# Unraveling the role of early coeliac disease diagnosis in the risk of developing immune-mediated renal diseases

## TL;DR

Early diagnosis of coeliac disease is linked to a lower risk of developing immune-related kidney diseases later in life.

## Contribution

This study is the first to show how the timing of coeliac disease diagnosis affects the risk of immune-mediated renal diseases.

## Key findings

- Undiagnosed coeliac disease is associated with a higher risk of most immune-mediated renal diseases.
- Early diagnosis of coeliac disease before age 15 reduces the risk of developing these kidney conditions.
- CD patients diagnosed between 16 and 30 years had a 60% higher risk of IMRDs compared to reference individuals.

## Abstract

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

we used data from the Swedish national patient register to retrospectively construct two subcohorts of CD patients 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.

we found that unrecognized CD patients had a higher risk to develop the majority of the IMRDs here investigated compared with matched reference individuals. Following a CD diagnosis, the risk was reduced in eight of the twelve IMRDs. Furthermore, if patients were diagnosed with CD earlier in childhood they showed less or no increased risk to develop IMRDs compared with reference individuals. CD patients diagnosed by the age of 15 had an overall 12% increased risk of developing any IMRD, (HR: 1.12; CI = 1.02, 1.24; p < 0.02), as those with a CD diagnosis between 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).

Our data show that individuals diagnosed with CD at an earlier age have a lower risk of developing immune-mediated kidney conditions.

The online version contains supplementary material available at 10.1186/s12876-025-03705-5.