Association Between ALDH2 rs671 Polymorphism and CKD Incidence: A Prospective Cohort Study in the Korean Population

Background: CKD is a growing public health concern. The aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism, common in East Asians, affects alcohol metabolism and may influence CKD development. We investigated the association between ALDH2 rs671 genotypes and CKD incidence, and whether alcohol consumption modifies this relationship. Methods: We analyzed 5,369 CKD-free participants from the Korean Genome and Epidemiology Study (KoGES) Ansan–Ansung cohort, followed for a median of 11.6 years. Participants were classified into GG and GA+AA genotype groups. CKD incidence was defined by estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2 or proteinuria 1+ or more on two consecutive measurements ≥ 90 days apart. Alcohol consumption was assessed using structured health surveys and standardized protocols. Cox proportional hazards models adjusted for age, sex, hypertension, diabetes, and other confounders estimated hazard ratios (HRs) for CKD incidence by genotype group and evaluated potential interactions between genotype and alcohol consumption. Results: Of the participants, 3,818 (71.1%) had the GG genotype and 1,551 (28.9%) had GA or AA genotypes. The hazard ratio for CKD in GA+AA carriers vs. GG was 1.07 (95% CI, 0.95–1.30; p=0.295), showing no significant association. CKD incidence did not differ significantly by alcohol consumption within genotype groups. Stratified analyses by sex also showed no significant differences in CKD risk. Conclusion: The ALDH2 rs671 polymorphism was not associated with CKD incidence. Alcohol consumption and sex did not significantly modify CKD risk within ALDH2 genotype groups. These findings suggest that ALDH2 genetic variants, alcohol intake, and sex are not major determinants of CKD development in this population.Comparison of CKD Incidence by ALDH2 Genotype (GG vs GA+AA)