Renal Patients and Alcohol

One of the most difficult problems with living with a chronic condition is that it never goes away, it has a constant impact upon daily life and may even change the direction that the person living with the condition hoped their life would go in. The great challenge is to make sense of the condition and find a way to adapt to make it fit around it. It is the people who struggle to adapt to a chronic condition who often end up distressed.

In particular, the life of a renal patient is often made difficult by various restrictions imposed by illness. Pre-Dialysis patients may manage their diet and lifestyle to lengthen the health of their kidneys, dialysis patients are asked to manage diet and fluid as well as dealing with a frequent dialysis regime. Transplant patients are still not out of the woods and need to be consistent with daily medication as well as looking after their health and drinking enough water.

People often talk of feeling that others do not understand and they feel different. They might do what they can to fit in.

One of the ways individuals look to manage this balance is through alcohol intake. In British culture alcohol may be part of many social activities: the local pub quiz night, a Sunday afternoon family meal, dinner out, family parties, and so on. For a renal patient trying to balance a fluid intake and having restrictions upon the alcohol they can drink, these social events can become difficult. For instance, others who may not understand or may question a person who is not drinking much and put pressure upon that individual to “join in”.

Some find alcohol helps them to relax in social situations and find without alcohol they feel less enjoyment. Unfortunately, it is problems like these that may discourage people from going to such events.

This then has an impact upon that person’s social life, and then upon how that person feels. Most people do well when they have others around them for support but also when they are involved in the kinds of activities that help them feel “normal”- a person first, and a renal patient second.

Therefore, we have collated a few tips from renal patients about managing alcohol and social situations:

For alcohol limitations:

•    How close is the friendship/social group – can they be as supportive or is it a “beer” culture?
•    Try shandy- with half the alcohol content this helps reduce overall alcohol intake
•    Choosing lower-alcohol or alcohol-free drinks.
•    Alternating alcoholic and non–alcoholic drinks
•    Avoid the bargain “doubles”
•    Drive so there is no alcohol and it’s just a social experience. That way you can leave when you want to and have complete control            over your drinking.

For fluid restrictions

•    Drinking slowly and taking small sips, rather than having no drink at all – try having a drink that can be sipped, not gulped – ie, not            beer.
•    Not having ice and the extra fluid it brings.
•    Missing every other “round” of drinks.
•    Save as much fluid as possible by drinking minimum amounts the day prior to the pub trip.
•    Avoid salty snacks which may drive thirst.
•    Extra lemon may help with thirst.

It may also be a good idea to encourage your friends and family into social activities where alcohol is not central. 

Remember that all people, not just renal patients, have recommendations for restricting alcohol intake and there is nothing wrong with being the healthier one in the group. Some individuals put social pressure upon others to drink to justify their own intake and you do not need to give in to this pressure.

General Advice with Alcohol

Remember to follow the individual advice set for you by your Consultant and Dietitian.  Be aware of the particular medication you are on and how this may limit the alcohol you are allowed.  

Certain types of alcohol contain more potassium than others, so if you are following a potassium restriction ask your Dietitian for more details about the types and amounts of alcohol you can have per week.  Alcohol contains a lot of energy so an excessive alcohol intake might result in unnecessary weight gain.

Try to spread your drinking throughout the week and have at least 1-2 alcohol-free days per week.

From our experience with individuals living with kidney failure, the key is to live first and be a patient second.

How much can I drink?

Research into alcohol consumption and chronic kidney disease is conflicting, as most research into this looks at otherwise healthy individuals, however, kidney injury can occur due to excessive alcohol use. Excessive alcohol consumption can put a strain on the kidneys as about 10% of alcohol that is ingested is excreted into the kidneys in its original form. (Fan et al, 2019).

Whilst excessive alcohol consumption can cause damage to kidneys, the current research base tells us that some alcohol consumption does not negatively impact on kidney health (Fan et al, 2019), and the NHS currently recommends the following:

“You may still be able to drink alcohol if you have kidney disease, but it’s advisable not to exceed the recommended limits of more than 14 alcohol units a week.

Speak to your GP or care team if you find it difficult to cut down the amount of alcohol you drink.”

Although the evidence suggests there is limited harm in drinking some alcohol, alcohol consumption can impact on other organs and negatively impact on your overall health, which may in turn affect your chronic kidney disease. For example, alcohol intake may be paired with an unhealthy lifestyle and diet, leading to other health issues. Alcohol can also negatively impact on your cardiovascular health and contribute to problems such as hypertension (high blood pressure) or high cholesterol.

General advice for alcohol consumption

Please follow individual advice that is set for you by your renal team and dietician, and if you aren’t sure if you should be following any specific diet, please speak with your medical team. Be aware of the particular medication you are taking, as this may also limit how much alcohol you are allowed to drink. Drinking alcohol alongside some medications can cause problems with other organs such as your liver.

Other things that may help to reduce/dilute alcohol intake are:

•    wine with soda (to reduce alcohol, potassium)
•    spirit with diet mixer/ice instead of pints of beer (to reduce fluid/   kcal/potassium/phosphate)
•    can also get plastic ice cubes for home (make drink cold and refreshing but doesn’t add extra fluid)
•    half pt or 330ml bottle instead of pint (to reduce fluid/kcal/potassium/phosphate)

Fan, Z., Yun, J., Yu, S., Yang, Q., & Song, L. (2019). Alcohol Consumption Can be a “Double-Edged Sword” for Chronic Kidney Disease Patients. Medical science monitor : international medical journal of experimental and clinical research, 25, 7059–7072.

Written by Dr. Julie Highfield - Clinical Psychologist,
Beverley Beynon-Cobb, Senior Dietitian
Dr Louise Evans, Clinical Psychologist
and Jane Dursley, Renal Dietitian.

More information can be found at

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The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.