Beer And Dialysis: Is It A Safe Combination?

Drinking alcohol while on kidney dialysis is a complex issue that requires careful consideration. For individuals with chronic kidney disease (CKD) who are undergoing dialysis, consuming alcohol can be challenging due to the need for a low-potassium and/or low-phosphate diet. Beers and wines, for example, can contain significant amounts of potassium, and the fluid intake restrictions for dialysis patients may be as low as one litre per day, making it difficult to include alcoholic drinks.

Additionally, certain medications may interact with alcohol, and diabetes can increase the risk of low blood sugar when consuming alcohol. It is crucial to consult with a doctor or dietitian before including alcohol in one's diet while on dialysis, as individual circumstances vary. While moderate alcohol consumption may be allowable for some, it must be carefully managed within fluid allowances and in consideration of medications.

Beer and wine contain potassium and phosphorus

The consumption of beer and wine, therefore, can impact the body's mineral balance. A study analysing 52 types of bottled beer found that while beer is a good source of calcium, it is a poor source of chlorine, potassium, and phosphorus. The study showed that the potassium content in beer ranged from 0.064 to 0.191 grams per litre, while the phosphorus content ranged from 0.012 to 0.036 grams per litre. These amounts can contribute to the daily requirement of these minerals, with one bottle of beer providing up to 3% of the daily need.

For individuals with kidney disease who are on dialysis or a low-potassium and/or low-phosphate diet, the choice of alcoholic beverages can be challenging. Beer and wine contain different amounts of potassium and phosphorus, and dialysis patients should limit their consumption accordingly. Spirits, on the other hand, have the lowest amount of these minerals and are a better option for those on fluid restriction. It is important to note that the recommendations for alcohol consumption for people with kidney disease are the same as for the general population: no more than 14 units per week for both men and women.

It is always advisable to consult a doctor or dietitian before consuming alcohol while on dialysis, as certain medications can interact with alcohol. Additionally, individuals with diabetes need to be cautious as alcohol can affect blood sugar levels, especially when consumed on an empty stomach. Overall, while beer and wine do contain potassium and phosphorus, consumption should be limited and done so in consultation with a healthcare professional to ensure it aligns with an individual's specific needs and restrictions.

Alcohol can be included in a kidney diet in moderation

If you have kidney disease, drinking alcohol can be challenging, especially if you are on dialysis or a low-potassium or low-phosphate diet. However, by working with your doctor and dietitian, it may be possible to include alcohol in your diet in moderation. Here are some considerations to keep in mind:

Talk to your doctor

Before consuming alcohol while on dialysis, it is essential to check with your nephrologist or renal dietitian. They will review your medical history and medications to ensure that drinking alcohol is safe for you. Your doctor will advise you on the types and amounts of alcohol that are suitable for you.

Know your risk factors

If you have diabetes, drinking alcohol can increase the risk of low blood sugar, especially if you have not eaten. It is recommended to not drink on an empty stomach or when your blood sugar is low. Additionally, be mindful of drink mixers that are high in sugar and carbohydrates, as these can cause a spike in blood sugar levels. Select mixers without calories, such as club soda, diet soda, or water, to avoid blood sugar fluctuations.

Be mindful of fluid intake

Moderation is crucial when it comes to fluid intake, especially if you are on a fluid restriction due to dialysis. Excessive fluid intake can be challenging for your heart. A typical fluid limit for patients on dialysis is 32 ounces per day, so drinking a single 12-ounce beer will significantly impact your daily fluid allowance. Talk to your doctor or dietitian about your personalised fluid recommendations. Limiting alcoholic beverages to one serving can help manage your fluid intake and reduce the intake of potassium and phosphorus.

Choose drinks wisely

Be cautious of drinks high in potassium or phosphorus. Cocktails made with milk, cream, tomato juice, or orange juice are loaded with potassium and should be avoided. Beer and wine contain varying amounts of potassium and phosphorus, so dialysis patients should limit their intake. Spirits have the least amount of these minerals, but it is important to stick to the recommended serving size of 1.5 ounces (1 shot). Be mindful that mixers can also contribute to the potassium and phosphorus content of a drink. Select mixers low in these minerals, such as club soda, sprite, tonic water, or juice.

Medication interactions

Some medications may interact with alcohol and affect their effectiveness. Check with your doctor or pharmacist to ensure that alcohol will not interfere with your medications.

Safe drinking guidelines

According to the federal government's Dietary Guidelines for Americans, moderate drinking is defined as one drink per day for women and older people and two drinks per day for men. However, it is important to note that these guidelines may vary depending on individual health factors.

Alcohol can cause high blood sugar

For people with kidney disease who are on dialysis, drinking alcohol can be challenging. This is especially true for those who are on a low-potassium or low-phosphate diet, as many alcoholic drinks contain these minerals. Beer, for example, contains phosphorus, and some wines and beers can have high amounts of potassium.

Now, onto the topic of alcohol and blood sugar. Alcohol can cause high blood sugar, and this is how:

Alcohol Interferes with Blood Sugar Regulation

The liver is the organ responsible for releasing glucose (sugar) into the bloodstream to maintain healthy blood sugar levels. It also breaks down toxins, such as alcohol, to be flushed out of the body. When you drink alcohol, the liver prioritises breaking it down instead of releasing glucose, leading to unstable blood sugar levels. This is more likely to happen when drinking on an empty stomach, and the risk increases with each additional drink.

Alcohol Increases Appetite and Calorie Intake

Alcohol stimulates your appetite and may impair your judgment, leading to overeating and disrupting your blood sugar control. Alcoholic drinks are often high in calories, making it more challenging to lose weight and manage blood sugar levels.

Alcohol Interferes with Diabetes Medication

Alcohol can reduce the effectiveness of oral diabetes medications and insulin. It interferes with the liver's ability to turn proteins and fats into carbohydrates when the body needs energy, such as during exercise or between meals. This can worsen blood sugar control.

Alcohol and High-Sugar Mixers

Drinks mixed with sugary juices or sodas can further increase blood sugar levels. It is recommended to choose mixers wisely, opting for low-calorie options such as club soda, diet tonic water, or water.

Recommendations for People with Diabetes

If you have diabetes and are considering drinking alcohol, it is crucial to consult your doctor first. They can advise you on whether alcohol may interfere with your medications or cause other health issues.

If you choose to drink, it is important to drink in moderation and only when your diabetes and blood sugar levels are well-managed. Here are some additional recommendations:

• Drink alcohol only with food, preferably including some carbohydrates.
• Avoid drinking on an empty stomach or when your blood sugar levels are low.
• Monitor your blood sugar levels before, during, and after drinking.
• Opt for low-carb alcoholic beverages, such as distilled spirits, dry wines, or light beers.
• Avoid sweet wines or drinks mixed with sugary ingredients.
• Choose calorie-free or low-calorie mixers, such as diet soda or tonic water.
• Keep hydrated with zero-calorie beverages like water.

Alcohol can be harmful to those with high blood pressure

Drinking excessive alcohol is considered one of the most common causes of raised blood pressure. It can affect blood pressure through a variety of mechanisms, including by affecting the renin-angiotensin-aldosterone system (RAAS), stimulating the sympathetic nervous system, and diminishing baroreceptor sensitivity.

The effects of alcohol on blood pressure are dose-dependent. Low-dose alcohol consumption (less than 14 g) within six hours does not affect blood pressure but does increase heart rate. Medium-dose alcohol (14 to 28 g) within six hours decreases systolic and diastolic blood pressure but increases heart rate. High-dose alcohol (>30 g) within six hours decreases systolic and diastolic blood pressure and increases heart rate. The effects of alcohol on blood pressure can last up to 12 hours after consumption, and alcohol consistently increases heart rate within 24 hours of consumption.

For people with kidney disease who are on dialysis, choosing suitable drinks, especially those containing alcohol, can be challenging. Alcoholic drinks come in different strengths and sizes, so it is important to be aware of how much alcohol you are consuming. The recommendations for alcohol intake for people with kidney disease are the same as for the general population: it is recommended to not drink more than 14 units per week for both men and women.

If you are on dialysis and want to include alcohol in your diet, it is important to talk to your doctor and dietitian to determine what is safe for you. Moderation is key if you are on a fluid restriction, as being fluid overloaded is hard on your heart. Alcoholic drinks can also be high in potassium and phosphorus, so it is important to be mindful of this if you have been advised to lower your intake of these minerals.

Alcohol has no nutritional benefit but contains calories

While it is not outright wrong to drink beer while having kidney dialysis, there are several factors to consider. Firstly, alcohol can be challenging for people with kidney disease who are on dialysis or a low-potassium and/or low-phosphate diet. Beer and wine, for example, contain potassium and phosphorus in different amounts. For those on fluid restrictions, it is important to note that one can of beer contains 12 ounces of fluid. This can quickly add up and exceed the typical fluid limit for patients on dialysis, which is 32 ounces of fluid per day.

Regarding the statement "Alcohol has no nutritional benefit but contains calories", it is true that alcoholic beverages primarily consist of water, alcohol (ethanol), and different amounts of sugar. Alcohol contains seven calories per gram, which is higher than the calories per gram of protein and carbohydrates. These calories from alcohol are considered "empty calories" as they provide no nutritional value and are not essential to the body. Alcohol does not fall under the category of essential nutrients, and its consumption can even inhibit the absorption of vital nutrients.

The negative health impacts of alcohol consumption are well-known, and it is classified as a drug and a known depressant. Alcohol can damage your health and negatively impact your nutritional status, even when consumed in small quantities. It increases the risk of developing cardiovascular disease, liver disease, digestive disorders, and certain types of cancer. Additionally, alcohol interferes with the body's normal digestion process, inhibiting the absorption of essential nutrients like thiamine (B1), B12, folic acid, and zinc. This can lead to nutritional deficiencies and related health issues.

In conclusion, while it may be tempting to unwind with a beer or celebrate with an alcoholic beverage, it is important to remember that alcohol provides no nutritional benefits and can have detrimental effects on your health, especially when coupled with kidney dialysis. It is always advisable to consult with your doctor or dietitian to make informed choices regarding alcohol consumption, especially if you have specific health concerns or are undergoing treatment like dialysis.

Frequently asked questions