Effect of a Gluten-Free Diet on Albuminuria in Children with Newly Diagnosed Celiac Disease
<b><i>Background and Objectives:</i></b> 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. <b><i>Methods:</i></b> We performed a cohort study comparing urinary albumin (μg): Cr (mg) ratio (ACR) in CD patients versus controls and in response to a GFD. <b><i>Results:</i></b> Children with CD (<i>n</i> = 46) had higher ACR than controls (<i>n</i> = 21), 20.2 ± 5.6 versus 8.4 ± 1.1 μg/mg, <i>p</i> = 0.16 and exceeded 30 μg/mg (microalbuminuria cutoff) in 7/46 cases. Seventeen 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, <i>p</i> = 0.035. <b><i>Conclusion:</i></b> 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.