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The link between Chronic Kidney Disease and Coeliac Disease

https://www.fau.eu/2017/08/07/news/research/important-messenger-substances-in-the-immune-system/

Coeliac Disease might not be one of the first things that comes to mind when we hear the term “Chronic Kidney Disease”, but there are some interesting links between the two diseases, and the increasing incidence of Coeliac Disease globally makes this a topic worth discussing, especially for those of you who have been diagnosed with either disease, or have a family history of them.

 

Coeliac Disease is on the rise…

The estimated rate of Coeliac Disease worldwide is 1%. That’s 1 in every 100 people. The fact that this rate is increasing and that there is a strong genetic link suggest that we can expect this figure to rise. The fact that we do not understand the mechanisms responsible for this increase means there is not a lot we can do at this stage to prevent it.

 

CD vs CKD…

Coeliac Disease is a complex and as yet not well understood autoimmune disease, however the predisposing factors are clear. Sufferers must experience a combination of genetic, immune and environmental factors for the disease to develop. It cannot develop without dietary exposure to the protein gluten, and can only be managed by removing this trigger.

 

Chronic Kidney Disease, although the majority of cases can be attributed to high blood pressure and diabetes, can develop as a result of many different factors, including autoimmune conditions, urinary tract infections, congenital malformations (meaning they are present at birth), physical obstructions of the urinary tract or prostatitis, and many other inflammatory and genetic conditions. Diet and nutrition can be of great benefit in reversing kidney disease as we know, but it is rarely the direct cause of the condition.

 

The conditions do not appear related do they? But a cohort study published by Nephrology Dialysis Transplantation, which investigated the link between any form of glomerulonephritis, dialysis treatment and kidney transplantation and Coeliac Disease, has found statistical significance associating CD with an increased risk of Glomerulonephritis and renal failure.

https://academic.oup.com/ndt/article/21/7/1809/1821933

On the surface, the 2 diseases appear to be completely unrelated, so let’s look below the surface…

 

What are the links between the diseases?

In a nutshell, it appears that immune characteristics are at the core of the connection between these 2 common and very serious diseases.

There is currently a lot of scientific interest in the gut (our gastrointestinal tract), it’s mechanisms of immune regulation and that factors of modern life that present a threat to the delicate balance that it serves to maintain. In the gut resides the gut-associated lymphoid tissue, or GALT. This makes up around 70% of our body’s immune cells – 70%! If this balance is compromised therefore, so is our immune system and its’ ability to protect us from disease. I will not go into too much depth about the role of GALT in this article, and to be honest there is still an awful lot we do not yet know about what goes on in there! But here is what we do know about the gut, and the similarities that have been found between Coeliac Disease and Chronic Kidney Disease sufferers.

 

Activated Immune System 

The mucosal immune system exists in the lining of the gastrointestinal tract and serves as our first line of defence against harmful pathogens, just as our skin does. It is an entire ecosystem made up of a complex network of immune cells and beneficial bacteria. Like any ecosystem, it relies on adequate nutrition, hydration and other factors to thrive and maintain homeostasis, or ‘balance’. When this barrier is compromised, protective mechanisms are initiated, one of which is the production and secretion of Secretory Immunoglobulin A (IgA). Almost 100% of Coeliac Disease patients have these antibodies present, and it appears that this same mucosal immune mechanism is also active in many forms of glomerulonephritis.

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2249.1992.tb07947.x

https://www.frontiersin.org/articles/10.3389/fimmu.2016.00240/full

Gut permeability 

Tight junctions are part of the structural component of the mucosal immune system in the gut wall. They prevent toxins and harmful bacteria from entering the blood stream. Essentially, it’s what separates our internal environment from the outside world, so it’s pretty important! If these tight junctions are damaged, unwanted pathogens enter the systemic circulation and cause inflammation and oxidative stress throughout the body. This has been linked, as both a cause and effect, to generalised autoimmune diseases including Coeliac Disease.

Studies have shown that a loss in kidney function can also reduce the effectiveness of the intestinal barrier, allowing pathogens to enter the bloodstream and potentially increase the decline of kidney function. Conversely, an impaired intestinal barrier can potentially lead to autoimmune kidney diseases in susceptible individuals due to the inflammation and oxidative stress caused by the failure of the body’s first line of defence.

 

Image source: https://uncexchanges.org/2017/04/03/leaky-gut-a-potential-contributor-to-the-brain-gut-microbiota-axis/

https://academic.oup.com/ndt/article/16/3/513/1823041

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071212/

Auto-antibodies 

What are auto-antibodies you ask? These are similar to the antibodies our immune systems produce to fight invading pathogens, but autoantibodies are produced when the immune system mistakenly identifies its’ own tissue as the foreign invader. Auto = Self. This is what happen in autoimmune disease. Being an auto-immune condition, auto-antibodies are raised in Coeliac Disease, and studies have shown the same auto-antibodies to be present in renal disease.

https://www.karger.com/Article/PDF/13497

What are the main threats to our internal environment?

  • Overuse of antibiotics and mediations
  • Stress
  • Chemicals in our food, water and environment
  • Pathogenic bacteria from food water and the environment
  • Poor diet
  • Genetics
  • Methods of birth and infant feeding

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483960/

 

In Conclusion…

As with CD, the incidence of end stage kidney disease is on the increase globally, the underlying causes of which are still largely unknown. Many other chronic, autoimmune and immune related conditions are also on the rise. There are of course theories which speculate on this phenomenon, such as industrialisation, the hygiene hypothesis, overuse of antibiotics, the quality and preparation of the modern diet, stress and infections to name a few, but at the end of the day there are no definitive answers and therefore no definitive solutions.

With the growing body of evidence linking the gut to a myriad of health conditions, looking after our internal ecosystem seems like a pretty logical place to start in preventative health and disease management though. Don’t you agree?

http://www.worldgastroenterology.org/publications/e-wgn/e-wgn-expert-point-of-view-articles-collection/the-global-village-of-celiac-disease-and-its-evolution-over-time

 

 

Kidney News Weekly #3: A Round Up of the Top 8 Kidney News Stories

kidney news

Welcome to my third edition of KidneyCoach.com News Weekly! The place where I do a round-up of all the top stories related to kidneys, kidney health and kidney disease for the week.

This edition covers many interesting stories where you will discover how low levels of vitamin D is linked to kidney disease complications, new insights into the cause of chronic inflammatioin in kidney disease sufferers, how gene mutations may hold the key for a certain kidney disease, a mystery kidney disease epidemic in Central America, among many others.

…There are plently of interesting and eyeopening news stories below that will both help and inform you.

Here are the top 8 news stories for the week:

News Story #1

Gene mutation play a major role in 1 cause of kidney disease …
Mutations in a gene called INF2 are by far the most common cause of a dominantly inherited condition that leads to kidney failure, according to a study appearing in an upcoming issue of the Journal of the American …
http://www.breakthroughdigest.com/

News Story #2

Low Vitamin D Linked to Kidney Disease Complications in Children
CINCINNATI—Vitamin D deficiency is more common in children who suffer from kidney disease and contributes to thryroid problems and inflammation. These findings were published online ahead of print in the journal Kidney International. …
www.naturalproductsinsider.com

News Story #3

Scientists discover new susceptibility genes for kidney disease
Singapore and Chinese scientists have identified new susceptibility genes for a specific kidney disease and found risk variants that could influence the clinical symptoms of patients. Their discovery is related to the disease immunoglobulin A …
health.asiaone.com

News Story #4

Mystery Kidney Disease in Central America
Kidney disease has killed so many men here that locals now call their community not simply La Isla – which means “The Island” – but La Isla de las Viudas – “The Island of the Widows.” The epidemic extends far beyond Nicaragua. It’s prevalent along the …
www.theworld.org

Kidney News Weekly #2: A Round Up of the Top 6 Kidney News Stories

kidney news

Welcome to my second edition of KidneyCoach.com News Weekly! The place where I do a round up of all the top stories related to kidneys, kidney health and kidney failure for the week.

The featured news stories for this week cover everything from a potential new treatment that may halt the progression of kidney failure; feel-good stories where family members give their loved ones a new lease of life; clinical studies on how diet impacts the progression of kidney failure, and many more. But rather than me tell you about them…

Here are the top 6 news stories for the week:

News Story #1

Research aims to prevent diabetic kidney failure
The enzyme arginase-2 plays a major role in kidney failure, and blocking the action of this enzyme might lead to protection against renal disease in diabetes, according to researchers. “We believe these arginase inhibitors may be one of the new targets …
www.virtualmedicalcentre.com

News Story #2

Comment: Here are two articles on the same story. The first is for the more technically minded, the second is in plain english. The articles are a another great example of the power that diet has on the human body in preventing and treating kidney disease.

Intensive treatment preserves kidney function in patients with type 1 diabetes

“Our primary outcome was an estimated GFR less than 60 milliliters per minute, which represents a substantial loss of kidney function and is known to confer an increased risk of cardiovascular disease and death; essentially, it’s stage-III chronic …
www.endocrinetoday.com

Intense Kidney Protection
People can develop end-stage renal disease (the complete or almost complete failure of the kidneys) when they have an impaired glomerular filtration rate (GFR) – the volume of fluid filtered from the kidney. Dr. de Boer and colleagues wanted find out …
www.dailyrx.com

News Story #3

Comment: Here is a feel good story where a 14 y.o. daughter was able to save her mother’s life.

Kidney News Weekly #1: A Round Up of the Top Kidney News Stories

kidney news

I thought I would do something a little different today. I thought I would do a weekly round-up of the all the top news related to the kidneys and kidney health. But further to that, I plan to do this as a regular featured post each and every week to keep you up to date with all the latest (and best) information on the web. The web is a big place, and so by doing this I would like to make it a little smaller by “distilling” all the information for you, making this the place to go to when you want the facts. Any news related to community events, scientific breakthroughs, diet, medicines, treatments, etc. related to kidney health, I will report it here!

But I won’t just leave it there, my goal will also to report on other stories that I feel that you might find interesting, inspiring, funny, and/or enlightening. In fact it is my hope that it gives you and me the opportunity to get off the beaten path and explore the many facets of life, health, and kidneys.

So here is how it will generally work:

1. I will post the links to the main news stories of the past week with a small description, and if needed, a few comments by myself to give you further insight.

2. You click on the link, and it will take you to the website that is reporting the news. Done!

OK, so let’s get on with it shall we? Excellent.

News Story #1

New Study in NEJM Offers Hope to Lupus Patients with Kidney Disease
Nephrologists at the Miller School of Medicine have played a key role in an international study that has uncovered an effective therapy for treating patients with lupus nephritis, a debilitating kidney disease linked to lupus. …
www.healthcanal.com

News Story #2

Vitamin B derivative helps diabetics with mild kidney disease
A vitamin B6 derivative may help slow or prevent the progression of mild kidney disease in patients with diabetes, according to a study appearing in an issue of the Journal of the American Society Nephrology (JASN). The drug may benefit increasing …
www.stlamerican.com