Review for 10.1186/s12876-025-03705-5 (2025)

Title: Unraveling the role of early coeliac disease diagnosis in the risk of developing immune-
mediated renal diseases
Version: 1 Date: 04 Jul 2024
Reviewer's report:
Reviewer's report:
Thank you for this manuscript which described the risk of developing immune-mediated renal
diseases (IMRDs) in patients with celiac disease (CD). The study area is interesting, however
there seems to be some major concerns I would like to rise. Therefore, I would like to ask the
authors to clarify some issues:
General
- Throughout the manuscript, please include the confidence intervals with HRs.
- Please make sure that abbreviations are used throughout the manuscript with the same manner
(for instance, the specific word should be written in full with the abbreviation in brackets
appearing first time in the text).
- I also suggest not to use abbreviations for different IMRDs, making the text more complex
to read.
- Please consider including the data on specific renal disorders included to the group of IMRDs
to the Abstract and/or Material and Methods (not only to Supplementary Table). Further, how
did the authors decide this classification of IMRDs including various syndromes and specific
diagnoses?
Abstract
- I would like to know what was the actual numeric risk increase or decrease of having IMRDs
in different analysis? Please consider using more accurate descriptions of the risks.
- I suggest downregulating some of the conclusions, because even though these results may
indicate some lower risk of IMRDs in patients diagnosed with CD in earlier life, many other
factors should also be considered.
Introduction
- Rows 49-50, please highlight that CD can still present at any age.
- I would recommend using different term than ´gluten sensitivity´ in CD diagnosis to avoid it
to be confused with another entity called ´non-celiac gluten sensitivity´.
- Rows 56-75; I suggest that this part is written compactly concentrating on the theme of this
article.
- I would like to read more about the known association of CD and renal disorders.
- Rows 76-77, please include more detailed data on the potential benefits of gluten-free diet
(what kind of benefits and in which studied renal disorders)?
Material and methods
- Could the term “Socialstyrelsen” be changed to “National Board of Health and Welfare”?
- Did you consider some potential factors, for instance other comorbidities, when analyzing the
data?
Results
- This section includes some discussion of the results, for instance on the rows 144-145 and
181-185. Please re-consider the location of these sentences.
Discussion
- The sentence from the row 212 needs to be cited.
- Data of compliance with gluten-free diet are lacking. To discuss this weakness more deeply, it
would be interesting to show some data from Sweden about the general compliance with a such
diet in CD. Further, I think that the discussion of the role of gluten in kidney damage would
improve the sections of Introduction or Discussion.
- I kindly ask authors to ponder whether there are any other factors potentially affecting the risk
of IMRDs with respect to the time of the CD diagnosis.
Tables and Figures
- Please include the abbreviations to the Tables and Figures.
References
- Majority of the references are over 20 years old. Please re-consider using some current
references.