Glomerular Dis. 2021 Apr;1(1):3-9. doi: 10.1159/000514635. Epub 2021 Mar 18.

Jeremiah Levine ¹, Leora Hauptman ¹, Libia Moy ¹, Howard Trachtman ²

Author information

• ¹NYU Langone Health, Department of Pediatrics, Divisions of Gastroenterology, New York, NY.
• ²NYU Langone Health, Department of Pediatrics, Divisions Nephrology, New York, NY.

Abstract

Background and objectives: Altered gastrointestinal permeability in celiac disease (CD) is mediated by zonulin. The receptor for zonulin is expressed on podocytes. Therefore, we tested the effect of a gluten-free diet (GFD) on albuminuria in pediatric patients with newly diagnosed CD.

Methods: We performed a cohort study comparing urinary albumin (μg):creatinine (mg) ratio (ACR) in CD patients vs controls and in response to a GFD.

Results: Children with CD (n=46) had higher ACR compared to controls (n=21), 20.2±5.6 versus 8.4±1.1 μg/mg, P=0.16 and exceeded 30 μg/mg (microalbuminuria cut-off) in 7/46 cases. 17 patients had a follow-up assessment (interval 6.1±0.7 months) on a GFD. Baseline ACR was 20.7±5.2 that fell to 10.4±1.5 μg/mg, P=0.035.

Conclusion: Children and adolescents with newly diagnosed CD have low-grade albuminuria that is numerically higher than controls and that declined after implementation of a GFD. CD may be associated with reversible defects in the glomerular barrier.