The risk of renal comorbidities in celiac disease patients depends on the phenotype of celiac disease.
IgA nephropathy
celiac disease
dermatitis herpetiformis
end-stage renal disease
glomerulonephritis
kidney disease
Journal
Journal of internal medicine
ISSN: 1365-2796
Titre abrégé: J Intern Med
Pays: England
ID NLM: 8904841
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
pubmed:
18
6
2022
medline:
15
10
2022
entrez:
17
6
2022
Statut:
ppublish
Résumé
An increased risk of kidney disease in patients with celiac disease has been reported, but the association has remained obscure. Only few studies have investigated the association between renal comorbidities and dermatitis herpetiformis, a cutaneous manifestation of celiac disease. We investigated whether patients with different phenotypes of celiac disease are at higher risk of kidney diseases than age- and sex-matched references. The diagnoses of glomerulonephritis, diabetic nephropathy, interstitial nephritis, and end-stage renal disease obtained from the National Hospital Discharge Register between 1970 and 2015 were identified in celiac disease (Marsh III, n = 1072) and dermatitis herpetiformis (n = 368) patients diagnosed at Tampere University Hospital catchment region and in 4296 reference subjects. Using the Cox proportional hazards model, we compared the risk of kidney diseases between patients and references. The study protocol was approved by the Regional Ethics Committee of Tampere University Hospital (R16090). As the study was register based, no consent from patients was required. Even after adjusting for type 1 diabetes, celiac disease was associated with an elevated risk of kidney disease (hazard ratio [HR] 1.85, 95% confidence interval [CI] 1.12-3.03), glomerulonephritis (HR 3.37, 95% CI 1.64-6.95), and IgA nephropathy (IgAN) (HR 18.98, 95% CI 2.29-157.63). No similarly elevated risk was found among dermatitis herpetiformis patients (HR 1.50, 95% CI 0.63-3.55; HR 2.21, 95% CI 0.77-6.38; and HR 5.87, 95% CI 0.53-64.79, respectively). Celiac disease patients were at increased risk of kidney diseases, notably IgAN. The risk was dependent on the celiac disease phenotype and was not seen in patients with dermatitis herpetiformis. Awareness of possible renal manifestations is recommended when treating celiac disease patients.
Sections du résumé
BACKGROUND
An increased risk of kidney disease in patients with celiac disease has been reported, but the association has remained obscure. Only few studies have investigated the association between renal comorbidities and dermatitis herpetiformis, a cutaneous manifestation of celiac disease.
OBJECTIVES
We investigated whether patients with different phenotypes of celiac disease are at higher risk of kidney diseases than age- and sex-matched references.
METHODS
The diagnoses of glomerulonephritis, diabetic nephropathy, interstitial nephritis, and end-stage renal disease obtained from the National Hospital Discharge Register between 1970 and 2015 were identified in celiac disease (Marsh III, n = 1072) and dermatitis herpetiformis (n = 368) patients diagnosed at Tampere University Hospital catchment region and in 4296 reference subjects. Using the Cox proportional hazards model, we compared the risk of kidney diseases between patients and references. The study protocol was approved by the Regional Ethics Committee of Tampere University Hospital (R16090). As the study was register based, no consent from patients was required.
RESULTS
Even after adjusting for type 1 diabetes, celiac disease was associated with an elevated risk of kidney disease (hazard ratio [HR] 1.85, 95% confidence interval [CI] 1.12-3.03), glomerulonephritis (HR 3.37, 95% CI 1.64-6.95), and IgA nephropathy (IgAN) (HR 18.98, 95% CI 2.29-157.63). No similarly elevated risk was found among dermatitis herpetiformis patients (HR 1.50, 95% CI 0.63-3.55; HR 2.21, 95% CI 0.77-6.38; and HR 5.87, 95% CI 0.53-64.79, respectively).
CONCLUSION
Celiac disease patients were at increased risk of kidney diseases, notably IgAN. The risk was dependent on the celiac disease phenotype and was not seen in patients with dermatitis herpetiformis. Awareness of possible renal manifestations is recommended when treating celiac disease patients.
Identifiants
pubmed: 35713926
doi: 10.1111/joim.13532
pmc: PMC9796855
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
779-787Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2022 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.
Références
Ann Med. 2017 Feb;49(1):23-31
pubmed: 27499257
BMC Med. 2019 Jul 23;17(1):142
pubmed: 31331324
Arch Pathol Lab Med. 1983 Jun;107(6):324-7
pubmed: 6601939
Br J Dermatol. 2012 Dec;167(6):1331-7
pubmed: 22708883
Diabetes Care. 2015 May;38(5):801-7
pubmed: 25690004
J Am Acad Dermatol. 1983 Aug;9(2):219-23
pubmed: 6886113
Ann Intern Med. 2004 Jul 20;141(2):95-101
pubmed: 15262664
Acta Derm Venereol. 2020 Feb 12;100(5):adv00056
pubmed: 32039457
Am J Nephrol. 2016;43(1):1-19
pubmed: 26844777
Nutrients. 2018 Aug 03;10(8):
pubmed: 30081502
Mol Immunol. 2020 May;121:1-6
pubmed: 32135400
Kidney Int. 2005 Jun;67(6):2187-95
pubmed: 15882262
Nat Rev Nephrol. 2016 Mar;12(3):147-56
pubmed: 26714580
Nephron. 2021;145(1):78-84
pubmed: 33271538
J Intern Med. 2022 Nov;292(5):779-787
pubmed: 35713926
Br J Dermatol. 1997 Mar;136(3):315-8
pubmed: 9115907
Am J Clin Dermatol. 2021 May;22(3):329-338
pubmed: 33432477
Front Endocrinol (Lausanne). 2018 Sep 19;9:553
pubmed: 30283404
Am J Med. 1986 Mar;80(3):508-10
pubmed: 3953625
Am J Nephrol. 1996;16(6):500-5
pubmed: 8955761
Diabetes Care. 2011 Oct;34(10):2158-63
pubmed: 21911773
Diabetologia. 2014 Jul;57(7):1339-45
pubmed: 24663809
Am J Gastroenterol. 2002 Oct;97(10):2572-6
pubmed: 12385441
Acta Diabetol. 2013 Jun;50(3):319-24
pubmed: 22539236
NDT Plus. 2009 Apr;2(2):161-3
pubmed: 25949317
J Clin Gastroenterol. 2013 Sep;47(8):678-83
pubmed: 23442839
Gut. 2014 Aug;63(8):1210-28
pubmed: 24917550
Lancet. 2013 Jul 20;382(9888):260-72
pubmed: 23727169
Front Immunol. 2021 Mar 29;12:657280
pubmed: 33854513
Nephrol Dial Transplant. 2006 Jul;21(7):1809-15
pubmed: 16574681
PLoS One. 2014 Apr 14;9(4):e94677
pubmed: 24732864
Gut. 2012 Jan;61(1):64-8
pubmed: 21813475
Pediatr Nephrol. 2018 Jan;33(1):53-61
pubmed: 28389744
Kidney Int. 2015 Aug;88(2):276-85
pubmed: 25807036
Dig Liver Dis. 2016 Dec;48(12):1418-1424
pubmed: 27633269
Minerva Med. 2018 Apr;109(2):126-140
pubmed: 28974086