Högskolan i Skövde

Background coeliac disease (CD) is an inflammatory condition of the small intestine caused by immunologicalintolerance towards dietary gluten. Associations between CD and other autoimmune disorders have been extensivelyreported. However, the risk in CD patients of developing immune‑mediated renal diseases (IMRDs) as a functionof the duration of exposure to gluten remains uncharacterized.

Methods we used data from the Swedish national patient register to retrospectively construct two subcohorts of CDpatients by either years before or after CD diagnosis, matched by sex and age to reference individuals (ratio 1:6).Adopting cox regressions, we assessed the risk in CD to develop IMRDs.

Results we found that unrecognized CD patients had a higher risk to develop the majority of the IMRDs hereinvestigated compared with matched reference individuals. Following a CD diagnosis, the risk was reduced in eightof the twelve IMRDs. Furthermore, if patients were diagnosed with CD earlier in childhood they showed less or noincreased risk to develop IMRDs compared with reference individuals. CD patients diagnosed by the age of 15 hadan overall 12% increased risk of developing any IMRD, (HR: 1.12; CI = 1.02, 1.24; p < 0.02), as those with a CD diagnosisbetween 16 and 30 years of age had a 60% increased risk of developing IMRD (HR: 1.61; CI = 1.36, 1.91; p < 0.001).

Conclusions Our data show that individuals diagnosed with CD at an earlier age have a lower risk of developingimmune‑mediated kidney conditions.