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NDT Advance Access originally published online on March 30, 2006
Nephrology Dialysis Transplantation 2006 21(7):1809-1815; doi:10.1093/ndt/gfl117
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Original Articles: Clinical Nephrology

Coeliac disease and risk of renal disease—a general population cohort study

Jonas F. Ludvigsson1,3, Scott M. Montgomery2,3, Ola Olén3,4, Anders Ekbom3,5, Johnny Ludvigsson6 and Michael Fored3

1 Department of Paediatrics, 2 Clinical Research Centre, Örebro University Hospital, 3 Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital/Institute and4 Department of Paediatrics, Stockholm Söder Hospital, Sweden, 5 Harvard Medical School, Boston, Massachusetts, USA and 6 Division of Paediatrics and Diabetes Mellitus Research Centre, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Sweden

Correspondence and offprint requests to: Jonas F Ludvigsson, Department of Paediatrics, Örebro University Hospital, Sweden. Email: jonasludvigsson{at}yahoo.com

Background. Coeliac disease (CD) may be a risk factor for renal disease.

Methods. We investigated the risk of any form of glomerulonephritis (GN) (acute, chronic and non-specified), chronic glomerulonephritis (CGN) and renal replacement therapy including dialysis treatment and kidney transplantation (KT) in patients with CD in a general population-based cohort study. We used Cox regression to assess the risk of renal disease in 14 336 patients who had received a diagnosis of CD (1964–2003) and 69 875 reference individuals matched for age, calendar year, sex and county. Patients were identified using the Swedish Hospital Discharge Registry. Follow-up began 1 year after study entry.

Results. CD was associated with an increased risk of any form of GN (hazard ratio (HR) = 1.64; 95% confidence intervals (CI) = 1.01–2.66; P = 0.046; 89 events), CGN (HR = 2.65; 95% CI = 1.34–5.24; P = 0.005; 39 events), dialysis (HR = 3.48; 95% CI = 2.26–5.37; P<0.001; 102 positive events) and KT (HR = 3.15; 95% CI = 1.29–7.71; P = 0.012; 22 events).

Conclusion. We suggest that immune characteristics associated with CD increase the risk of chronic renal disease. Individuals with CD may also be at a moderately increased risk of any form of GN.

Keywords: auto-immune; coeliac; cohort study; diabetes mellitus; kidney; renal disease


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