Thursday, 26 April 2007

alcohol effect on kidney function

Gross and Microscopic changes
• Alcohol alters the form and structure of the kidney
• The basement membrane of glomerulus become abnormally thickened and was characterized by cell proliferation
• Further changes included enlarged and altered cells in kidney tubules
• These effects alter the ability of the kidneys to function normally.

Rate of blood flow
• The rate of blood flow through the kidneys is an important determinant of the amount of filtration of the blood and absorption of substances from the blood that can take place.
• Various effects of alcohol have been reported including both increased and reduced blood flow.
• These effects seem to be related to whether or not the person also had liver disease and in animal models which species of animal was used.

Effect on electrolytes balance
• Alcohol’s on electrolyte balance has major implications for the satisfactory functioning of the cells of the body
• As a prime example, the cells of the brain and particularly neurons are highly dependent upon proper amounts of sodium, potassium, chloride, and calcium being available.
• Disruption in the proper flow and availability of these electrolytes alters the ability of the neurons to function which leads to modifications in behavior and the ability of the brain to regulate other bodily processes.

Effect of Ethyl Alcohol on Electrolytes

Major Cause(s)
Low sodium level (hyponatremia Massive intake of solute-free fluid (beer
Low potassium level (hypokalemia) Dietary deficiency, gastric losses, leaky membranes, shifts from extracellular to intracellular
Low phosphorus level (hypophosphatemia) Dietary deficiency, malabsorption, increased cellular uptake
Low magnesium level (hypomagnesemia) Dietary deficiency, malabsorption, phosphorus deficiency

• Alcohol can produce urine output within 20 minutes of consumption
• It inhibit the secretion of Anti-Diuretic Hormone(ADH) which promotes the concentration of urine by inducing the kidney to conserve water
• Under this condition, the urine become diluted and electrolytes concentration in blood simultaneously arised
• Ages makes a difference in how rapidly the body escape from alcohol’s ADH suppressive effect
• People with older age than 50 escape quicker from the ADH suppressive effect than their younger counterparts. It is thought that sensitivity to increase electrolytes concentration is enhanced with age

Acid-Base Balance
• Proper acid-base balance (i.e. hydrogen ion concentration) is crucial to the proper functioning of most of the body’s metabolic reactions.
• The kidneys play an important role in regulating this acidity, thus the rate at which metabolic processes proceed.
• Examples of alcohol-related acid-base disturbances include low levels of phosphate, which may result from hyperventilation during withdrawal from alcohol and cases of alkalosis which may be a result of severe vomiting after binge drinking.
• The latter sickness leads to losses of fluid, salt, and stomach acid.
• A potential serious condition known as alcoholic ketoacidosis is another disorder associate with abnormally high blood acidity
• This is characterized by the accumulation of ketone bodies, which is produced in the liver as a reserve fuel for brain and muscle tissues
• Typically, this happen to chronic alcohol abuser following a severe binge in which they consume alcoholic beverages and nothing else over the several days

Blood pressure
• Chronic alcohol consumption can lead to accumulation of both fluid and solutes, thereby increasing of the volume of overall body fluid
• This can contribute to high blood pressure
• Clinical studies of hypertensive patients show that reducing alcohol intake lower the blood pressure
• The mechanism responsible for this effect is not well established. However, study has showed that alcohol’s influence on blood pressure may be attributable, at least in part, to its effect on the production of hormones that act on the kidneys to regulate fluid balance or that act on blood vessels to constrict them.

Contributed by Lawrence Oh