Alcohol use disorder (AUD) is a spectrum of high risk behaviors including alcohol abuse and dependence. Chronic kidney disease (CKD) is progressive loss of renal function for more or equal to 3 months or presence of any irreversible kidney damage. Common risk factors of CKD have been identified, but the impact of alcohol consumption on kidney function is controversial. The study aims to investigate the relationship between alcohol use disorder and CKD on a national scale. This retrospective cohort study was conducted using Taiwan’s National Health Insurance research database. Patients aged 20 years or older, without CKD and with the diagnosis of AUD (ICD-9-CM codes 303.X; 305.0, V113) from years 2000 to 2013 were enrolled. Control cohort was selected to match the demographics of the target population. Patients were followed until the end of 2013 or earlier if they developed CKD, died, or lost follow up. Baseline characteristics and comorbidities were identified for risk stratification. We identified 11639 patients in the AUD cohort and 46556 patients in the control cohort. Compared to patients in the control cohort, those in the AUD group were more likely to have multiple comorbidities (p < 0.001 for all comorbidities). After adjustment of age, gender, baseline comorbidities, and nonsteroidal anti-inflammatory drug use, the diagnosis of AUD was associated with an increased risk of CKD development (aHR = 1.62, 95% CI, 1.46–1.81). During the mean follow up periods of 6.47 (standard deviation (SD) = 3.80) years for the AUD cohort and 7.23 (SD = 3.75) years for the control cohort, the overall incidence density of CKD was significantly higher in patients with AUD than those in the control cohort (3.48 vs 6.51 per 1000 person-years, aHR = 1.68, 95% CI, 1.50–1.87). Kaplan-Meier analysis showed that the AUD cohort had a higher cumulative incidence of CKD than the control cohort (log-rank test, p value < 0.001). Patients with AUD had higher risks of CKD in all the stratified groups, except for the subgroup with age over 65 years old. Our study suggested that AUD was associated with an increased incidence of newly diagnosed CKD by nearly two folds. Young age, in particular, had a higher association between AUD and CKD. Considering the preventable nature of AUD, establishing effective health policies is imperative to reduce high-risk alcohol behaviors and thereby prevent alcohol-related kidney disease. Further prospective studies are warranted to further elucidate the causation of AUD on kidney function.

Purpose: To identify clinical markers associated with hemodialysis in patients with severe lactic acidosis and concurrent ethanol intoxication. Methods: A retrospective study of 22 adults (pH < 7.20, lactate > 5.0 mmol/L). We compared hemodialyzed (n=6) and non-hemodialyzed (n=16) patients. Results: Hemodialysis was associated with higher peak lactate (24.4 vs 13.7 mmol/L), lower lactate clearance (4.5% vs 7.9%/h), and more profound acidemia (pH 6.7 vs 6.94). Vasopressor use was exclusive to the hemodialysis group. Conclusion: Hemodialysis may serves as a physiological rescue therapy for metabolic collapse in this population.

Background and Objectives: Intoxicated patients with acute kidney injury (AKI) experience high morbidity and mortality. While prior studies suggest that toxicology care settings improve outcomes, the impact of care settings on patients with AKI remains unclear. This study aimed to compare the outcomes of intoxicated patients with AKI managed in toxicology versus non-toxicology care settings. Materials and Methods: This retrospective cohort study included intoxicated patients admitted to a tertiary hospital between January 2022 and December 2023. Patients were categorized into toxicology and non-toxicology care settings. Demographic characteristics, clinical outcomes focusing on mortality and length of hospital stay, and evaluation scores were compared. Results: A total of 31 intoxicated patients with AKI were included in the study. There were no significant differences in mortality or hospital length of stay between toxicology and non-toxicology care settings. However, the mortality rate in the AKI group was significantly higher (16%) compared to intoxicated patients without AKI (1.9%). Additionally, hospital stays were consistently longer in the AKI group than in the non-AKI group across all age groups. Conclusions: Hospital length of stay and mortality did not differ significantly between toxicology and non-toxicology care settings for intoxicated patients with AKI. However, both hospital length of stay and mortality were notably higher in patients with AKI compared to those without AKI.