Review articleWine consumption and renal diseases: new perspectives
Introduction
The protective effects of wine on the cardiovascular system have been widely documented. Less investigated is the relation that links wine consumption to kidney diseases. Patients with chronic renal failure (CRF) exhibit accelerated atherosclerotic damage and frequently undergo cardiovascular events [1]. It would be useful to know in detail the effects of wine components on kidney function, with the aim of clarifying whether moderate wine consumption could be allowed or even recommended in patients with renal disease.
Section snippets
Pathophysiologic mechanisms of renal disease progression
Oxidative stress and endothelial dysfunction, which are inter-related, play a role in many diseases, including atherosclerosis and several nephropathies.
Oxidative stress, defined as an imbalance between production of reactive oxygen species (ROSs) and antioxidant pathways, is involved in the pathophysiology of many renal diseases, including acute renal failure and CRF [2]. ROSs induce glomerular and tubulointerstitial damage by activating and maintaining vicious cycles through cytokine release,
Alcohol effects on kidney
In the rat kidney, acute ethanol administration causes a dose-dependent impairment of the antioxidant system [17], but long-term consumption increases the activity of antioxidant enzymes such as catalase [18], superoxide dismutase [19], and glutathione peroxidase [20], so that the prevailing long-term effect is difficult to predict, even in this animal organ.
To test the hypothesis that ethanol can inhibit tissue fibrosis and therefore progression of renal diseases, some investigators used a rat
Wine polyphenols and kidney
Recent studies [25], [26], [27] have confirmed that, among alcoholic beverages, especially wine shows healthy properties. A likely explanation can be its peculiar composition due to the methods employed to obtain it. Maturation in oak barrels distinguishes wine from beer by enriching the polyphenol content in wine. In a meta-analysis of 26 clinical studies concerning the relation between wine or beer consumption and vascular risk, Di Castelnuovo et al. [25] showed a significant inverse
Effects of ethanol and wine on arterial hypertension in CRF
The effects of wine on renal and cardiovascular diseases could be mediated also by its action on blood pressure. Moreover, from this point of view ethanol actions must be distinguished from those ascribable to polyphenols.
A recent meta-analysis [54] has underlined that ethanol consumption is directly related to the relative risk of arterial hypertension. However, hypertensive subjects who are moderate wine drinkers seem to have a lower hypertension-related mortality compared with hypertensive
Conclusions
All the studies presented in this review indicate that moderate wine consumption may be useful in patients with renal disease for its protective effect on the kidney itself and the cardiovascular system. Controlled clinical trials are needed to confirm the efficacy and minimize the risk of unfavorable effects, even though they are not easy to realize because of the subject matter.
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