Celiac disease or positive tissue transglutaminase antibodies in patients undergoing renal biopsies

Nurmi, Rakel; Metso, Martti; Pörsti, Ilkka; Niemelä, Onni; Huhtala, Heini; Mustonen, Jukka; Kaukinen, Katri; Mäkelä, Satu

doi:10.1016/j.dld.2017.09.131

Cited by 17 publications

(17 citation statements)

References 38 publications

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“…The referral letters and the pathology reports of the kidney samples were reread and structurally categorized [25]. The indications for kidney biopsy were classified in a hierarchical order (1 > 2 > 3 > 4 > 5 > 6) as follows: (1) renal insufficiency: the presence of renal insufficiency stated by the clinician as the cause of a biopsy irrespective of renal findings, (2) nephritic syndrome: proteinuria >1.5 g/24 h or dipstick urinary albumin ++/+++ and either red cell casts or urinary erythrocytes (dipstick ++ or +++), (3) proteinuria and hematuria: proteinuria <1.5 g/24 h or dipstick urinary albumin + and either red cell casts or urinary erythrocytes (dipstick +), (4) nephrotic syndrome: proteinuria >3.5 g/24 h or dipstick urinary albumin +++ and no hematuria, (5) proteinuria: proteinuria <3.5 g/24 h or dipstick urinary albumin +/++ and no hematuria, (6) hematuria alone: urinary erythrocytes either by dipstick test (+, ++, and +++) or microscopy.…”

Section: Methodsmentioning

confidence: 99%

“…The incidence of celiac disease is increasing, as in IBD, due to the more effective detection of the disease and a true rise in prevalence [9, 19, 21]. Previous studies suggest that celiac disease is overrepresented in patients with IgAN even though the results have been inconclusive [22-25]. Of note, some of the reports have suggested that IgAN might improve on gluten-free diet, which is the gold standard treatment for celiac disease [17, 26, 27].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Inflammatory Bowel Disease and Celiac Disease in Patients with IgA Nephropathy over Time

Nurmi

Pohjonen

Metso

et al. 2020

Nephron

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Introduction: IgA nephropathy (IgAN) has been connected with increased intestinal permeability and subclinical intestinal mucosal inflammation as well as with inflammatory bowel disease (IBD) and celiac disease – nevertheless, the results are controversial. The prevalence of bowel diseases has increased over time in Western populations. Whether similar trend is seen among IgAN patients remains obscure. Our aim was to study the prevalence of IBD and celiac disease in IgAN patients over time. Methods: The study cohort consisted of altogether 629 patients with newly diagnosed IgAN during years 1976–2012. Data on diagnosis of IBD and celiac disease were retrospectively collected from medical records. Further, to detect unrecognized celiac disease, IgA-class tissue transglutaminase antibodies (tTGA) were measured from serum samples taken at the time of kidney biopsy during years 1980–2012 (defined as screen-detected celiac disease autoimmunity). Results: The prevalence of IBD among IgAN patients increased over time from 0 to 4.4%, while the prevalence of clinically diagnosed celiac disease decreased from 2.6 to 0.6%. Moreover, the number of screen-detected tTGA-positive cases decreased from the 1980s to the 21st century (2.8–0.7%). Conclusion: The prevalence of IBD increased over time in IgAN patients, which exceeds the prevalence of 0.6% in Finnish general population. In parallel, the prevalence of celiac disease and screen-detected celiac disease autoimmunity decreased over time. The coexistence of IBD and IgAN is not negligible. Whether this finding is caused by the increase in the prevalence of IBD in the population or shared pathophysiology between IgAN and IBD remains a matter of further studies.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of Inflammatory Bowel Disease and Celiac Disease in Patients with IgA Nephropathy over Time

Nurmi

Pohjonen

Metso

et al. 2020

Nephron

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“…The histories of all 819 patients were retrospectively collected from the medical records of TAUH between 2014 and 2016 [8]. Plasma creatinine concentration, quantitative 24-h urinary protein excretion and haematuria data were gathered from medical records at the time of the renal biopsy and the most recent follow-up.…”

Section: Methodsmentioning

confidence: 99%

“…Interestingly, intestinal permeability seems to be already increased in the earlier stages of CKD [5]. The linkage between the most common primary glomerulopathy [6], immunoglobulin A nephropathy (IgAN) and the mucosa is well known [7, 8]. Genome-wide association studies (GWASs) in patients with IgAN have identified risk loci in the genes involved in intestinal mucosa integrity and the immune network [9].…”

Section: Introductionmentioning

confidence: 99%

Inflammatory bowel disease in patients undergoing renal biopsies

Pohjonen

Nurmi

Metso

et al. 2019

Clinical Kidney Journal

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Background There are no good data in the literature on the prevalence of inflammatory bowel disease (IBD) in patients with kidney disease and we do not know whether IBD affects the course of kidney disease or if the type of IBD is an influential factor. The aim of this study was to evaluate the prevalence of IBD among patients who have undergone renal biopsies due to clinical indications and to elucidate whether the presence of IBD influences renal and patient outcomes. Methods We collected retrospective data on concomitant diseases, especially IBD, from adult patients undergoing renal biopsy for any clinical indication between 2000 and 2012 at Tampere University Hospital, Tampere, Finland. Information was systematically collected on the activity of IBD, medication for IBD, surgery performed for IBD and markers of kidney function. Results Of the 819 patients biopsied, 35 (4.3%) had IBD. The prevalence of IBD was 13.3 and 4.6% in patients with tubulointerstitial nephritis (TIN) and immunoglobulin A nephropathy (IgAN), respectively. In comparison, the prevalence of IBD in the Finnish population is 0.6%. Ulcerative colitis and Crohn’s disease were equally represented. The presence of IBD showed no impact on renal and patient outcomes. Conclusions IBD should not be overlooked in patients undergoing renal biopsies, especially those diagnosed with TIN or IgAN. The renal findings did not associate with the activity of intestinal inflammation. Whether a concomitant IBD truly affects the course of chronic kidney disease should be examined in further studies.

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“…Based on previous clinical surveys, celiac disease was also associated with other extra-intestinal manifestations such as endocrine, connective tissue, and pulmonary disorders ( 70 , 71 ). Compared to the general population, patients with celiac disease carry a higher risk of renal diseases e.g., IgA nephropathy ( 72 – 75 ). Based on eight Northern European studies, the relative risk of kidney disease was ~2-fold higher in patients with celiac disease compared to those without.…”

Section: Kidney Manifestations In Patients With Gastrointestinal Disementioning

confidence: 99%

The Gut-Kidney Axis: Putative Interconnections Between Gastrointestinal and Renal Disorders

Lehto

Groop

2018

Front. Endocrinol.

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Diabetic kidney disease (DKD) is a devastating condition associated with increased morbidity and premature mortality. The etiology of DKD is still largely unknown. However, the risk of DKD development and progression is most likely modulated by a combination of genetic and environmental factors. Patients with autoimmune diseases, like type 1 diabetes, inflammatory bowel disease, and celiac disease, share some genetic background. Furthermore, gastrointestinal disorders are associated with an increased risk of kidney disease, although the true mechanisms have still to be elucidated. Therefore, the principal aim of this review is to evaluate the impact of disturbances in the gastrointestinal tract on the development of renal disorders.

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Celiac disease or positive tissue transglutaminase antibodies in patients undergoing renal biopsies

Cited by 17 publications

References 38 publications

Prevalence of Inflammatory Bowel Disease and Celiac Disease in Patients with IgA Nephropathy over Time

Prevalence of Inflammatory Bowel Disease and Celiac Disease in Patients with IgA Nephropathy over Time

Inflammatory bowel disease in patients undergoing renal biopsies

The Gut-Kidney Axis: Putative Interconnections Between Gastrointestinal and Renal Disorders

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