Case Study: Drink and Flush

Bintou and Maeva are college students. They are along with the other party guests — have
been drinking alcoholic beverages over the course of the evening. As the night goes on, the line
for the restroom has gotten longer and longer. You may have noticed this phenomenon if you
have been to places where large numbers of people are drinking alcohol. They wonder why
alcohol makes you have to pee, Maeva says she learned about this in her Human Biology class
that alcohol inhibits a hormone that helps you retain water. Instead of your body retaining
water, you urinate more out, this could lead to dehydration.

For people who drink occasionally or moderately, this effect of alcohol on the excretory system,
the system that removes wastes such as urine is usually temporary. However, in people who
drink excessively, alcohol can have serious, long-term effects on the excretory system. Heavy
drinking on a regular basis can cause liver and kidney disease, the liver and kidneys are
important organs of the excretory system, and impairment of the functioning of these organs
can cause serious health consequences.

Case Study Conclusion: Drink and Flush

We are probably aware that, because of its effects on the brain, drinking alcohol can cause
visual disturbances, slurred speech, drowsiness, impaired judgment, and loss of coordination.
Although it may be less obvious, alcohol also can have serious effects on the functioning of the
excretory system. Alcohol consumption inhibits a hormone that causes our bodies to retain
water. As a result, more water is released in urine, increasing the frequency of restroom trips,
as well as the risk of dehydration. Antidiuretic hormone (ADH; also called vasopressin) is
secreted by the posterior pituitary gland and acts on the kidneys. We have learned, the kidneys
filter the blood, reabsorb needed substances, and produce urine. ADH helps the body conserve
water by influencing this process. ADH makes the collecting ducts in the kidneys permeable to
water, allowing water molecules to be reabsorbed from the urine back into the blood through
osmosis into capillaries. Alcohol is thought to produce more dilute urine by inhibiting the
release of ADH. This causes the collecting ducts to be more impermeable to water, so less
water can be reabsorbed, and more is excreted in urine. Because the volume of urine is
increased, the bladder fills up more quickly, and the urge to urinate occurs more frequently.
This is part of the reason why you often see a long line for the restroom in situations where
many people are drinking alcohol. In addition to producing more dilute urine, simply consuming
many beverages can also increase urine output. In most cases, moderate drinking causes only a
minor and temporary effect on kidney function. However, when people consume a large
quantity of alcohol in a short period of time, or abuse alcohol over long time periods, there can
be serious effects on the kidney. Binge drinking (consuming roughly four to five drinks in two
hours) can cause a condition called “acute kidney injury,” a serious and sudden impairment of
kidney function that requires immediate medical attention. As with the other cases of kidney
failure that you learned about in this chapter, the treatment is to artificially filter the blood
using hemodialysis. While normal kidney function may eventually return, acute kidney injury
can sometimes cause long-term damage to the kidneys.

In cases where people abuse alcohol, particularly for an extended period of time, there can be
many serious effects on the kidneys and other parts of the excretory system. The dehydrating
effect of alcohol on the body can impair the function of many organs, including the kidneys
themselves. Additionally, because of alcohol’s effect on kidney function, water balance, and ion
balance, chronic alcohol consumption can cause abnormalities in blood ion concentration and
acid-base balance, which can be very dangerous. Drinking more than two alcoholic beverages a
day can increase your risk for high blood pressure, too. As you have learned, high blood
pressure is a risk factor for some kidney disorders, as well as a common cause of kidney failure.
Drinking too much alcohol can damage the kidneys by raising blood pressure.

Finally, chronic excessive consumption of alcohol can cause liver disease. The liver is an
important organ of the excretory system that breaks down toxic substances in the blood. The
liver and kidneys work together to remove wastes from the bloodstream. You may remember,
for example, the liver transforms ammonia into urea, which is then filtered and excreted by the
kidneys. When the liver is not functioning normally, it puts added strain on the kidneys, which
can result in kidney dysfunction. This association between alcohol, liver disease, and kidney
dysfunction is so strong that most of the patients in Canada with both liver disease and related
kidney dysfunction are alcoholics. As you have learned, the excretory system is essential in
removing toxic wastes from the body and regulating homeostasis. Having an occasional drink
can temporarily alter these functions, but excessive alcohol exposure can seriously and
permanently damage this system in many ways. Limiting alcohol consumption can help
preserve the normal functioning of the excretory system, so that it can protect your health.

-Suzanne Wakim & Mandeep Grewal

Butte College

May 13, 2020