Pretransplant and Posttransplant Alcohol Consumption and Outcomes in Kidney Transplantation: A Prospective Multicenter Cohort Study

Abstract

The impact of pretransplant and posttransplant alcohol consumption on outcomes in kidney transplant recipients (KTRs) is uncertain. Self-reported alcohol consumption was obtained at the time of transplant and 2 years after transplant in a prospective cohort study. Among 907 KTRs, 368 (40.6%) were drinkers at the time of transplant. Compared to non-drinkers, alcohol consumption did not affect the risk of death-censored graft failure (DCGF), biopsy-proven acute rejection (BPAR), cardiovascular events, or all-cause mortality. Compared to persistent non-drinkers, the development of DCGF, BPAR, cardiovascular events, all-cause mortality, or posttransplant diabetes mellitus was not affected by the alcohol consumption pattern (persistent, de novo, or stopped drinking) over time. However, de novo drinkers had a significantly higher total cholesterol (p < 0.001) and low-density lipoprotein cholesterol levels (p = 0.005) compared to persistent non-drinkers 5 years after transplant, and had significantly higher total cholesterol levels (p = 0.002) compared to the stopped drinking group 7 years after transplant, even after adjusting for the use of lipid-lowering agents, age, sex, and body mass index. Although pretransplant and posttransplant alcohol consumption were not associated with major outcomes in KTRs during the median follow-up of 6.0 years, a new start of alcohol use after KT results in a relatively poor lipid profile. Clinical Trial Registration: clinicaltrials.gov, identifier NCT02042963.

Keywords: alcohol; all-cause mortality; biopsy-proven acute rejection; cardiovascular events; death-censored graft failure; kidney transplantation; low-density lipoprotein cholesterol; total cholesterol.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Jung, Jeon, Huh, Park, Kim, Lee, Han, Ro, Yang, Ahn, Cho, Park, Kim and Kim.

Figures

FIGURE 1

Flow chart of study inclusion.

FIGURE 2

Annual estimated glomerular filtration rates (eGFRs) between groups based on alcohol consumption over time. No significant differences were observed between persistent non-drinkers, persistent drinkers, de novo drinkers, and the stopped drinking group.

FIGURE 3

Lipid profiles [(A) Total cholesterol, (B) LDL cholesterol, (C) HDL cholesterol, (D) TGs] based on alcohol consumption over time after adjusting for the use of lipid-lowering agents, age, sex and BMI. 5 years after transplant, total cholesterol levels (p = 0.007) and LDL cholesterol levels (p = 0.044) significantly differed between the groups. In particular, total cholesterol levels (p < 0.001) and LDL cholesterol levels (p = 0.005) were significantly higher in de novo drinkers than in persistent non-drinkers. 7 years after transplant, total cholesterol levels significantly differed between the groups (p = 0.022). In particular, total cholesterol levels were significantly higher in de novo drinkers than in the stopped drinking group (p = 0.002). *indicates significant difference between de novo drinkers and persistent non-drinkers (p < 0.0083). ** indicates significant difference between de novo drinkers and the stopped drinking group (p < 0.0083).