Early detection of diabetic nephropathy in children and adolescents with type 1 diabetes mellitus

Abstract

Introduction: Diabetic nephropathy commences early after the diagnosis of type 1 DM, described risk factors include time after diagnosis, deficient metabolic control, puberty and arterial hypertension. 

Objective: To evaluate the aforementioned parameters and their association with early renal compromise in children with type 1 DM. 

Methods: Prospective study measuring microalbuminuria, random morning creatininuria (index microalbuminuria/creatininuria (ACR), plasma creatinine, creatinine clearence, renal ultrasound, actual glycosylated hemoglobin and previous average, age of diagnosis, puberty and blood pressure. 

Results: 44 patients were studied, 20 males, average age 11.68 ± 3.01 years, with a follow-up since DM diagnosis of 3.8 ± 2.84 years. Average HbA1c was 9.1 ± 1.9%. Hyperfiltration was observed in 7/44 (15.9%) and nephromegalia was noted in 7/28 (25%). 8/44 patients (18,2%) had a raised ACR, and the 25% of prepuberal patients who has increase ACR were diagnosed at an earlier age. There was no correlation between metabolic control, hyperfiltration or nephromegalia with other studied parameters. 

Conclusions: Microalbuminuria determined by ACR is present in 18.2% of patients, presented more frequent in prepuberal children who debut at youngest age, being a possible risk factor for its future development.