The Frequency of Diabetic Nephropathy in Children and Adolescents with Type 1 Diabetes Mellitus

Document Type : Original Article (s)

Authors

1 Assistant Professor, Isfahan Endocrine and Metabolism Research Center AND Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease AND Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, School of Medicine AND Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

3 Professor, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease AND Isfahan Endocrine and Metabolism Research Center AND Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

4 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

5 Assistant Professor, Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Diabetes mellitus is a chronic metabolic disorder caused by insulin secretion disorder. The aim of this study was to determine the distribution of diabetic nephropathy in children and adolescents with type 1 diabetes mellitus in Isfahan City, Iran.Methods: In this cross-sectional study conducted in 2018, in the Pediatric Endocrinology Clinic of Isfahan University of Medical Sciences, 301 patients under the age of 18 years with type 1 diabetes mellitus were selected Then, the ratio of microalbumin to random urinary creatinine, as a method for diagnosis of diabetic nephropathy, was measured, and its relationship with demographic characteristics, clinical history, hemoglobin A1c (HbA1c), and blood pressure was investigated.Findings: Of 301 patients, 12 (4%) had diabetic nephropathy. Among the studied variables, there was a significant relationship between nephropathy with blood glucose control (P = 0.020), mean HbA1c (P < 0.001), and mean systolic blood pressure (P < 0.001).Conclusion: The results of this study showed that the prevalence of diabetic nephropathy in children with type 1 diabetes mellitus in Isfahan was 4%, and some of risk factors such as proper control of blood glucose, systolic blood pressure, and HBA1C levels were significantly associated with it. Therefore, patients with type 1 diabetes mellitus should be monitored for risk factors of nephropathy.

Keywords

References

  1. Giorgino F, Laviola L, Cavallo PP, Solnica B, Fuller J, Chaturvedi N. Factors associated with progression to macroalbuminuria in microalbuminuric Type 1 diabetic patients: the EURODIAB Prospective Complications Study. Diabetologia 2004; 47(6): 1020-8.
  2. Hovind P, Tarnow L, Rossing P, Jensen BR, Graae M, Torp I, et al. Predictors for the development of microalbuminuria and macroalbuminuria in patients with type 1 diabetes: inception cohort study. BMJ 2004; 328(7448): 1105.
  3. Jones CA, Krolewski AS, Rogus J, Xue JL, Collins A, Warram JH. Epidemic of end-stage renal disease in people with diabetes in the United States population: Do we know the cause? Kidney Int 2005; 67(5): 1684-91.
  4. Caramori ML, Fioretto P, Mauer M. Enhancing the predictive value of urinary albumin for diabetic nephropathy. J Am Soc Nephrol 2006; 17(2): 339-52.
  5. KDOQI. KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease. Am J Kidney Dis 2007; 49(2 Suppl 2): S12-154.
  6. Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, et al. Care of children and adolescents with type 1 diabetes: A statement of the American Diabetes Association. Diabetes Care 2005; 28(1): 186-212.
  7. Lambers Heerspink HJ, Gansevoort RT, Brenner BM, Cooper ME, Parving HH, Shahinfar S, et al. Comparison of different measures of urinary protein excretion for prediction of renal events. J Am Soc Nephrol 2010; 21(8): 1355-60.
  8. Witte EC, Lambers Heerspink HJ, de Zeeuw D, Bakker SJ, de Jong PE, Gansevoort R. First morning voids are more reliable than spot urine samples to assess microalbuminuria. J Am Soc Nephrol 2009; 20(2): 436-43.
  9. Hosseini SM, Amini M, Roosta S, Beigrezaei S. Trends of serum creatinine among patients with type 2 diabetes in Isfahan endocrine and metabolism research center; a longitudinal study. J Prev Epidemiol 2017; 2(1): e01.
  10. Klein R. Hyperglycemia and microvascular and macrovascular disease in diabetes. Diabetes Care 1995; 18(2): 258-68.
  11. Stratton Irene M, Adler Amanda I, Neil H Andrew W, Matthews David R, Manley Susan E, Cull Carole A, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): Prospective observational study. BMJ 2000; 321: 405.
  12. Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001; 414(6865): 782-7.
  13. Alberti KG, Zimmet P, Shaw J. International Diabetes Federation: A consensus on Type 2 diabetes prevention. Diabet Med 2007; 24(5): 451-63.
  14. Razavi Z, Momtaz HE, Sahari S. Frequency of microalbuminuria in type 1 diabetic children. Iran J Pediatr 2009; 19(4): 404-8.
  15. Basiratnia M, Abadi SF, Amirhakimi GH, Karamizadeh Z, Karamifar H. Ambulatory blood pressure monitoring in children and adolescents with type-1 diabetes mellitus and its relation to diabetic control and microalbuminuria. Saudi J Kidney Dis Transpl 2012; 23(2): 311-5.
  16. Abdel-Motal UM, G A, Abdelalim EM, Ponnuraja C, Iken K, Jahromi M, et al. Prevalence of nephropathy in type 1 diabetes in the Arab world: A systematic review and meta-analysis. Diabetes Metab Res Rev 2018; 34(7): e3026.
  17. Omar MA, Rezk MM, El-Kafoury AA, Kandil MS. Microalbuminuria and glycated hemoglobin in children with type 1 diabetes mellitus. Alexandria J Med 2015; 51(1): 83-8.
  18. Cizmecioglu FM, Noyes K, Bath L, Kelnar C. Audit of microalbumin excretion in children with type I diabetes. J Clin Res Pediatr Endocrinol 2009; 1(3): 136-43.
  19. Lutale JJ, Thordarson H, Abbas ZG, Vetvik K. Microalbuminuria among type 1 and type 2 diabetic patients of African origin in Dar Es Salaam, Tanzania. BMC Nephrol 2007; 8: 2.
  20. Raile K, Galler A, Hofer S, Herbst A, Dunstheimer D, Busch P, et al. Diabetic nephropathy in 27,805 children, adolescents, and adults with type 1 diabetes: effect of diabetes duration, A1C, hypertension, dyslipidemia, diabetes onset, and sex. Diabetes Care 2007; 30(10): 2523-8.
  21. Huang CY, Ting WH, Lo FS, Tsai JD, Sun FJ, Chan CI, et al. Factors associated with diabetic nephropathy in children, adolescents, and adults with type 1 diabetes. J Formos Med Assoc 2017; 116(12): 924-32.
  22. Roy MS, Affouf M, Roy A. Six-year incidence of proteinuria in type 1 diabetic African Americans. Diabetes Care 2007; 30(7): 1807-12.
  23. Moore TH, Shield JP. Prevalence of abnormal urinary albumin excretion in adolescents and children with insulin dependent diabetes: the MIDAC study. Microalbinuria in Diabetic Adolescents and Children (MIDAC) research group. Arch Dis Child 2000; 83(3): 239-43.
  24. Twyman S, Rowe D, Mansell P, Schapira D, Betts P, Leatherdale B. Longitudinal study of urinary albumin excretion in young diabetic patients--Wessex Diabetic Nephropathy Project. Diabet Med 2001; 18(5): 402-8.
  25. Daneman D. Early diabetes-related complications in adolescents: risk factors and screening. Horm Res 2005; 63(2): 75-85.
  26. Salgado PP, Silva IN, Vieira EC, Simoes e Silva AC. Risk factors for early onset of diabetic nephropathy in pediatric type 1 diabetes. J Pediatr Endocrinol Metab 2010; 23(12): 1311-20.
Journal of Isfahan Medical School
Volume 37, Issue 529 - Serial Number 529
May and June 2019
Pages 617-623

Files

History

  • Receive Date: 30 April 2019
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics