Screening for celiac disease among patients with chronic kidney disease

Celiac disease (CD) is considered to be a risk factor for chronic kidney disease (CKD) but there is no study determining the prevalence of CD, among patients with CKD. We aim to determine the prevalence of CD in patients with CKD.

Anti-endomysial IgA (EMA) antibody was screened in patients with CKD (glomerular filtration rate <60 mL/min). Patients who were EMA positive underwent upper gastrointestinal system endoscopy and intestinal biopsy for confirmation of definite diagnosis for CD.

Two hundred and ninety-two patients (161 males, mean age was 47.3 ± 16.3 years) with CKD were included. The EMA testing was positive in 10 patients (6F/4M). Of these, eight underwent upper gastrointestinal endoscopy and biopsies, two of them rejected endoscopy. Biopsy specimen of one of the patients was not appropriate for histopathological examination. Specimens of remaining cases (4F/3M) were compatible with CD on histopathological examination. The EMA-positive CKD patients were 3.42% (1/29 cases) and frequency of CD was 2.39% (1/42 cases). Frequency of CD was 3.1% in females and 1.85% in males. Female/male ratio was 1.67. We did not find statistically significant difference between two groups according to age and gender. Apparent chronic gastrointestinal symptoms such as abdominal pain, distension, constipation, dyspepsia, and diarrhea were absent in patients diagnosed with CD. Differences between some laboratory parameters (such as complete blood count, albumin, calcium, phosphate, total cholesterol, ferritin, parathormone) of CD and non-CD patients were not significant statistically.

Our results showed increased frequency of CD among patients with CKD and screening for CD in CKD population can be helpful.