Researchers discovered that children with a rare kidney disease called nephrotic syndrome are more likely to have celiac disease—a condition where the body can’t handle gluten—than kids in the general population. In this study of 147 children, about 8% of those with kidney disease also had celiac disease, compared to only 1% of people without kidney problems. The exciting news: when kids with both conditions followed a gluten-free diet, about two-thirds of them had fewer or no kidney disease flare-ups. This suggests that hidden celiac disease might be triggering some kidney problems, and testing for it could help these children feel better.

The Quick Take

  • What they studied: Whether children with nephrotic syndrome (a rare kidney disease that causes protein loss) are more likely to have celiac disease (a gluten sensitivity), and whether avoiding gluten helps reduce kidney disease flare-ups.
  • Who participated: 147 children hospitalized at one medical center between 2020 and 2024. The main group had 98 children with nephrotic syndrome, and a comparison group had 49 children without the kidney disease.
  • Key finding: 8% of children with nephrotic syndrome had celiac disease—eight times higher than the 1% rate in the general population. Among those with both conditions who avoided gluten, 66% experienced no relapses or fewer relapses of their kidney disease.
  • What it means for you: If your child has nephrotic syndrome and keeps having flare-ups, asking their doctor to test for celiac disease might be worth considering. A gluten-free diet could potentially reduce how often the kidney disease returns, though more research is needed to confirm this connection.

The Research Details

This was a retrospective cohort study, which means researchers looked back at medical records of children who had already been treated at their hospital. They compared 98 children with nephrotic syndrome to 49 children without the kidney disease (the control group). The researchers checked blood tests for signs of celiac disease, including special antibodies that appear when someone has the condition. They also reviewed medical histories, asked families about symptoms and allergies, and tracked how often the kidney disease flared up, especially in children who followed a gluten-free diet.

The study collected information on several factors: how much steroid medication each child received, how long they had the kidney disease, blood protein levels, and urine test results. Researchers also asked detailed questions about childhood symptoms and family history of allergies and autoimmune diseases, since celiac disease often runs in families and is related to other immune system problems.

This research approach is important because it allowed scientists to look at real-world patient data over several years, showing patterns that might not be obvious in a single patient. By comparing children with nephrotic syndrome to a control group, they could determine whether celiac disease is actually more common in kidney disease patients. This type of study is practical and cost-effective for identifying potential connections between diseases.

This study has some strengths: it used objective blood tests to diagnose celiac disease rather than relying on symptoms alone, and it tracked actual patient outcomes over time. However, readers should know that the study looked backward at existing records rather than following children forward, which can sometimes miss information. The study was conducted at a single medical center, so the results might not apply to all populations. The researchers themselves noted that the number of children with both conditions was small, which means the findings need confirmation with larger studies.

What the Results Show

The main discovery was that celiac disease appeared in 8% of children with nephrotic syndrome, compared to the 1% rate typically seen in the general population. This means children with this kidney disease are roughly 8 times more likely to have celiac disease than average children.

Among the children who had both nephrotic syndrome and celiac disease and followed a gluten-free diet, 66% experienced either no relapses or significantly fewer relapses of their kidney disease. This is a substantial improvement, suggesting that gluten exposure may be triggering some of the kidney disease flare-ups in these children.

The study also found that celiac disease in these children was often “silent” or mild—meaning kids didn’t always show obvious symptoms like stomach problems. This is important because it suggests doctors shouldn’t wait for obvious signs before testing for celiac disease; they should screen all children with nephrotic syndrome.

The research revealed that children with both conditions often had elevated levels of certain antibodies (IgA and IgG) in their blood, which are markers of immune system activity. Family history was also significant—children with nephrotic syndrome were more likely to have relatives with allergies or autoimmune diseases, suggesting a genetic component to having both conditions. The study noted that some children with celiac disease had minimal digestive symptoms, highlighting why blood tests are more reliable than symptom-based diagnosis.

Previous research has shown that celiac disease is more common in people with autoimmune diseases (up to 8% in some autoimmune conditions) compared to the general population (1%). This study fits that pattern, suggesting that nephrotic syndrome—which involves the immune system attacking the kidneys—may be another autoimmune condition linked to celiac disease. The finding that a gluten-free diet reduces kidney disease flare-ups is relatively novel and adds to growing evidence that diet can influence autoimmune disease activity.

The researchers were honest about several limitations: the study looked at only 147 children from one hospital, so results might differ in other locations or populations. The number of children with both conditions was small (only about 8 children), which limits how confident we can be in the findings. Because this was a retrospective study, some information from medical records might have been incomplete or missing. The study didn’t include a randomized controlled trial (where some kids deliberately avoid gluten while others don’t), so we can’t be 100% certain the gluten-free diet caused the improvement rather than other factors. The researchers emphasized that larger, more controlled studies are needed to confirm these findings.

The Bottom Line

Based on this research, doctors should consider testing all children with nephrotic syndrome for celiac disease, even if they don’t have obvious digestive symptoms. If celiac disease is found, a gluten-free diet appears to be a reasonable approach that may help reduce kidney disease flare-ups. However, this should be done under medical supervision, as the evidence is promising but not yet definitive. Confidence level: Moderate—the findings are interesting and suggest a real connection, but larger studies are needed for stronger conclusions.

This research is most relevant to children diagnosed with nephrotic syndrome and their families, as well as pediatric nephrologists (kidney doctors) and gastroenterologists. Parents of children with recurring nephrotic syndrome flare-ups should discuss celiac disease screening with their child’s doctor. Children with celiac disease who also have kidney problems might benefit from ensuring strict gluten avoidance. This is less immediately relevant to children without nephrotic syndrome or to adults, though the principles might apply to them as well.

If a child with both conditions starts a gluten-free diet, improvements in kidney disease flare-ups might not be immediate. Based on the study results, meaningful changes could take weeks to months to become apparent. Parents should expect this to be a long-term dietary change rather than a quick fix, and should work closely with their medical team to monitor progress.

Want to Apply This Research?

  • Track nephrotic syndrome flare-ups (dates, severity, symptoms like swelling or protein in urine) alongside dietary adherence to gluten-free eating. Record any accidental gluten exposure and note whether flare-ups follow these exposures within 1-4 weeks.
  • If diagnosed with both conditions, use the app to log daily gluten-free meals and snacks, set reminders to check food labels for hidden gluten sources, and mark calendar dates when the child feels well versus when symptoms appear. This creates a visual pattern showing the diet-disease connection.
  • Establish a monthly review where you compare gluten-free adherence percentage with flare-up frequency. Track trends over 3-6 months to see if stricter gluten avoidance correlates with fewer kidney disease episodes. Share this data with the child’s doctor to guide treatment decisions.

This research suggests a potential connection between celiac disease and nephrotic syndrome in children, but it is not definitive proof. These findings should not replace professional medical advice. If your child has nephrotic syndrome with frequent flare-ups, discuss celiac disease screening with their pediatrician or nephrologist before making any dietary changes. A gluten-free diet should only be started under medical supervision and after proper testing, as eliminating gluten can interfere with celiac disease diagnosis if done before testing. This study involved a small number of patients at a single medical center, so results may not apply to all children. Always consult with healthcare providers before implementing dietary changes for medical conditions.