Jump to content



Celiac.com Sponsor (A1):



Celiac.com Sponsor (A1-m):


  • You've found your Celiac Tribe! Join our like-minded, private community and share your story, get encouragement and connect with others.

    💬

    • Sign In
    • Sign Up
  • Jefferson Adams
    Jefferson Adams

    No Excess Risk of Kidney Disease in Patients with Both Type 1 Diabetes and Celiac Disease

    Reviewed and edited by a celiac disease expert.
    No Excess Risk of Kidney Disease in Patients with Both Type 1 Diabetes and Celiac Disease - Photo: CC--National Museum of Health and Medicine
    Caption: Photo: CC--National Museum of Health and Medicine

    Celiac.com 05/21/2014 - A team of researchers recently studied the risk of renal disease in patients with both type 1 diabetes (T1D) and celiac disease.

    Photo: CC--National Museum of Health and MedicineThe research team included K. Mollazadegan, M. Fored, S. Lundberg, J. Ludvigsson, A. Ekbom, S.M. Montgomery, and J.F. Ludvigsson, with the Clinical Epidemiology Unit of the Department of Medicine at the Karolinska Institutet in Stockholm, Sweden.



    Celiac.com Sponsor (A12):






    Celiac.com Sponsor (A12-m):




    For their study, the team used the Swedish Patient Register to review data on cases of T1D recorded at or before 30 years of age between 1964 and 2009.

    The team used biopsy reports from 28 pathology departments in Sweden between 1969 and 2008 to gather data on patients with celiac disease with villous atrophy (Marsh stage 3). They found 954 patients with both T1D and celiac disease. They age and sex-matched each patient with T1D + celiac disease to five reference individuals with T1D only (n = 4,579).

    They used Cox regression to estimate the following risks of both chronic and end-stage renal disease in patients with celiac disease + T1D compared with T1D patients only. They found that forty-one (4.3%) patients with celiac disease + T1D and 143 (3.1%) patients with T1D only developed chronic renal disease. This corresponded to an HR of 1.43 for chronic renal disease (95% CI 0.94, 2.17) in patients with celiac disease + T1D compared with T1D only.

    In addition, for end-stage renal disease there was a positive (albeit statistically non-significant) HR of 2.54 (95% CI 0.45, 14.2). For chronic renal disease, the excess risk was more pronounced after >10 years of celiac disease (HR 2.03, 95% CI 1.08, 3.79).

    Overall the two groups showed similar risk estimates when the cohort was restricted to T1D patients who had an inpatient diagnosis of T1D; those who had never received oral glucose-lowering medication; and (3) those who had not received their first diabetes diagnosis during pregnancy.

    The team found no excess risk of chronic renal disease in patients with T1D and celiac disease. Interestingly, a sub-analysis did show a connection between long-term celiac disease and chronic renal disease in people with T1D.

    Source:



    User Feedback

    Recommended Comments

    There are no comments to display.



    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Restore formatting

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-m):




  • Related Articles

    Scott Adams
    The following was taken from a lecture given by Dr. Joseph Murray in October, 1996. It was published by the Sprue-Nik Press (Published by the Tri-County Celiac Sprue Support Group, a chapter of CSA/USA, Inc. serving southeastern Michigan) Volume 5, Number 9, December 1996. Dr. Joseph Murray, one of the leading USA physicians in the diagnosis of celiac disease (celiac disease) and dermatitis herpetiformis (DH). Dr. Murray (murray.joseph@mayo.edu) of the Mayo Clinic Rochester, MN, is a gastroenterologist who specializes in treating Celiac disease:
    Q: Is there any kidney disease associated with celiac disease?
    A: Yes: IgA nephropathy, which is a common condition causing blood in the urine (possibly in microscopic amounts that would not be detected visually), may be caused by celiac disease. This may be similar to what happens in DH, where antibodies produced in the intestine get deposited under the skin. In IgA nephropathy, youve got IgA that was produced somewhere (we dont know where) getting deposited in the kidneys, causing secondary damage to the kidneys.


    Jefferson Adams
    Celiac.com 07/10/2007 - This study demonstrates that people with celiac disease face an elevated risk of glomerulonephritis. Multiple studies have shown higher levels of celiac disease auto-antibodies in patients with renal disease; and certain renal disease will improve on a low-antigenic diet that is gluten-free. Not much is understood about the risk of severe renal disease such as renal failure in individuals with celiac disease. In a general population based cohort study, a team of researchers set out to assess the individuals with celiac disease for any form of glomerulonephritis (acute, chronic and non- specified), chronic glomerulonephritis and renal replacement therapy including dialysis treatment and kidney transplantation.
    The research team was made up of Anders Ekbom, Michael Fored, Jonas F. Ludvigsson, Johnny Ludvigsson, Nders ekbom, Ola Ole, & Scott M. Montgomery.
    They looked at data from 14,336 patients who were diagnosed with celiac disease between 1964 and 2003. Patients were chosen from the Swedish Hospital Discharge Registry. They established a control group of 69,875 individuals matched for age, calendar year, sex and county.
    Higher Risk of Glomerulonephritis for Celiac Patients
    The results showed that patients with celiac disease face an increased risk of developing chronic renal disease, and may also be at a face a slightly higher risk for any form of glomerulonephritis.
    Nephrology Dialysis Transplantation 2006 21(7):1809-1815
    health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.


    Jefferson Adams
    Celiac.com 09/19/2011 - Rates of end-stage renal disease are rising globally, and even though doctors often see elevated levels of celiac disease autoantibodies in renal disease, they do not yet fully understand the role of biopsy-verified celiac disease as a risk factor for end-stage renal disease.
    To gain a gleaner picture of possible connections, a team of researchers based in Sweden conducted a study of end-stage renal disease in individuals with celiac disease.
    The research team included A. Welander, K. G. Prütz, M. Fored, J. F. Ludvigsson. They are affiliated with the Department of Medicine at the Karolinska Institutet of the Karolinska University Hospital in Stockholm, Sweden.
    To identify individuals for their population-based prospective cohort study, the team used small-intestinal biopsy reports. They found data on 29,050 individuals with celiac disease (Marsh III) obtained between July 1969 and February 2008 in Sweden's 28 pathology departments.
    The team defined end-stage renal disease as the need for renal dialysis or renal transplant in accordance with the international classification of disease and procedure codes in Swedish patient registers.
    They used Cox regression to compare the risk of end-stage renal disease in individuals with celiac disease against the risk for age- and sex-matched reference individuals.
    They found that, on follow-up, 90 individuals with celiac disease had developed end-stage renal disease, compared with a projected number of 31.
    This means that people with celiac disease face an end-stage renal disease risk estimate of 2.87 (95% CI 2.22 to 3.71, p<0.001).  Adjusting for diabetes mellitus lowered that risk estimate only slightly, to 2.52 (95% CI 1.92 to 3.31).
    When the team excluded people with prior urinary/renal disorders, the risk estimate for end-stage renal disease in people with celiac disease was 2.47 (95% CI 1.80 to 3.40).
    However, once the team restricted the outcome measure to end-stage renal confirmed by independent data from the Swedish Renal Registry (SRR), the overall risk estimate increased to 3.20 (95% CI 2.39 to 4.28).
    The results of this study show that people with biopsy-verified celiac disease face a higher risk of developing end-stage renal disease.
    Source:

     Gut. 2011 Aug 3.


    Jefferson Adams
    Celiac.com 04/27/2012 - Urinary stone disease is condition often caused by malabsorption. Because of its high prevalence and incidence, doctors regard it as a serious issue. However, there are few population-based studies on the risk of urinary stone disease in patients with celiac disease.
    A team of medical researchers recently studied the risk of urinary stone disease in people with celiac disease. The research team included J. F. Ludvigsson, F. Zingone, M. Fored, C. Ciacci and M. Cirillo.
    For their population-based cohort study, the team used small intestinal biopsy reports gathered from all 28 Swedish pathology departments from 1969 to 2008. In all, the team found 28,735 patients with celiac disease, all with the equivalent of Marsh 3 villous atrophy.
    They then isolated a control group of 142,177 people from the Swedish general population. They matched patients and control subjects for age, gender, age, county and calendar year.
    Using Cox regression, they estimated hazard ratios for future urinary stone disease. Using conditional logistic regression they then calculated odds ratios for urinary stone disease before celiac disease diagnosis.
    The team used Swedish National Patient Register data on inpatient care, outpatient care and day surgery to find cases of urinary stone disease.
    During follow-up, a total of 314 people with celiac disease developed urinary stone disease, compared with 1142 from the control group.
    These numbers indicated that people with celiac disease face a 27% increased risk of urinary stone disease [95% confidence interval (CI) = 1.12–1.44].
    For celiac disease, patients the absolute risk of developing urinary stone disease was 107 cases per 100,000 person-years; which corresponds to an excess risk of 23 cases per 100,000 person years.
    Men and women faced similar risk levels, and showed no difference with respect to age at celiac disease diagnosis.
    Using conditional logistic regression the team found that celiac disease patients also faced a moderately higher risk of prior urinary stone disease (OR = 1.19; 95% CI = 1.06–1.33).
    The study indicates that people with celiac disease face a slightly higher risk of urinary stone disease both before and after celiac disease diagnosis.
    Source:
    Alimentary Pharmacology & Therapeutics. 2012;35(4):477-484.


  • Popular Now

×
×
  • Create New...