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

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.

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).

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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.

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