Abstract

GALLARDO T., Vivian et al. Early detection of diabetic nephropathy in children and adolescents with type 1 diabetes mellitus. Rev. bol. ped. [online]. 2007, vol.46, n.2, pp.138-144. ISSN 1024-0675.

Introduction: Diabetic nephropathy begins 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 increased 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 begin at youngest age, being a possible risk factor for its future development.

Keywords : diabetic nephropathy; early diagnosis; microalbuminuria.

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