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Increased risk of end-stage renal disease in individuals with coeliac disease

Welander, Adina; Prütz, KG LU ; Fored, Michael and Ludvigsson, Jonas F. (2012) In Gut 61(1). p.64-68
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Gut
volume
61
issue
1
pages
64 - 68
publisher
BMJ Publishing Group
external identifiers
  • wos:000298179200010
  • scopus:83555176417
ISSN
1468-3288
DOI
10.1136/gutjnl-2011-300134
language
English
LU publication?
yes
id
563fa89c-f112-4af6-bfb2-98a7822fae2d (old id 2333803)
date added to LUP
2012-02-01 07:40:44
date last changed
2017-07-09 04:12:53
@article{563fa89c-f112-4af6-bfb2-98a7822fae2d,
  abstract     = {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&lt;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.},
  author       = {Welander, Adina and Prütz, KG and Fored, Michael and Ludvigsson, Jonas F.},
  issn         = {1468-3288},
  language     = {eng},
  number       = {1},
  pages        = {64--68},
  publisher    = {BMJ Publishing Group},
  series       = {Gut},
  title        = {Increased risk of end-stage renal disease in individuals with coeliac disease},
  url          = {http://dx.doi.org/10.1136/gutjnl-2011-300134},
  volume       = {61},
  year         = {2012},
}