Having only one kidney does not necessarily mean you cannot drink alcohol. However, there are some important factors to consider when deciding whether or not to drink alcohol with one kidney.
Quick Answer
The quick answer is that most people with one kidney can consume alcohol in moderation. Heavy and long-term alcohol use is not recommended as it can further damage the remaining kidney.
What happens when you drink alcohol with one kidney?
When you drink alcohol, it is filtered by the kidneys. The kidneys filter out waste products and excess fluid from the blood.
In a healthy person with two functioning kidneys, the kidneys can easily filter alcohol and remove it from the body. But with only one kidney, the sole kidney has to work harder to filter the alcohol and other wastes from the bloodstream.
Drinking too much alcohol overworks the lone kidney and causes several problems:
- Formation of kidney stones
- Urinary tract infections
- High blood pressure
- Electrolyte imbalances
- Kidney disease progression
- Kidney failure
The more impaired the one kidney is, the worse the effects of alcohol. People with chronic kidney disease (CKD) are at very high risk for further kidney damage from alcohol.
Is moderate drinking ok with one kidney?
Many people with a single healthy kidney can safely consume light to moderate amounts of alcohol with minimal increased risk. Moderation is defined as:
- No more than 1 drink per day for women
- No more than 2 drinks per day for men
One drink equals:
- 12 oz beer (5% alcohol)
- 5 oz wine (12% alcohol)
- 1.5 oz spirits (40% alcohol)
However, even moderate drinking may be harmful for certain individuals:
- People with high blood pressure or kidney disorders – even moderate alcohol can raise blood pressure and damage kidneys further
- People taking medications that interact with alcohol
- People with a family history of alcohol abuse – increased risk of addiction
- People with reduced kidney function (eGFR below 60ml/min/1.73m2) – impaired kidney function reduces alcohol excretion
For these higher risk groups, avoiding alcohol completely is likely the safest option.
Is occasional drinking ok?
For most people with one kidney, having an occasional alcoholic drink once in a while is unlikely to cause any immediate damage. However, it is difficult to define exact safe limits for occasional drinking.
Most experts advise limiting intake to:
- No more than 1-2 drinks per occasion
- No more than 3-4 drinking occasions per week
Binge drinking (more than 3-4 drinks per occasion) and drinking several days in a row are considered harmful and strongly discouraged.
Tips for drinking alcohol safely with one kidney
If you plan to drink alcohol with one kidney, here are some tips to reduce your risk:
- Stay well hydrated – drink water before, during, and after consuming alcohol
- Eat before and while drinking to slow alcohol absorption
- Limit alcohol intake – no more than 1-2 drinks per day
- Avoid binge drinking and drinking consecutive days
- Avoid alcohol if taking certain medications like NSAIDs or diuretics
- Monitor kidney function with regular testing
- Stop drinking alcohol if there are any signs of kidney problems
Can I ever drink heavily with one kidney?
Heavy alcohol consumption is never advisable for anyone with one kidney. Heavy drinking is defined as:
- More than 3-4 drinks in one occasion
- Drinking more than the daily limits regularly
- Drinking for multiple days in a row
Heavy drinking substantially raises the risks of kidney damage, kidney failure, liver damage, high blood pressure, and electrolyte disturbances. It can also interfere with medications prescribed for kidney disease.
People with chronic kidney disorders like renal insufficiency should strictly avoid heavy alcohol use altogether.
How does alcohol affect kidney transplant patients?
Kidney transplant recipients need to be extra cautious with alcohol consumption. After a kidney transplant:
- Alcohol tolerance is lower due to the medications required to prevent transplant rejection
- Alcohol interacts with several anti-rejection drugs
- Any kidney damage can lead to losing the transplanted kidney
Most transplant centers recommend either complete abstinence from alcohol or limiting intake to no more than 1-2 drinks per week.
Can alcohol cause kidney failure?
Yes, long-term heavy alcohol use can lead to kidney failure, also called end stage renal disease (ESRD). Exact alcohol amounts that cause kidney failure vary by the individual. But in general:
- Drinking more than 4 drinks daily for many years can cause kidney failure
- Binge drinking accelerates kidney damage
- Pre-existing kidney disease increases risk of alcohol-related kidney failure
Alcohol harms the kidneys through multiple mechanisms:
- Direct kidney tissue damage
- Obstruction of urine flow
- Increased uric acid levels
- Electrolyte disturbances
- High blood pressure
- Liver damage contributing to kidney impairment
Once the kidneys fail completely, the only treatment options are long-term dialysis or a kidney transplant.
How much alcohol can you drink with CKD?
Individuals with chronic kidney disease (CKD) should avoid alcohol as much as possible. Even small amounts of alcohol can worsen kidney function in those with CKD.
Many nephrologists recommend strict abstinence from alcohol for CKD patients, especially those with advanced CKD stages 3-5. Moderate alcohol use may be permitted for some people with very early CKD.
For individuals who do choose to drink with CKD:
- Limit is no more than 1 drink per day maximum
- Always drink in moderation
- Monitor kidney function closely
- Avoid alcohol if taking anti-rejection medications after a kidney transplant
How much alcohol can you drink with one kidney and CKD?
Having both CKD and a single kidney multiplies the risks from alcohol. Each condition alone impairs kidney function, and together they compound the damaging effects of alcohol.
Nearly all nephrologists advise complete abstinence from alcohol for patients with one kidney and CKD. At most, very light alcohol intake may be tolerated such as 1 drink or less per week.
Drinking alcohol regularly with CKD and one kidney will likely accelerate disease progression and kidney failure.
The bottom line
In summary, light to moderate alcohol intake is permissible for most people with one healthy kidney. But any amount of alcohol carries some increased risks. Individuals with CKD, high blood pressure, or reduced kidney function should avoid alcohol completely.
Anyone planning to drink alcohol with one kidney should do so in strict moderation and monitor their kidney health closely. Overall the safest approach for the kidney is to minimize or avoid alcohol intake if possible.
| Number of Kidneys | Amount of Alcohol | Risk Level |
|---|---|---|
| Two healthy kidneys | Moderate | Low |
| One healthy kidney | Light to moderate | Moderate |
| One kidney with CKD | None to very light | High |
| Kidney transplant | None to very light | Very high |
This summarizes the recommended alcohol intake and associated kidney health risks depending on your kidney status.
Remember, when in doubt it is always safest to avoid alcohol if you have any kidney issues. Consult your doctor for personalized advice about alcohol use with your specific kidney condition.
References
[1] Alcohol research and kidney disease. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/effects/alcohol
[2] Can I drink alcohol if I have only one kidney? Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/alcohol/faq-20058017
[3] Alcohol and transplantation. British Renal Society. https://britishrenal.org/information-resources/the-uk-kidney-association/living-with-kidney-disease/lifestyle/alcohol-and-transplantation/
[4] Alcohol and chronic kidney disease. DaVita Kidney Care. https://www.davita.com/education/ckd-life/drink-alcohol-chronic-kidney-disease
