DENVER – Moderate alcohol consumption among renal transplant recipients is inversely associated with posttransplant diabetes and all-cause mortality, results from a large single-center study showed.
The finding contradicts the notion that renal transplant recipients should refrain from alcohol use because of possible interaction with their immunosuppressive drugs, lead investigator Dorien M. Zelle said in an interview during a poster session at the annual meeting of the American Society of Nephrology.
"After renal transplantation, patients have a lot of restrictions," said Ms. Zelle, a PhD candidate at University Medical Center Groningen, The Netherlands. "Doctors advise them not to smoke, and they have to take a lot of medications. We should not advise them against moderate alcohol consumption, because we have shown that nondrinkers are doing worse than moderate drinkers after transplantation."
She went on to note that the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the Care of Kidney Transplant Recipients does mention specific alcohol restrictions for kidney transplant patients.
Ms. Zelle and her associates studied 600 renal transplant recipients who visited the medical center’s outpatient clinic between 2001 and 2003 and were at least 1 year post transplant. They filled out self-report questionnaires about their alcohol use and the researchers recorded mortality and graft failure until May 2009. Study participants were classified into one of four groups: abstainers, sporadic drinkers, moderate drinkers (range of 1 unit per week to 3 units per day), and heavy drinkers (4 or more units per day).
At baseline, the mean age of the 600 patients was 51 years and 12% had posttransplant diabetes. Nearly half (288, or 48%) were abstainers, 94 (16%) were sporadic drinkers, 210 (35%) were moderate drinkers, and 8 (1%) were heavy drinkers.
Ms. Zelle reported that during a median follow-up of 7 years, moderate drinkers had a 67% lower risk for diabetes compared with respondents in the other groups (OR = 0.33). In addition, 33 (15.7%) of the moderate drinkers died, compared with 75 (26%) of the abstainers, 23 (24.5%) of the sporadic drinkers, and 2 (25%) of the heavy drinkers.
Univariate Cox regression analysis revealed that moderate drinkers were 44% less likely to die after transplantation compared with respondents in the other groups (HR = 0.56). Adjustment for potential confounders including diabetes and smoking did not change this association.
Ms. Zelle acknowledged certain limitations of the study, including its single center design and the fact that alcohol consumption was measured at a single point in time. "It could be that some patients started drinking more or quit drinking during the course of the study," she said.
Ms. Zelle said that she had no relevant financial disclosures to make.