Hayrunnisa Unlu ¹ Asmaa Hatem ¹ Khalid Manji ¹ Noah Manji ¹ Mark A. Frye ² Leslie F. Thomas ¹ Osama Abulseoud ^1*

• ¹ Mayo Clinic Arizona, Scottsdale, Arizona, United States
• ² Mayo Clinic, Rochester, Minnesota, United States

Despite a well-established direct toxic effect of alcohol on renal cells by alcohol, there is a salutary dosedependent positive effect of alcohol consumption salutary to on common laboratory parameters related to kidney performance. Alcohol also impacts thyroid hormones, and while thyroid status modulates kidney function. The modulation of kidney parameters with thyrotropin (TSH) and thyroid status indicates a possible interaction between alcohol, kidney, and thyroid functions. This retrospective study was conducted to test the hypothesis that some portion of the positive effect of correlation between alcohol use and on the estimated glomerular filtration rate (eGFR) is mediated indirectly viaby alcohol's effect on thyroid hormones. We reviewed the electronic medical records of 767 hospitalized adult patients free of thyroid disorders who received medical care in the Mayo Clinic Health System from June 2019 through June 2022 and had blood alcohol concentration (BAC), serum TSH, and serum creatinine measured during the hospitalization. We calculated the eGFR using both the re-expressed Isotope-Dilution Mass Spectrometry (IDMS)-traceable Modification of Diet in Renal Disease (MDRD II) study equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Creatinine equation. We found a significant relationship of BAC with eGFR (CKD-EPI) and TSH in males only. BAC had a positive association with eGFR (β = 0.24, p = 0.0001) and negative with TSH (β = -0.17, p = 0.006). The covariance between the two outcomes (eGFR and TSH) was negative (β = -0.12, p = 0.049). The path analyses using eGFR MDRD equation were not significant in males, whereas females had no significant path analyses with either eGFR equations. Despite our results are not translated into mediation, we observe that BAC can influence both eGFR and TSH, whereas eGFR and TSH can influence each other. So, even after considering the covariates (age, body mass index, ALT and AST, diabetes, and cardiovascular, renal, and hepatic diseases) and the observation of a negative bidirectional effect of TSH and eGFR, BAC still has a positive effect on eGFR in men.