Living with a kidney disease often requires making changes to what you eat and drink to support your health. Many people wonder if it’s safe to drink alcohol with kidney disease or if it will make their condition worse. It’s important to understand safe alcohol use and kidney disease so you can make wise choices about your health and well-being. Below are five facts to know about drinking and your kidneys.

1. Alcohol and Kidney Disease Have a Complex Relationship

Most people’s risk of kidney disease isn’t tied to whether or not they choose to drink alcohol. In fact, it’s safe for some people with kidney disease to drink once in a while.

Alcohol most commonly damages the liver, though the kidneys work to filter some of the alcohol you drink, too. If you drink heavily, you double your risk of developing kidney disease during your lifetime. According to the National Kidney Foundation, heavy drinking means having three drinks in a day or seven in a week if you were assigned female at birth, and more than four drinks in a day or 14 in a week if you were assigned male at birth.

That said, even people who have only two drinks a day may see their blood pressure rise. Hypertension (high blood pressure) can also cause kidney disease. Many people can safely consume relatively low amounts of alcohol, but not everyone.

It’s important to note that some rare kidney conditions, like complement 3 glomerulopathy (C3G) and immune complex membranoproliferative glomerulonephritis (IC-MPGN), are caused by issues in the immune system or genetics. These conditions are not caused by alcohol or other lifestyle factors.

If you’re concerned that drinking alcohol may lead to kidney disease, talk to a healthcare provider. They can give you medical advice based on your specific health situation.

2. Alcohol Is Generally Safe for People With Kidney Disease

In general, the alcohol recommendations for people with kidney disease are the same as those for people without it. Some doctors say that drinking alcohol won’t make kidney disease worse.

While this may suggest that drinking moderate amounts of alcohol won’t affect your kidneys, that’s not entirely true. Alcohol may make it harder for the kidneys to do their job. Some experimental studies have shown that alcohol can damage the parts of the kidneys that filter the blood to remove toxins and waste products. However, clinical studies do not share the same results.

Outside of filtering, your kidneys also help make sure your body always has the right amount of water. Alcohol can make you dehydrated, which can make it harder for your kidneys to do their job. If your kidneys are sensitive, your doctor may ask you to avoid alcohol.

In addition, chronic heavy drinking can make it hard for your liver to do its job. This means more work for your kidneys, which can result in kidney damage.

If you want to drink, make sure you talk to your nephrology (kidney care) team first. They can help you understand if alcohol will worsen your particular kind of kidney disease and help you know what level of alcohol intake is safe for you.

3. Some People on Dialysis May Need To Limit Alcohol

People who are on dialysis to support their kidney function may need to limit alcoholic beverages, or at least be cautious about the type of alcohol they choose. Some people on dialysis have limits on how much potassium or phosphates they can consume. If you need to limit your fluid intake, that includes alcohol.

If you’re concerned about potassium, consider drinking white wine or spirits (hard liquors like vodka, whiskey, or tequila). If you’re worried about phosphates, avoid wines and beer (particularly lagers). A serving of spirits is lower in volume, useful to know if you’re concerned about how much fluid you’re drinking.

4. Your Doctor Can Help You Make Choices About Drinking After a Kidney Transplant

Alcohol and kidney transplants are another complicated subject. While some research shows that drinking either before or after a transplant doesn’t affect the success of the procedure itself, some transplant centers require people to abstain from consuming alcohol and other potentially harmful substances. This is because they claim that using alcohol can reduce the risk of a successful transplant.

In addition, some organizations also recommend that you abstain from alcohol after a kidney transplant. This may be because alcohol’s interaction with medications can have negative side effects, cause you to forget to take your medications, or prevent your body from processing medications properly.

The best thing you can do is to get instructions specifically from your transplant doctor or nephrologist. They will know the specific medications you’re on and how they might interact with alcohol.

5. Other Factors To Consider Before You Choose To Drink

There are a few other factors you should think about before you drink alcohol with kidney disease.

How It Affects Other Symptoms

Alcohol affects more than just your kidneys. For instance, it can cause both your heart rate and your blood pressure to go up. If you already have issues with your heart rate or blood pressure, you might want to reconsider drinking, or you might want to take it slow.

Your Level of Self Control

Drinking can cause you to do things like eat foods that aren’t good for your kidneys, forget to take medication, and more. These behaviors can significantly affect your kidneys and how you feel, especially if it happens frequently. If you find that you tend to do these things when you drink, it might be better to stop or limit alcohol consumption.

Alcohol and Other Medications

Alcohol can interact with medications that you take for other health issues, like heart disease, diabetes, or pain. Make sure you understand all of these interactions before you choose to drink. Check in with your pharmacist, who can see all of the different medications you’re taking, for advice. You can also talk to your primary care provider or other healthcare providers. Make sure you share every medication you take, including any supplements.

The State of Your Liver

Since alcohol mainly affects your liver, you may want to assess your liver health, and maybe your overall health, before you decide to drink. If you’re at risk for liver disease, it may be important to stop drinking alcohol.

How To Quit Drinking

Sometimes, drinking alcohol starts to feel like it is out of control. If you think your drinking has reached that point, or if you think it is causing problems for your kidneys or general health, talk to your healthcare provider. They can help you quit drinking or cut back, and they may recommend options like therapy, support groups (such as Alcoholics Anonymous), and other lifestyle changes. They may also suggest medications, alcohol counseling, or other treatment options.

Talk With Others Who Understand

MyKidneyDiseaseTeam is the social network for people with rare kidney diseases and their loved ones. On MyKidneyDiseaseTeam, members come together to ask questions, give advice, and share their stories with others who understand life with kidney disease.

Do you drink alcohol with kidney disease? What has your doctor told you is the best choice for your kidney health? Share your experience in the comments below, or start a conversation by posting on your Activities page.