Diabetic kidney disease in pediatric patients: A current review

Abstract

In the last decades, a significant increase in the incidence of diabetic kidney disease (DKD) was observed concomitant with rising diabetes mellitus (DM) incidence. Kidney disease associated with DM in children and adolescents is represented by persistent albuminuria, arterial hypertension, progressive decline in estimated glomerular filtration rate to end-stage renal disease and increased cardiovascular and all-cause morbidity and mortality of these conditions. In medical practice, the common and still the “gold standard” marker for prediction and detection of diabetic kidney involvement in pediatric diabetes is represented by microalbuminuria screening even if it has low specificity to detect early stages of DKD. There are some known limitations in albuminuria value as a predictor biomarker for DKD, as not all diabetic children with microalbuminuria or macroalbuminuria will develop end-stage renal disease. As tubular damage occurs before the glomerular injury, tubular biomarkers are superior to the glomerular ones. Therefore, they may serve for early detection of DKD in both type 1 DM and type 2 DM. Conventional and new biomarkers to identify diabetic children and adolescents at risk of renal complications at an early stage as well as renoprotective strategies are necessary to delay the progression of kidney disease to end-stage kidney disease. New biomarkers and therapeutic strategies are discussed as timely diagnosis and therapy are critical in the pediatric diabetic population.

Screening for Nephropathy in Pediatric Type 2 Diabetes: Quality Improvement to Increase Nephropathy Screening

“…7 These structural changes worsen over 10-20 years, and for youth with T2D, they may start to impact kidney function in late adolescence, depending on the age of onset. 8 Children with T2D are at an increased risk of microvascular complications over their peers with T1D or adults with T2D. Compared with youth with T1D, youth-onset T2D is associated with a 4-fold increased risk of renal failure.…”

Profile of plasma free amino acids, carnitine and acylcarnitines, and JAK2v617f mutation as potential metabolic markers in children with type 1 diabetic nephropathy

“…The most common methods for determining renal involvement are albuminuria and changes in GFR, which are late indicators. Early kidney involvement biochemical diagnostic indicators are required (Muntean et al, 2022).…”

“…albuminuria and changes in GFR, which are late indicators. Early kidney involvement biochemical diagnostic indicators are required (Muntean et al, 2022). Downstream metabolic dysfunction results from the metabolic disorder diabetes mellitus, which is characterized by a persistent increase in glucose.…”

Curcumins from <em>Curcuma longa </em>Potential Inhibit PTP1B and α-Glucosidase: Experimental and Computational Study

“…This number may be increased to 643 and 783 million by 2030 and 2045, respectively. Diabetes causes 6.7 million deaths with approximately 541 million adults at risk of type 2 diabetes [1][2][3]. Up to date, the common therapeutic approaches focus on simultaneously inhibit insulin-and glucose-based enzyme.…”