Can You Drink Alcohol With C3G?

Note: While research on alcohol is evolving, the World Health Organization says drinking less or not at all is better for your health.

The decision to avoid alcohol when you live with complement 3 glomerulopathy (C3G) isn’t only about whether alcohol could make the disease more active. So far, there’s no established evidence that alcohol directly affects the part of the immune system involved in C3G or triggers a flare, says Stefanie Diaz, MD, a board-certified nephrologist and a member of the teaching faculty at the University of Texas in Tyler.

How Alcohol Affects C3G

Alcohol Can Raise Blood Pressure

An alcoholic beverage may temporarily lower blood pressure, but drinking regularly can gradually raise it, says Michael Klein, MD, a board-certified nephrologist and an associate professor of medicine at New York Medical College.

To protect kidney function when you have C3G, Diaz recommends minimizing factors — including alcohol — that can make blood pressure more difficult to manage.

Alcohol Can Disrupt Fluid Balance

Fluid retention can also occur. When the kidneys aren’t working well or if you have heart disease, your body may not effectively remove excess fluid, Diaz says. Drinking larger amounts of alcohol can make fluid management more difficult and worsen existing swelling in the feet, ankles, or legs, she notes, although alcohol itself doesn’t generally cause swelling.

Heavy Drinking May Lead to Proteinuria

Diaz advises limiting heavy or binge drinking, which could place additional stress on kidneys already affected by C3G.

Is It Safe to Drink During Active C3G or Remission?

As C3G and kidney function change, advice about alcohol may change, too. Diaz and Klein offer these recommendations for different situations:

• Stable C3G or Remission “If the disease is in remission and the patient is feeling well, measured small social amounts of drinking alcohol should be considered safe,” says Klein who also recommends checking with your nephrologist first.
• Active C3G or Relapse Diaz recommends avoiding alcohol during active disease. Rising proteinuria, swelling, or blood pressure changes may indicate that the kidneys are under more strain and require closer management.

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  Dehydration or medication interactions related to alcohol could also affect the ability to manage the condition.

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• Declining Kidney Function This is another reason to minimize or avoid alcohol, says Diaz. When kidney function declines, the body may have more difficulty managing fluid, which can contribute to dehydration, high blood pressure, and swelling.

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  Reduced kidney function can also cause certain medications to build up in the body longer, and alcohol can worsen their side effects.

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• Dialysis Ask your dialysis team before drinking. Alcohol counts toward your daily fluid allowance, and some alcoholic beverages contain potassium or phosphorus you may need to limit while on dialysis, Diaz says.
• After a Kidney Transplant Talk to your transplant team before drinking alcohol. Your medications, blood pressure, liver health, and overall condition can all affect whether drinking is appropriate after a kidney transplant, Diaz notes.

Does Alcohol Interact With C3G Medications?

Many medications used to treat C3G don’t have a known direct interaction with moderate alcohol use, Klein says. Still, alcohol may make certain medication side effects more likely or harder to manage.

Are Some Alcoholic Drinks Safer for C3G Than Others?

• 12 ounces (oz) of regular beer containing 5 percent alcohol (about a standard bottle)
• 5 oz of wine containing 12 percent alcohol (about one glass)
• 1.5 oz of distilled spirits containing 40 percent alcohol (about one “shot”)

If your nephrologist says alcohol is acceptable, keep the following in mind:

• Be mindful of the serving size. A strong beer, generous glass of wine, or cocktail made with multiple shots may count as more than one standard drink.

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  At home, measure your pour instead of estimating, and when ordering a cocktail, ask how many shots it contains.
• Consider your kidney-related dietary limits. If you’re on dialysis or have been told to limit potassium or phosphorus, discuss alcohol-containing drinks with your nephrologist or renal dietitian. Certain alcoholic beverages contain potassium or phosphorus, which people on dialysis often need to limit, Diaz says.
• Count alcoholic beverages toward your fluid limit. Alcoholic and nonalcoholic drinks both count toward a prescribed daily fluid limit, says Diaz. If you need to limit fluids, count the full serving — including any mixer and ice — toward the total your kidney team recommends, Diaz says.

Safer Drinking Practices for People With C3G

Getting your nephrologist’s approval is the first step before drinking alcohol with C3G. If you get the green light for an occasional alcoholic beverage, certain habits can protect your kidneys and reduce medication-related problems.

• Discuss any potential interactions between alcohol and your current medications with your care team. Diaz notes that the answer may change when you start a medication, adjust a dose, or if you develop another health condition.
• Skip alcohol when C3G is active or when you feel sick or unusually tired because your kidneys may already be under additional strain, says Klein, who also advises against drinking when you’re generally unwell.
• Ask your kidney team how to manage hydration if you drink alcohol. It’s important to have water or another alcohol-free beverage alongside alcohol to prevent dehydration, but drinking extra water may not be safe if you have a fluid restriction.

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  Diaz recommends following the fluid target your care team set for you.
• Keep track of your blood pressure if you have hypertension or take medication to manage it, because alcohol can make it harder to keep your blood pressure in a healthy range.

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• Watch for increased swelling or sudden weight gain after drinking. These changes may mean your body is holding on to extra fluid, which alcohol can make harder to manage when kidney function is reduced, Diaz says. Discuss these changes with your kidney team.
• Don’t skip medical appointments or laboratory tests, even if you feel fine. Tests can detect changes in kidney function or protein in the urine that aren’t causing noticeable symptoms, Diaz says.
• Be open with your care team about how much you drink, and tell them if you often drink more than you intended or find it hard to cut back. Klein says difficulty limiting alcohol may increase the risks and make it harder to manage C3G treatment safely.

Your care team can also connect you with support if you need help cutting back or stopping. For free, confidential information and treatment referrals, call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-HELP (4357).