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Renal Doppler indices in diabetic children with insulin resistance syndrome

Shereen Abd El Ghaffar1, Khaled El Kaffas, Ranya Hegazy

  • 1Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.

Pediatric Diabetes
|March 6, 2010
PubMed

Insights

Type 1 diabetes in children is linked to higher kidney vascular resistance, especially in those with insulin resistance syndrome. Renal Doppler assessment may detect early diabetic nephropathy before microalbuminuria appears.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Medical Imaging

Background:

  • End-stage renal failure is a major cause of mortality in type 1 diabetes patients.
  • Insulin resistance is a significant, often underestimated, factor in type 1 diabetes progression.
  • Early detection of diabetic nephropathy is crucial for delaying disease progression.

Purpose of the Study:

  • To evaluate renal Doppler indices (resistive index and pulsatility index) in children with type 1 diabetes.
  • To investigate the relationship between these indices and features of insulin resistance.
  • To correlate Doppler indices with established markers of early diabetic nephropathy, such as microalbuminuria.

Main Methods:

  • Renal Doppler ultrasonography was used to measure resistive index (RI) and pulsatility index (PI).
  • One hundred children with type 1 diabetes and 30 healthy controls were studied.
  • Parameters assessed included blood pressure, waist-hip ratio, insulin dose, estimated glucose disposal rate, microalbuminuria, HbA1c, and diabetes duration.

Main Results:

  • Renal Doppler indices (RI and PI) were significantly elevated in children with type 1 diabetes compared to controls.
  • The most abnormal indices were found in children with insulin resistance syndrome (IRS), hypertension, and obesity.
  • Resistive index correlated significantly with blood pressure, waist-hip ratio, insulin dose, and estimated glucose disposal rate, but not with microalbuminuria, HbA1c, or diabetes duration.

Conclusions:

  • Renal Doppler indices are impaired in children with type 1 diabetes, particularly those with IRS.
  • Children with type 1 diabetes and IRS face a higher risk of developing diabetic nephropathy.
  • Renal Doppler assessment could aid in diagnosing diabetic nephropathy at a prealbuminuric stage in these patients.

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