Kidney disease patient health: Moderate alcohol and calcium help, obesity harms

1. Moderate Drinking Benefits Kidney Transplant Recipients
Modest Amounts of Alcohol Prevent Diabetes and Premature Death

Moderate alcohol consumption reduces one's risk for diabetes and premature death in the general population. To find if the same were true for stable kidney transplant recipients, Dorien Zelle (University Medical Center Groningen, the Netherlands) and her colleagues studied 600 renal transplant recipients who had their transplant more than one prior and followed them for several years post-transplant. Of these, 288 (48%) were abstainers, 94 (16%) sporadic drinkers, 210 (35%) had moderate alcohol intake, and 8 (1%) were heavy drinkers. Moderate alcohol drinkers were 67% less likely to develop diabetes than other types of drinkers/nondrinkers. During an average follow-up of seven years, moderate alcohol drinkers were 44% less likely to die than other types of drinkers/nondrinkers. The authors concluded that in contrast with common advice for kidney transplant recipients to refrain from drinking alcohol, drinking moderate amounts of alcohol appears to protect against diabetes and premature death in kidney transplant recipients, similar to the general population. "Quality of life in renal transplant recipients is under pressure by many threats, restrictions, and recommendations," said Ms. Zelle. "Our results indicate that one of the restraints on quality of life in stable renal transplant recipients may be released. There seems no reason to advise renal transplant recipients to abstain from alcohol post-transplant."

Study co-authors include Eva Corpeleijn, Ronald Stolk, MD, PhD, Jaap Homan vd heide, MD, Willem Van son, MD, PhD, Gerjan Navis, MD, PhD, and Stephan Bakker, MD, PhD (University Medical Center Groningen, the Netherlands).

Disclosures: The authors reported no financial disclosures.

The study abstract, "Moderate Alcohol Consumption Is Associated with Low Prevalence of Post-Transplant Diabetes and Reduced Risk for Mortality in Renal Transplant Recipients," [TH-PO941] will be presented as a poster on Thursday, November 18, 2010 from 10:00 AM - 12:00 PM MT in Exhibit Halls A & F of the Colorado Convention Center in Denver, CO. Embargo until Thursday, November 18, 2010 11:00 AM MT

2. Despite Recommendations, Low Dialysis Calcium Levels May Harm Patients
Dialysis Solutions Low in Calcium Increase Risk of Sudden Cardiac Arrest

Sudden cardiac arrest is the leading cause of death among kidney disease patients on dialysis. Because hardening of the blood vessels due to calcium deposits has been linked to increased cardiovascular deaths in dialysis patients, national guidelines recommend lowering the amount of calcium that patients receive from dialysis fluids. (Dialysis solution contains levels of minerals like potassium and calcium similar to their natural concentration in healthy blood.) Patrick Pun, MD, MHS (Duke University) and his colleagues found that lower concentrations of calcium in dialysis fluids may be linked to an increased risk of suffering from a sudden cardiac arrest. They compared the calcium concentrations in the dialysis fluids of 502 dialysis patients who experienced sudden cardiac arrest with 1,632 randomly selected dialysis patients who did not..The findings may help clinicians determine the optimal calcium concentration to include in dialysis solutions.