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Risk factors for early onset of diabetic nephropathy in pediatric type 1 diabetes

Patrícia Paz Cabral de Almeida Salgado1, Ivani Novato Silva, Erica Cristina Vieira

  • 1Medical School, Federal University of Minas Gerais (UFMG), Brazil.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|July 1, 2011
PubMed

Insights

Diabetic nephropathy (DN) is more common than expected in children with type 1 diabetes (DM1). Poor glucose control, high LDL cholesterol, and older age at diagnosis are linked to DN development.

Area of Science:

  • Pediatric Endocrinology
  • Nephrology
  • Diabetology

Background:

  • Diabetic nephropathy (DN) is a significant complication of long-standing type 1 diabetes mellitus (DM1).
  • Assessing DN prevalence and risk factors in pediatric DM1 patients is crucial for early intervention.

Purpose of the Study:

  • To determine the prevalence of diabetic nephropathy (DN) in children with type 1 diabetes (DM1).
  • To investigate the association of DN with clinical and metabolic factors, including age at diagnosis, glucose control, dyslipidemia, hypertension, and diabetic retinopathy (DR).

Main Methods:

  • Retrospective analysis of medical records for 205 pediatric patients with DM1.
  • Kaplan-Meier method and COX regression models were employed to analyze survival and prognostic factors.

Main Results:

  • The prevalence of microalbuminuria was 11.2%, proteinuria 6.8%, and end-stage renal disease (ESRD) 2.9%.
  • Microalbuminuria/proteinuria showed significant associations with poor glucose control (p=0.025, p=0.005), elevated LDL cholesterol (p=0.006, p=0.004), and age >6 years at diagnosis (p=0.049, p=0.05).
  • Proteinuria was also associated with diabetic retinopathy (DR) (p=0.016).

Conclusions:

  • The prevalence of DN, including severe forms, was higher than anticipated in this pediatric cohort.
  • Key factors associated with DN in these young patients include suboptimal long-term glucose control, elevated LDL-C, later age at DM1 diagnosis, and the presence of DR.
Abstract

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