NOTE: This article was first published in Winter 2019 in Issue 4 of our Kidney Matters magazine

For people with kidney disease who are on dialysis or on a low-potassium and/or low-phosphate diet, choosing suitable drinks, especially those containing alcohol can be particularly challenging.

Some wines and beers pose potential problems around the amount of potassium they contain. For those who need to limit their fluid to less than 1 litre (2 pints) per day. including one of these drinks can have a big impact on the total fluid consumed over the course of the day.

The recommendations for alcohol for people with kidney disease are the same as for the general population: not to drink more than 14 units a week (for both men and women). One unit is 10ml of pure alcohol. Because alcoholic drinks come in different strengths and sizes, units are a good way of telling how strong your drink is. It’s not as simple as one drink, one unit. For example 1 unit is the equivalent to

• a single measure of spirits (ABV 37.5%);
• half a pint of average-strength (4%) lager;
• two-thirds of a 125ml glass of average-strength (12%) wine;
• half a 175ml glass of average strength (12%) wine;
• a third of a 250ml glass of average-strength (12%) wine.

(For more information on alcohol and units, visit: www.drinkaware.co.uk)

The following should be considered when including alcohol in your renal diet:

If you regularly drink as much as 14 units per week, it’s best to spread your drinking evenly over three or more days. If you have one or two heavy drinking episodes a week, you increase your risk of death from long-term illness and injuries

Avoid becoming dehydrated by making sure you consume non-alcoholic drinks in between the alcohol containing ones. Choose water, soda water, diet fizzy drinks or no added sugar squash as healthier alternatives

Red wine has a little more potassium than white so try choosing sparkling white wines. Or enjoying a glass of pinot grigio or chardonnay would be better than a glass of red with your meal if you are on a low-potassium diet

Spirits will be lower volume but be mindful of the units. Consider using diet mixers or soda water if you have diabetes or are trying to lose weight (avoiding cola if on a low-phosphate diet)

Many wines, beer and lager contain added phosphates, so if you are prescribed a phosphate binder, ensure you take this with your meals as normal. Speak with your doctor or renal dietitian if you would like to discuss increasing the dose to cover a ‘special treat’

Try to have several alcohol-free days over the week

Limit to ½-1 pint of your favourite beer/lager or cider. Remember ciders are high in potassium so be mindful of this if you are on a low-potassium diet

Remember to incorporate other fluids you may behaving into your fluid allowance such as gravy, soups, ice creams, custards, creams and yoghurts.

For people with diabetes and chronic kidney disease (CKD), alcohol may be safe to drink if you have your blood sugar level under control. It’s always wise to check with your doctor or dietitian before incorporating alcohol into your diet and it is recommended that you combine your alcohol with food. Alcohol on an empty stomach can cause blood sugar levels to drop in those with diabetes. Additional ingredients in mixed drinks may also add carbohydrate that must be considered.

Finally, please discuss with your pharmacist and doctor if you want to consume alcohol as some medications do interact with alcohol. If you have any other questions regarding how to safely enjoy alcohol please speak with your doctor or renal dietitian.