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Increased risk of end-stage renal disease in individuals with coeliac disease
Clinical Epidemiology Unit, Department of Medicine, T2, Karolinska Institutet, Stockholm, Sweden.
Department of Nephrology and Transplantation, Ska ne University Hospital, Malmö, Sweden.
Clinical Epidemiology Unit, Department of Medicine, T2, Karolinska Institutet, Stockholm, Sweden.
Clinical Epidemiology Unit, Department of Medicine, T2, Karolinska Institutet, Stockholm, Sweden; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-1024-5602
2012 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 61, no 1, 64-68 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The prevalence of end-stage renal disease (ESRD) is increasing worldwide. Although increased levels of coeliac disease (CD) autoantibodies are often seen in renal disease, the importance of biopsy-verified CD for the risk of future ESRD is unclear. The aim of this study was therefore to investigate the risk of future ESRD in individuals with CD.

Methods: This was a population-based prospective cohort study. 29 050 individuals with CD (Marsh III) were identified through small-intestinal biopsy reports obtained between July 1969 and February 2008 in Sweden's 28 pathology departments. ESRD was defined as the need for renal dialysis or renal transplant in accordance with the international classification of disease and procedure codes in Swedish patient registers. Using Cox regression, the risk of ESRD in individuals with CD compared with age- and sex-matched reference individuals was estimated.

Results: During follow-up, 90 individuals with CD developed ESRD (expected count 31). This corresponded to a HR for ESRD of 2.87 (95% CI 2.22 to 3.71, p<0.001). Adjusting for diabetes mellitus had only a marginal effect on the risk estimate (HR 2.52, 95% CI 1.92 to 3.31). Excluding individuals with any urinary/renal disorder before study entry, the HR for ESRD in CD was 2.47 (95% CI 1.80 to 3.40). When restricting the outcome measure to ESRD confirmed by independent data from the Swedish Renal Registry (SRR), the risk estimate increased to 3.20 (95% CI 2.39 to 4.28).

Conclusion: This study indicates that individuals with biopsy-verified CD suffer increased risk of subsequent ESRD.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2012. Vol. 61, no 1, 64-68 p.
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-55864DOI: 10.1136/gutjnl-2011-300134ISI: 000298179200010PubMedID: 21813475Scopus ID: 2-s2.0-83555176417OAI: oai:DiVA.org:oru-55864DiVA: diva2:1075540
Funder
Swedish Society of MedicineSwedish Research Council
Note

Funding Agencies:

Karolinska Institute Board of Postgraduate education (KID) 

Örebro University Hospital

Sven Jerring Foundation

Örebro Society of Medicine

Karolinska Institutet

Clas Groschinsky Foundation

Juhlin Foundation

Majblomman Foundation

Swedish Celiac Society

Available from: 2017-02-20 Created: 2017-02-20 Last updated: 2017-02-20Bibliographically approved

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