, Volume 57, Issue 7, pp 1339–1345 | Cite as

Risk of renal disease in patients with both type 1 diabetes and coeliac disease

  • Kaziwe MollazadeganEmail author
  • Michael Fored
  • Sigrid Lundberg
  • Johnny Ludvigsson
  • Anders Ekbom
  • Scott M. Montgomery
  • Jonas F. Ludvigsson



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.


Coeliac disease Cohort studies Renal disease Type 1 diabetes 



Coeliac disease


End-stage renal disease


Gluten-free diet


Type 1 diabetes


Villous atrophy



This study was funded by the Swedish Research council and the Swedish Coeliac Society (JFL).

Duality of interest

The authors declare that there is no duality of interest associated with this manuscript.

Contribution statement

All authors made substantial contributions to the study’s conception and design, acquisition of data and analysis and interpretation of data. All authors were involved in drafting the article and revising it critically for important intellectual content and gave final approval of the version to be published. KM and JFL are responsible for the integrity of the work as a whole.

Supplementary material

125_2014_3223_MOESM1_ESM.pdf (32 kb)
ESM text (PDF 32 kb)
125_2014_3223_MOESM2_ESM.pdf (64 kb)
ESM Fig. 1 (PDF 64 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Kaziwe Mollazadegan
    • 1
    • 2
    Email author
  • Michael Fored
    • 1
  • Sigrid Lundberg
    • 3
  • Johnny Ludvigsson
    • 4
  • Anders Ekbom
    • 1
  • Scott M. Montgomery
    • 1
    • 5
    • 6
  • Jonas F. Ludvigsson
    • 1
    • 7
  1. 1.Clinical Epidemiology Unit, Department of MedicineKarolinska InstitutetStockholmSweden
  2. 2.St Erik Eye Hospital, Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
  3. 3.Department of MedicineKarolinska InstitutetStockholmSweden
  4. 4.Div. of Pediatrics, Linköping University, and University Hospital, Östergötland County CouncilLinköpingSweden
  5. 5.Clinical Epidemiology and BiostatisticsÖrebro University Hospital and Örebro UniversityÖrebroSweden
  6. 6.Department of Epidemiology and Public HealthUniversity College LondonLondonUK
  7. 7.Department of PediatricsÖrebro University HospitalÖrebroSweden

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