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Microalbuminuria in an adolescent cohort with insulin-dependent diabetes mellitus
T Quattrin1, W R Waz, L C Duffy
1Children's Hospital of Buffalo, Diabetes Center, NY 14222, USA.
Abstract:
To document the incidence of microalbuminuria in children and adolescents with longstanding insulin-dependent diabetes mellitus (IDDM) and to compare the clinical characteristics and determinant risk factors of those with and without microalbuminuria, 135 adolescent patients with IDDM for 5 years or longer were evaluated. The study population was divided on the basis of microalbumin excretion into normal (< 20 micrograms/min), incipient (20-200 micrograms/min), and overt (> 200 micrograms/min) nephropathy groups. There were 106 patients in the normal group, 24 patients in the incipient group, and five in the overt nephropathy group. Glycosylated hemoglobin, cholesterol concentration, and glomerular filtration rate (GFR) were analyzed. The incidence of incipient and overt nephropathy was 17.8% and 3.7%, respectively. Mean cholesterol concentration in the incipient and overt nephropathy groups (208 +/- 39 mg/dL [5.4 +/- 1.0 mmol/L]) and 227 +/- 49 mg/dL [5.9 +/- 1.3 mmol/L], respectively) was significantly higher than the normal group (186 +/- 37 mg/dL [4.8 +/- 0.9 mmol/L] P < 0.05). Similarly, systolic and diastolic blood pressures were significantly higher in the incipient and overt nephropathy groups compared to the normal group. This study confirms the high incidence of incipient and overt nephropathy in adolescents with IDDM early in the course of the disease.
Insights
Microalbuminuria is common in adolescents with longstanding insulin-dependent diabetes mellitus (IDDM). Higher cholesterol and blood pressure are linked to kidney damage in these young patients.
Area of Science:
- Nephrology
- Pediatrics
- Endocrinology
Background:
- Insulin-dependent diabetes mellitus (IDDM) is a chronic condition affecting children and adolescents.
- Diabetic nephropathy, characterized by microalbuminuria, is a significant complication of IDDM.
- Early detection and risk factor identification are crucial for managing diabetic nephropathy in pediatric populations.
Purpose of the Study:
- To determine the incidence of microalbuminuria in adolescents with longstanding IDDM.
- To compare clinical characteristics and risk factors between patients with and without microalbuminuria.
- To identify early indicators of kidney damage in pediatric diabetes.
Main Methods:
- A cohort of 135 adolescent patients with IDDM for at least 5 years was evaluated.
- Patients were categorized into normal, incipient, and overt nephropathy groups based on microalbumin excretion rates.
- Key parameters analyzed included glycosylated hemoglobin, cholesterol, glomerular filtration rate (GFR), and blood pressure.
Main Results:
- The incidence of incipient and overt nephropathy was 17.8% and 3.7%, respectively.
- Patients with incipient and overt nephropathy exhibited significantly higher mean cholesterol concentrations compared to the normal group.
- Elevated systolic and diastolic blood pressures were also observed in patients with incipient and overt nephropathy.
Conclusions:
- A substantial proportion of adolescents with longstanding IDDM develop microalbuminuria.
- Elevated cholesterol and blood pressure are significant risk factors associated with early-stage diabetic kidney disease in this population.
- These findings underscore the importance of regular screening for microalbuminuria and aggressive management of cardiovascular risk factors in pediatric IDDM patients.