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Risk of renal disease in patients with both type 1 diabetes and coeliac disease
Karolinska Institutet, Stockholm, Sweden; St Erik Eye Hospital, Stockholm, Sweden.
Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet, Stockholm, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
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2014 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 57, no 7, 1339-1345 p.Article in journal (Refereed) Published
Abstract [en]


Our aim was to study the risk of renal disease in patients with type 1 diabetes (T1D) and coexisting coeliac disease (CD).


Individuals with T1D were defined as having a diagnosis of diabetes recorded at ≤30 years of age in the Swedish Patient Register between 1964 and 2009. Individuals with CD were identified through biopsy reports with villous atrophy (Marsh stage 3) from 28 pathology departments in Sweden between 1969 and 2008. We identified 954 patients with both T1D and CD. For each patient with T1D + CD, we selected five age- and sex-matched reference individuals with T1D only (n = 4,579). Cox regression was used to estimate the following risks: (1) chronic renal disease and (2) end-stage renal disease in patients with CD + T1D compared with T1D patients only.


Forty-one (4.3%) patients with CD + T1D and 143 (3.1%) patients with T1D only developed chronic renal disease. This corresponded to an HR of 1.43 for chronic renal disease (95% CI 0.94, 2.17) in patients with CD + T1D compared with T1D only. In addition, for end-stage renal disease there was a positive (albeit statistically non-significant) HR of 2.54 (95% CI 0.45, 14.2). For chronic renal disease, the excess risk was more pronounced after >10 years of CD (HR 2.03, 95% CI 1.08, 3.79). Risk estimates were similar when we restricted our cohort to the following T1D patients: (1) those who had an inpatient diagnosis of T1D; (2) those who had never received oral glucose-lowering medication; and (3) those who had not received their first diabetes diagnosis during pregnancy.


Overall this study found no excess risk of chronic renal disease in patients with T1D and CD. However, in a subanalysis we noted a positive association between longstanding CD and chronic renal disease in T1D.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2014. Vol. 57, no 7, 1339-1345 p.
Keyword [en]
Coeliac disease; Cohort studies; Renal disease; Type 1 diabetes
National Category
Clinical Medicine
URN: urn:nbn:se:liu:diva-109122DOI: 10.1007/s00125-014-3223-yISI: 000337498700011PubMedID: 24663809OAI: diva2:737539
Available from: 2014-08-13 Created: 2014-08-11 Last updated: 2015-03-30Bibliographically approved

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Ludvigsson, Johnny
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Division of Clinical SciencesFaculty of Health SciencesDepartment of Paediatrics in Linköping
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