OBJECTIVE: The aim of this study was to conduct a systematic review of published observational studies on the association between alcohol consumption and renal functional impairment. METHODS: A search of Medline and Scopus (1985 through June 2013) was performed and supplemented with manual searches of bibliographies. Of the 430 studies considered, 15 were judged eligible for this systematic review. The quality of the studies was scored using a checklist of 22 items recommended by the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. RESULTS: Among 12 studies on the adjusted association between moderate alcohol consumption and renal function decline, most of the studies with higher quality scores found no such association. This systematic review indicates that moderate alcohol consumption has not been demonstrated to be a risk factor for kidney function decline. CONCLUSION: Although alcohol consumption in selected populations was inversely associated with renal impairment, a beneficial role of alcohol consumption on renal function has not been consistently demonstrated.