The effectiveness of a gluten-free diet in patients with IgA nephropathy

The aimed of this study was to evaluate the effectiveness of a gluten-free diet in patients with IgA nephropathy (IGAN). The study included 65 patients with morphologically verified IGAN aged from 18 to 63 years who were on inpatient treatment at the Main Military Clinical Hospital named after academical N. N. Burdenko from 2020 to 2022. Immunological markers were used as a screening method for determining gluten metabolism disorders: IgA antibodies to tissue transglutaminase and IgA antibodies to deamidated gliadin peptides in the blood. Depending on the level of antibodies, the patients were divided into two groups: group 1 – patients with antibody levels exceeding the reference values and group 2 – patients whose antibody levels did not exceed the reference values, or there were no antibodies at all. Patients were prescribed nephroprotective therapy according to clinical recommendations, in addition, all in group 1 and group 2 patients with proteinuria levels > 0.5 g/day and/or pre-reference values of antibodies in the blood were additionally prescribed a gluten-free diet for at least 6 months. Against the background of the treatment with the use of gluten-free diet in group 1 patients, a decrease in daily proteinuria was noted in 66.7% of patients and erythrocyturia in 77.8% of patients, there is a tendency to decrease the level of creatinine in the blood serum, which indicates the nephroprotective effect of gluten-free diet. The severity of erythrocyturia against the background of HD also decreased in 76.2% of patients from group 2. The frequency of controlled arterial hypertension increased to 90% in patients of both groups. Thus, the introduction of gluten-free diet into the diet of patients with IGAN is justified, as it expands the possibilities of nephroprotective therapy.

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