Let's talk about coffee
and kidney disease. What's the link? Does coffee help the kidneys
or does coffee hurt the kidneys? In order to understand this question better, we have to start
with an understanding of coffee. What's fascinating about coffee is,
is that has one of the highest consumptions of any beverage.
Over 500 billion cups per year consumed.
And it has over 1000 ingredients. It's got lots of properties. It's an antioxidant. It has antiinflammatory properties. It helps against cancers,
it helps against clotting. It also helps with antifibrotic properties, so helps against
scarring inside the body. And there are lots of ingredients
that are responsible for it. These are fancy names, but things like alkaloids,
things like diterpenes, chlorogenic acid, melanoidins are all things that are part
of coffee that may be responsible for all of these wonderful
effects that coffee has. That's not to say coffee
doesn't have side effects. There are known side effects. There's irritability. Caffeine can cause decreased sleep. And we've talked about
how important sleep is. But generally coffee is safe to consume
in about two to three cups per day. But what about kidney disease? What we find is, is it's fascinating. One in seven adults in the United States has kidney disease and kidney disease
is the 12th leading cause of death. But what's really devastating to nephrologist or kidney
specialists like myself is that kidney disease doesn't get the same attention
as some of the other diseases.
In fact, each year, kidney disease kills more people
than breast or prostate cancer. So let's talk about the link
between coffee and kidney disease. There's a new meta-analysis out. And the reason I like this, Mendelow says,
is because, one, it is one of the largest ones that's been done to date
on coffee and kidney disease. And number two, not only did they look
at what is the risk between coffee and kidney disease, they tried to quantify
that risk by seeing how many cups a day to get the best benefit or
harm with kidney disease. And what was good about the study was that they had a lot of people
included in the meta analysis. Remember, that analysis is to take
a lot of studies and put them together. So they had 12 studies with over half
a million people in them, and they followed them anywhere
between 6 to 24 years. So it's a very good amount
of time for followup. All right.
So what did they find? Well, first,
with kidney disease incidence, which means what is the likelihood
of you getting kidney disease? Those people who were drinking one cup or less had a 13 percent decrease
in risk of getting kidney disease.
And then for those people drinking two or more cups, they had even
a better improvement. They had an 18 percent decrease
in risk of getting kidney disease. So once again, one cup or two or more cups and looks like
the benefit was with two or more cups. How about the risk of end stage kidney
disease, which means going on dialysis. So anybody who was drinking any sort of coffee were those who weren't
drinking any coffee.
Those who drank coffee had an 18 percent
reduction in risk versus those who didn't. And when they compared whether they drank one cup or two cups or more,
there was the difference. But the bottom line there was if you drink coffee, you had a lower risk
of progressing to dialysis. How protein in the urine. We called it albuminuria,
but it's a fancy way of saying is as the pressure on the kidney gets worse
and kidney damage occurs, the barrier on the kidney breaks
and protein starts to go to the urine.
So what happens to albuminuria? It's one of the best predictors for how
fast your kidneys will decline. So the more protein you spill,
sorry, the more protein you spill in the urine,
the faster your kidneys will decline. So those people who consume the coffee any amount had a 19 percent decreased
risk of developing albumin area. And what about the risk of dying
from chronic kidney disease? Those people who drank any amount
of coffee had a 28 percent decrease risk. So what's the bottom line here? First,
this is a really large met analysis and it's a good one because it was
actually done with quantifying the large amount of population,
lots of follow up rain.
And what it shows is that, generally speaking, coffee is safe
for chronic kidney disease patients. Now, it's not talking about things like potassium and coffee
and how that can impact. And, of course, you have
to be careful about that. The other thing that was really good about this analysis was that it links
lower kidney disease incidence or the risk of getting kidney disease,
lower risk of dying, lower risk of protein in the urine and lower risk
of going on dialysis with coffee. And then the last thing was,
what this study is really showing is that the optimal amount of coffee really
is about two to three cups per day. Now, that's based on this analysis,
but a lot of other studies as well. And what's fascinating about the other data is that people who drink decaf,
if they can't tolerate the caffeine, they had the same benefits
and those who drink caffeinated. Now, before we get all excited about the study, you remember
this study is a population study. So what that means is it's only
telling you there's a link.
It's not telling you
that there's a causation. It's also saying there isn't really any randomized control studies
that they looked at. They were looking at population studies. Remember, the gold standard is
randomized controlled studies. And in the last part is
with population studies. There's always a chance there could
be some confounding variables. Maybe all of the people who drank coffee were healthy and those who didn't
drink coffee had lots of diseases. And that's why those people didn't
drink coffee got worse faster. So there's always a possibility. But bottom line here is this is more
evidence that coffee may be part of a healthy lifestyle if it's done
in the right amount, which seems to be about two to three cups
per day, caffeinated or non caffeinated.
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