Occurrence of microalbuminuria among children and adolescents with insulin-dependent diabetes mellitus

Abstract

Microalbuminuria precedes the onset of diabetic nephropathy in insulin-dependent diabetes mellitus (IDDM) pediatric patients. Its prevention is among the most important challenges in managing IDDM. We attempted to determine the occurrence of microalbuminuria among IDDM Saudi children and adolescents and its associated risk factors. This is a retrospective cross-sectional study conducted on 409 IDDM children and adolescents attending the pediatric clinic at King Abdul-Aziz University Hospital from 2006 to 2010. Their ages ranged from 1 to 18 years and the mean ± standard deviation (mean ± SD) was 12.3 ± 4.1 years. Twenty-four-hour urinary albumin excretion (on two separate occasions or more, 3 - 6 months apart each), HbA1c, duration of IDDM, Tanner staging and body mass index (BMI) were reviewed. Prevalence of microalbuminuria in our cohort was 11.3%. IDDM duration was ≥2 years in 55.8% of our patients; of them, 15.6% had microalbuminuria while 45.2% had IDDM duration <2 years (6% had microalbuminuria) (P <0.01). The prevalence of microalbuminuria was higher among the post-pubertal subjects (50%) than that among the pre-pubertal (8.7%) and pubertal (41.5%) subjects. Furthermore, microalbuminuria was present in 16.7% of those with elevated blood pressure, but only in 8.5% among those with normal blood pressure (P <0.05). The enrolled overweight and obese subjects showed a higher prevalence of microalbuminuria (14%) when compared with that among those with a normal BMI (6.6%) (P <0.05). In our cohort, duration of IDDM, pubertal status, hypertension and BMI affected the prevalence of microalbuminuria. Annual screening for microalbuminuria in IDDM children and adolescents is imperative.

Zinc alpha 2 glycoprotein as an early biomarker of diabetic nephropathy in patients with type 2 diabetes mellitus

“…A significant difference was found regarding the duration of T2DM which is in agreement with other studies that found a significant difference between normo-and microalbuminuric groups regarding duration of diabetes mellitus. [15][16][17] The results for FBG, RBG, HbA1C, serum creatinine, eGFR, urinary albumin/creatinine ratio, serum albumin and total plasma proteins were in agreement with another study, which documented a significant difference between both diabetic groups regarding the previous parameters. 18 Another study reported that progression of diabetic nephropathy was accompanied by declining GFR and increasing urinary albumin excretion.…”

The l-arginine/NO pathway, homoarginine, and nitrite-dependent renal carbonic anhydrase activity in young people with type 1 diabetes mellitus

“…The second T1DM group consisted of children with newly diagnosed diabetes (T1DM-ND). Only two diabetic patients of the T1DM-T group had microalbuminuria which serves as an early marker of diabetic nephropathy (Al-Agha et al 2013). The concentration of the circulating and urinary biochemical parameters of the Arg/NO pathway measured in our children with T1DM and healthy non-diabetic controls and the results of the statistical analyses are summarized in Table 2 (T1DM-T vs HC), Table 3 (T1DM-ND vs HC) and Table 4 (T1DM-T vs T1DM-ND).…”

In vivo evaluation of renal function using diffusion weighted imaging and diffusion tensor imaging in type 2 diabetics with normoalbuminuria versus microalbuminuria

“…Therefore, early detection and intervention for renal lesions of DN is necessary before the lesions advance to irreversible levels. Microalbuminuria (MAU) level, the current diagnostic gold standard for DN [1], also represents an index of diabetic renal damage severity [2][3][4]. Persistently high MAU may suggest the advent of stage III of DN, which is the result of progressive glomerulosclerosis due to long-term hyperfiltration.…”