Inflammatory Bowel Disease Is More Common in Patients with IgA Nephropathy and Predicts Progression of ESKD: A Swedish Population-Based Cohort Study

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Rehnberg, Johanna,1982-Department of Nephrology and Centre for Clinical Research, County Council of Värmland, Central Hospital Karlstad, Karlstad, Sweden (author)

Inflammatory Bowel Disease Is More Common in Patients with IgA Nephropathy and Predicts Progression of ESKD : A Swedish Population-Based Cohort Study

Article/chapterEnglish2021

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American Society of Nephrology,2021
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LIBRIS-ID:oai:DiVA.org:oru-87367
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-87367URI
https://doi.org/10.1681/ASN.2020060848DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:145958515URI

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Language:English
Summary in:English

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Funding Agency:County Council of Värmland (Region Värmland), Sweden
BACKGROUND: Case reports suggest an association between inflammatory bowel disease, a chronic autoimmune condition linked to increased circulating IgA levels, and IgA nephropathy, the most common form of primary GN and a leading cause of ESKD.METHODS: In a Swedish population-based cohort study, we compared 3963 biopsy-verified IgA nephropathy patients with 19,978 matched controls between 1974 and 2011, following up participants until 2015. Inflammatory bowel disease data and ESKD status were obtained through national medical registers. We applied Cox regression to estimate hazard ratios (HRs) for future inflammatory bowel disease in IgA nephropathy and conditional logistic regression to assess risk of earlier inflammatory bowel disease in IgA nephropathy. We also explored whether inflammatory bowel disease affects development of ESKD in IgA nephropathy.RESULTS: During a median follow-up of 12.6 years, 196 (4.95%) patients with IgA nephropathy and 330 (1.65%) matched controls developed inflammatory bowel disease (adjusted HR, 3.29; 95% confidence interval [95% CI], 2.73 to 3.96). Inflammatory bowel disease also was more common before a confirmed IgA nephropathy diagnosis. Some 103 (2.53%) IgA nephropathy patients had an earlier inflammatory bowel disease diagnosis compared with 220 (1.09%) controls (odds ratio [OR], 2.37; 95% CI, 1.87 to 3.01). Both logistic regression (OR, 2.60; 95% CI, 2.02 to 3.35) and time-varying Cox regression (HR, 1.84; 95% CI, 1.33 to 2.55) demonstrated that inflammatory bowel disease was associated with increased ESKD risk in patients with IgA nephropathy.CONCLUSIONS: Patients with IgA nephropathy have an increased risk of inflammatory bowel disease both before and after their nephropathy diagnosis. In addition, among patients with IgA nephropathy, comorbid inflammatory bowel disease elevates the risk of progression to ESKD.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Gastroenterologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Gastroenterology and Hepatology hsv//eng
ESKD
IgA nephropathy
clinical epidemiology
end stage kidney disease

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Symreng, AdinaClinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden (author)
Ludvigsson, Jonas F.,1969-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Division of Digestive and Liver Disease, Department of Medicine, Columbia University Medical Center, New York, New York, USA; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom(Swepub:oru)jsln (author)
Emilsson, Louise,1982-Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Årjäng Health Care Center and Centre for Clinical Research, County Council of Värmland, Värmland, Sweden; Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway(Swepub:oru)leen (author)
Department of Nephrology and Centre for Clinical Research, County Council of Värmland, Central Hospital Karlstad, Karlstad, SwedenClinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden (creator_code:org_t)

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In:Journal of the American Society of Nephrology: American Society of Nephrology32:2, s. 411-4231046-66731533-3450

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