Rena Diet And Beer: How Much Is Too Much?

People with kidney disease who are on dialysis or a low-potassium and/or low-phosphate diet need to be careful about their alcohol consumption. Alcohol can be challenging for those on a renal diet, and it's important to consult a doctor or dietitian for personalised advice. While a little alcohol—one or two drinks occasionally—usually has no serious effects, excessive drinking can worsen kidney disease and lead to acute kidney failure. For those with kidney disease, it is recommended to limit alcohol consumption to no more than 14 units per week, spread over three or more days, and to avoid becoming dehydrated by consuming non-alcoholic drinks in between alcoholic ones. Beer typically needs to be limited to a 12-ounce serving, and it is important to be mindful of the added phosphates and potassium content in many wines, beers, and lagers. Spirits are generally a better option for those on a fluid restriction, but it is crucial to watch out for drink mixers that are high in sugar and carbohydrates.

How much beer can someone on a renal diet drink?

Beer and kidney disease

Beer is a popular alcoholic drink, and like all alcoholic drinks, it should be consumed in moderation. Drinking beer in moderation is generally considered safe for people with chronic kidney disease (CKD) who are not on dialysis. However, for those with kidney disease, there are some important considerations to keep in mind.

Firstly, alcohol can be challenging for individuals with kidney disease, particularly those undergoing dialysis or following a low-potassium and/or low-phosphate diet. Beers contain varying amounts of potassium, which can be problematic for those with kidney disease. In addition, alcoholic drinks come in different strengths and sizes, so it's important to pay attention to the number of units of alcohol consumed rather than just the number of drinks. The recommendations for alcohol intake for people with kidney disease are similar to those for the general population: no more than 14 units per week for both men and women.

Secondly, people with kidney disease need to be mindful of their fluid intake. Since their kidneys may not be able to remove excess fluid from the blood effectively, drinking too much fluid can lead to serious health concerns. Beer is a liquid and contributes to daily fluid intake. Additionally, alcohol is a diuretic, which causes the body to remove fluid more rapidly, leading to dehydration if adequate water is not consumed. This is a particular concern for those with kidney disease who have restricted fluid intake.

Thirdly, alcohol can impact the effectiveness of certain medications, including those commonly prescribed for kidney disease, such as blood pressure medications. It is crucial to discuss alcohol consumption with your doctor or pharmacist to ensure it does not interfere with your medication.

Finally, alcohol can affect blood sugar levels, which is an important consideration for people with diabetes and CKD. Alcohol can cause blood sugar levels to drop, especially when consumed on an empty stomach. Therefore, it is recommended to drink alcohol with food and to monitor blood sugar levels closely.

In summary, while moderate beer consumption may be acceptable for individuals with kidney disease in some cases, it is crucial to follow medical advice and consider the impact on fluid intake, medication effectiveness, and blood sugar levels. Always consult with your doctor or renal dietitian to determine the safe amount and type of alcoholic beverage for your specific condition.

Alcohol intake and medication

Impact of Alcohol on Kidney Health:

• Dehydration and Kidney Function: Alcohol consumption can lead to dehydration, affecting the body's ability to maintain proper water balance. This dehydration can impact the normal function of cells and organs, including the kidneys, which play a crucial role in regulating water levels in the body.
• High Blood Pressure: Excessive alcohol intake is linked to an increased risk of high blood pressure, which is a common cause of kidney disease. Alcohol can also interfere with the effectiveness of medications used to treat high blood pressure.
• Liver Disease: Chronic alcohol consumption can result in liver disease, which in turn adds to the workload of the kidneys and impairs their ability to function optimally.
• Increased Risk of Kidney Disease: Heavy drinking, defined as more than three drinks per day for women and more than four drinks per day for men, significantly increases the risk of kidney disease. Binge drinking can lead to acute kidney injury, requiring dialysis, and potentially causing lasting kidney damage.

Guidelines for Alcohol Consumption on a Renal Diet:

• Moderate Drinking: According to the federal government's Dietary Guidelines for Americans, moderate drinking is defined as no more than one drink per day for women and no more than two drinks per day for men. This distinction is based on differences in weight and how their bodies process alcohol.
• Check with Your Doctor: It is crucial to consult your doctor or healthcare provider before consuming alcohol, especially if you have a medical condition or take medications that may interact with alcohol. Certain medications can increase blood alcohol levels and alter their effectiveness or toxicity.
• Diabetes Management: For individuals with diabetes and good blood sugar control, moderate alcohol consumption with meals is generally safe. However, drinking on an empty stomach can cause blood sugar levels to drop, so it is important to be mindful of this interaction.
• Kidney Disease Considerations: If you have chronic kidney disease (CKD) and are on dialysis or a low-potassium/low-phosphate diet, choosing alcoholic beverages can be challenging. Some wines and beers contain high levels of potassium, and the volume of fluid they contribute to your daily intake should be considered.
• Recommendations for CKD Patients: The general recommendation for individuals with kidney disease is to limit alcohol consumption to no more than 14 units per week for both men and women. It is advisable to spread this intake over three or more days and have several alcohol-free days during the week.
• Drink Choices: Spirits are a good option for those on a low-potassium or low-phosphate diet as they are lower in volume and have lower levels of these substances. However, it is important to be mindful of the number of units consumed.
• Non-Alcoholic Alternatives: To avoid dehydration, it is recommended to alternate alcoholic drinks with non-alcoholic options such as water, soda water, diet fizzy drinks, or no-added-sugar squash.
• Medication Interactions: Always discuss alcohol consumption with your pharmacist or healthcare provider, as some medications can interact with alcohol, affecting their effectiveness or increasing side effects.

In summary, alcohol intake while on a renal diet requires careful consideration and medical advice. It is important to understand the potential risks associated with alcohol consumption, especially for those with kidney disease or related conditions. By following guidelines for moderate drinking, choosing suitable beverages, and being mindful of medication interactions, individuals on a renal diet can make informed decisions about alcohol consumption while prioritising their kidney health.

Fluid intake and dialysis

Dialysis works by removing excess fluid from the blood, so it is important to manage your fluid intake. Fluids are typically limited on a dialysis diet, and the exact amount you should have each day depends on your health and the type of dialysis you're on. People on home dialysis may have fewer fluid restrictions, while those on in-centre haemodialysis generally have greater limitations.

People on a dialysis fluid restriction diet should typically limit fluids to 32 ounces or less each day. Your doctor or nephrologist will discuss your specific fluid requirements. To monitor your fluid intake, write down how much you're drinking or eating throughout the day. It may also help to plan what you're going to drink and when. For instance, if you have a special occasion in the evening, consume less fluid throughout the day.

While water, tea, and other beverages are obvious fluids, some foods contain enough liquid to be considered fluids and should be limited. These include ice cream, sherbet, sorbet, ice cubes, and ice chips. A good rule of thumb is that foods that melt or are liquid at room temperature are considered fluids.

Tips for Managing Fluid Intake

• Eat cold or frozen fruit, like grapes, strawberries, or blueberries.
• Freeze your favourite beverage and sip as it melts.
• Suck on sugar-free hard candy or chew sugar-free gum.
• Drink from small cups or glasses.
• Rinse your mouth with mouthwash.
• Avoid "fluid traps," situations where you drink out of boredom or habit.
• Wait for fluid cravings to pass.
• Stay cool during hot months with a misting fan and proper clothing.

Complications of Excess Fluid Intake

For dialysis patients, excess fluid intake can lead to:

• A sudden drop in blood pressure.
• Shortness of breath and, in some cases, fluid in the lungs.
• Heart problems, including a fast pulse, weakened heart muscles, and an enlarged heart.

Alcohol's impact on blood pressure

Alcohol has both acute and chronic effects on blood pressure.

Alcohol's Acute Effects on Blood Pressure

A single dose of alcohol can decrease systolic and diastolic blood pressure within six hours of consumption. This effect can last up to 12 hours, after which blood pressure increases. This biphasic effect is more pronounced with high doses of alcohol.

Alcohol's Chronic Effects on Blood Pressure

Excessive alcohol consumption is considered one of the most common causes of raised blood pressure. It can lead to hypertension and more than 200 associated disorders.

Mechanisms

The exact molecular mechanisms through which alcohol raises blood pressure are unclear. However, several studies have suggested the following potential mechanisms:

• Alcohol may affect the renin-angiotensin-aldosterone system (RAAS) by increasing plasma renin activity. This increases the production of angiotensin II, a potent vasoconstrictor that stimulates aldosterone and vasopressin secretion. As a result, peripheral resistance and blood volume increase, leading to elevated arterial blood pressure.
• Alcohol may stimulate the sympathetic nervous system and increase noradrenaline levels. Noradrenaline stimulates adrenergic receptors in the heart muscles, increasing blood pressure and heart rate.
• Alcohol may diminish baroreceptor sensitivity, which is a key factor in regulating blood pressure. Acute alcohol administration stimulates the release of histamine and endorphin, which interfere with baroreflex sensitivity.
• Heavy alcohol consumption may increase plasma cortisol levels. Several studies have suggested a role for cortisol in alcohol-induced hypertension. Excess cortisol has been associated with elevated blood pressure in normotensive individuals.

While moderate alcohol consumption may have cardioprotective effects, excessive alcohol intake can lead to hypertension and related health complications. Therefore, it is important to consume alcohol in moderation and consult a healthcare professional if concerned about alcohol's impact on blood pressure.

Choosing suitable drinks

Understand the impact of alcohol on the body:

Alcoholic beverages, including beer, can have varying effects on individuals, depending on factors such as size, frequency of drinking, and food consumption. Alcohol enters the bloodstream quickly and can affect multiple organs and systems in the body. It can influence the central nervous system, increase dopamine release, and slow down the body's response to stimuli. Excessive drinking can lead to negative consequences, including an increased risk of chronic conditions, violence, and cognitive function issues. Therefore, it is important to consume alcohol in moderation or consider non-alcoholic alternatives.

Explore low-calorie, nutritious options:

When choosing drinks, prioritize options that are low in calories but high in nutritional value. Skim milk and soy milk are excellent choices as they are low in calories and provide essential nutrients like calcium and vitamin D. Additionally, plant-based milk substitutes like almond milk can be a good alternative, although they may contain fewer proteins. Green tea is another recommended option, as it is calorie-free and may offer potential weight loss benefits, improved concentration, and a reduced risk of type 2 diabetes.

Be mindful of portion sizes and frequency:

Moderation is key when it comes to drinking, especially with alcoholic beverages. The National Institute on Alcohol Abuse & Alcoholism (NIAAA) defines moderate drinking as up to four drinks per day for men and three drinks per day for women, not exceeding 14 drinks per week for men and seven drinks per week for women. Binge drinking, which is consuming large amounts of alcohol in a short period, can lead to weight gain and negatively impact your health. Therefore, it is important to monitor your drinking habits and stick to recommended serving sizes.

Stay hydrated with water:

Water is the best beverage to restore fluids lost through metabolism, breathing, sweating, and waste removal. While the eight-glasses-a-day rule is a good guideline, your water intake may vary depending on factors such as age, activity level, weight, and climate. Staying hydrated has numerous benefits, including improved digestion, skin health, and mood. Additionally, drinking water before alcoholic beverages can help with moderation and prevent dehydration, as alcohol is a diuretic.

Opt for unsweetened tea and coffee:

Tea and coffee, when consumed plain, are calorie-free and packed with antioxidants and flavonoids. Green tea, in particular, has been linked to potential heart health benefits, while coffee may help protect against type 2 diabetes. However, adding cream, sugar, or flavoured syrups can significantly increase the calorie content and negate the health benefits. Therefore, it is best to drink tea and coffee in moderation and without excessive additives.

Be cautious with fruit juices and smoothies:

While fruit juices and smoothies can provide essential vitamins and antioxidants, they often contain high levels of sugar and calories. A better alternative is to opt for vegetable juice, which has fewer calories. For example, a cup of tomato juice has 41 calories compared to 122 calories in orange juice. If you choose to consume fruit juice, look for 100% fruit juice options and be mindful of portion sizes.

In conclusion, choosing suitable drinks while on the Renna diet involves selecting options that support your health goals. Opt for low-calorie, nutritious beverages like skim milk, soy milk, and green tea. Practice moderation with alcoholic drinks and prioritise water as your primary source of hydration. Tea, coffee, and vegetable juices can also be incorporated, but be mindful of any added sugars or sweeteners. Remember, it's important to consult with a healthcare professional or nutritionist to determine the best drink choices that align with your specific needs and requirements while on the Renna diet.

Frequently asked questions