and severe.

According to a 2022 review, symptoms do not usually manifest until stage 4 or 5 of the disease. At these stages, CKD moderately to severely impacts kidney function.

The 2022 review outlines some common signs and symptoms of later stage CKD from any cause. These include:

• nausea and vomiting
• loss of appetite
• weakness and fatigue
• sleep disturbances
• decreased alertness
• decreased urine output
• muscle twitches and cramps
• swelling of the feet and ankles
• persistent itchiness
• chest pain
• shortness of breath
• hypertension

According to the CDC, other potential signs of CKD include:

• anemia
• low blood calcium levels, and high blood potassium and phosphorous levels
• increased susceptibility to infections

According to the United Kingdom’s National Health Service (NHS), a person should consult a doctor if they experience symptoms consistent with kidney disease.

People should also consider speaking with a doctor if they drink heavily or have other risk factors for kidney disease, such as:

• obesity
• diabetes
• hypertension
• heart disease
• a family history of CKD

Individuals who are concerned about their drinking habits can also consult a doctor for guidance on professional help and support.

The treatment for alcohol-induced kidney problems depends largely on the type of kidney disease a person has sustained.

Treatments for acute kidney injury

According to the NKF, individuals who have sustained an alcohol-induced AKI may require dialysis, depending on severity. Dialysis is a procedure that involves filtering waste products and excess fluid from the blood.

If the AKI is mild, a person will most likely not require dialysis. Sometimes, AKI can resolve over time if a person makes sure to stay hydrated.

According to the AKF, other general treatments for AKI include:

• medications to adjust electrolyte levels in the blood
• medications to control blood pressure
• a kidney-friendly diet to promote healing

Treatments for chronic kidney disease

People with alcohol-induced CKD will require treatment for AUD as well as CKD.

As the National Institute on Alcohol Abuse and Alcoholism (NIAAA) notes, there are many different treatment options for AUD. Examples include:

• behavioral treatments, such as one-to-one or group counseling
• mutual support groups, such as alcoholics anonymous (AA) and other 12-step programs
• medications

The AKF lists some general treatment options for CKD. These include:

• medications to lower blood pressure or cholesterol
• diuretics
• regular dialysis or a kidney transplant, for advanced CKD and end-stage renal disease

Below are some answers to frequently asked questions about alcohol-induced kidney damage.

Can kidneys recover from alcohol damage?

The NKF notes that excessive drinking can cause AKI. This type of sudden-onset kidney damage often resolves with time, but it can be lasting in some cases.

The organization adds that regular heavy drinking can lead to CKD and that this type of kidney disease does not resolve with time.

Does alcohol affect your liver or kidneys first?

The NKF explains that chronic drinking can cause liver disease, which impairs the rate of blood flow to the kidneys.

Without adequate blood flow, the kidneys struggle to remove waste products and excess fluid from the blood. This may result in subsequent kidney damage.

The NKF adds that most people in the United States who have both liver disease and kidney dysfunction are alcohol dependent.

What drinks are hardest on kidneys?

There are no specific studies suggesting that certain types of alcohol are worse on the kidneys than others.

Rather than the type of beverage, it is the amount of alcohol that affects the kidneys, with binge or excessive drinking having the most impact.

To reduce harm to a person’s health, it is best to reduce or avoid consuming alcoholic drinks where possible.

What does kidney pain from alcohol feel like?

Regular, excessive drinking may cause AKI. According to the NKF, one potential symptom of AKI is flank pain, which is pain in the side of the back, between the ribs and hips.

However, it is important to note that alcohol-induced kidney damage may not always cause kidney pain.

Alcohol is a toxic substance that can cause dependence and other negative health effects.

Some sources state that binge drinking may cause acute kidney injury (AKI), while regular heavy drinking may cause chronic kidney disease (CKD).

Whereas AKI tends to resolve with time, CKD may worsen over time — although some individuals are able to stay relatively stable with CKD with close monitoring and lifestyle changes, such as quitting alcohol.

People should consider speaking with a doctor if they have concerns about their drinking habits or kidney health.