Rakel Nurmi1, Martti Metso2, Ilkka Pörsti3, Onni Niemelä4, Heini Huhtala5, Jukka Mustonen3, Katri Kaukinen6, Satu Mäkelä3. 1. Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Finland. Electronic address: rakel.nurmi@fimnet.fi. 2. Tampere University Hospital, Department of Internal Medicine, Tampere, Finland. 3. Tampere University Hospital, Department of Internal Medicine, Tampere, Finland; Faculty of Medicine and Life Sciences, University of Tampere, Finland. 4. Medical Research Unit, Seinäjoki Central Hospital, Finland; University of Tampere, Finland. 5. Faculty of Social Sciences, University of Tampere, Finland. 6. Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Finland; Tampere University Hospital, Department of Internal Medicine, Tampere, Finland.
Abstract
BACKGROUND: An association between celiac disease and renal diseases has been suggested, but the results are controversial. AIMS: To investigate the prevalence of celiac disease autoimmunity among individuals undergoing renal biopsies and to evaluate whether co-existent celiac autoimmunity influences the clinical outcome of the renal disease. METHODS: The prevalence of celiac autoimmunity (previous diagnosis of celiac disease or positive tissue transglutaminase antibodies) was determined in 827 consecutive patients undergoing kidney biopsies due to clinical indications. Up to 15 years' follow-up data on kidney function and co-morbidities were obtained. RESULTS: Celiac autoimmunity was found in 45 (5.4%) patients. Among the IgA nephropathy patients, 8.2% of had celiac autoimmunity. At the time of kidney biopsy and after a median follow-up of 5 to 6 years, renal function measured by estimated glomerular filtration rate (eGFR) was inferior in IgA nephropathy patients with celiac autoimmunity compared to those without it (P=0.048 and P=0.022, respectively). CONCLUSION: The prevalence of celiac autoimmunity seems to be high in patients undergoing renal biopsies, especially in patients with IgA nephropathy. Such autoimmunity may be associated with worse renal function in IgA nephropathy. Hence the co-existence of celiac disease should be taken into consideration when treating patients with renal diseases.
BACKGROUND: An association between celiac disease and renal diseases has been suggested, but the results are controversial. AIMS: To investigate the prevalence of celiac disease autoimmunity among individuals undergoing renal biopsies and to evaluate whether co-existent celiac autoimmunity influences the clinical outcome of the renal disease. METHODS: The prevalence of celiac autoimmunity (previous diagnosis of celiac disease or positive tissue transglutaminase antibodies) was determined in 827 consecutive patients undergoing kidney biopsies due to clinical indications. Up to 15 years' follow-up data on kidney function and co-morbidities were obtained. RESULTS: Celiac autoimmunity was found in 45 (5.4%) patients. Among the IgA nephropathypatients, 8.2% of had celiac autoimmunity. At the time of kidney biopsy and after a median follow-up of 5 to 6 years, renal function measured by estimated glomerular filtration rate (eGFR) was inferior in IgA nephropathypatients with celiac autoimmunity compared to those without it (P=0.048 and P=0.022, respectively). CONCLUSION: The prevalence of celiac autoimmunity seems to be high in patients undergoing renal biopsies, especially in patients with IgA nephropathy. Such autoimmunity may be associated with worse renal function in IgA nephropathy. Hence the co-existence of celiac disease should be taken into consideration when treating patients with renal diseases.
Authors: Jussi Pohjonen; Rakel Nurmi; Martti Metso; Pia Oksanen; Heini Huhtala; Ilkka Pörsti; Jukka Mustonen; Katri Kaukinen; Satu Mäkelä Journal: Clin Kidney J Date: 2019-02-28