Affiliation:
1. Faculty of Medicine, University of Latvia, Jelgavas Street 3, LV 1004 Riga, Latvia
2. Pauls Stradins Clinical University Hospital, Pilsoņu Street 13, LV 1002 Riga, Latvia
Abstract
(1) Background: Little research is conducted on the link between diabetic kidney disease (DKD) progression and diabetic gastroenteropathy in type 1 diabetes (T1D). (2) Methods. We performed a cross-sectional study with 100 T1D patients; 27 of them had progressive DKD, defined as an estimated glomerular filtration rate (eGFR) decline ≥3 mL/min/year or increased albuminuria stage, over a mean follow-up time of 5.89 ± 1.73 years. A newly developed score with 17 questions on gastrointestinal (GI) symptoms was used. Faecal calprotectin was measured by ELISA. Lower GI endoscopies were performed in 21 patients. (3) Results: The gastrointestinal symptom score demonstrated high reliability (Cronbach’s α = 0.78). Patients with progressive DKD had higher GI symptom scores compared to those with stable DKD (p = 0.019). The former group demonstrated more frequent bowel movement disorders (p < 0.01). The scores correlated negatively with eGFR (r = −0.335; p = 0.001), positively with albuminuria (r = 0.245; p = 0.015), Hba1c (r = 0.305; p = 0.002), and diabetes duration (r = 0.251; p = 0.012). Faecal calprotectin levels did not differ between DKD groups significantly. The most commonly reported histopathological findings of enteric mucosa were infiltration with eosinophils, lymphocytes, plasmacytes, the presence of lymphoid follicles, and lymphoid aggregates. Conclusion: The progression of DKD is positively correlated with gastrointestinal symptoms; however, more research is needed to clarify the causal relationships of the gut-kidney axis in T1D.
Funder
European Regional Development Fund
Subject
General Biochemistry, Genetics and Molecular Biology,Medicine (miscellaneous)
Reference37 articles.
1. Global, regional, and national burden of chronic kidney disease, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017;Bikbov;Lancet,2020
2. Biomarker panels associated with progression of renal disease in type 1 diabetes;Colombo;Diabetologia,2019
3. Gastrointestinal Symptoms in Diabetes: Prevalence, Assessment, Pathogenesis, and Management;Du;Diabetes Care,2018
4. Review article: The aetiology, diagnosis, mechanisms and clinical evidence for food intolerance;Lomer;Aliment. Pharmacol. Ther.,2015
5. Lower gastrointestinal symptoms are associated with worse glycemic control and quality of life in type 1 diabetes mellitus;Leeds;BMJ Open Diabetes Res. Care,2018